Year: 2014

Rheumatoid arthritis classification criteria 2010

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An international test evaluation for RA.  I scored 7 and I am RF negative.                                                        2010 Rheumatoid Arthritis Classification THE 2010 ACR-EULAR CLASSIFICATION CRITERIA FOR RHEUMATOID ARTHRITIS Score Target population (Who should be tested?): Patients who have at least 1 joint with definite clinical synovitis (swelling)* with the synovitis not better explained by another disease† Classification criteria for RA (score-based algorithm: add score of categories A – D; a score of ≥6/10 is needed for classification of a patient as having definite RA)‡ A. Joint involvement § 1 large joint¶ 0 2-10 large joints 1 1-3 small joints (with or without involvement of large joints)# 2 4-10 small joints (with or without involvement of large joints) 3 >10 joints (at least 1 small joint)** 5 B. Serology (at least 1 test result is needed for classification)†† Negative RF and negative ACPA 0 Low-positive RF or low-positive ACPA 2 High-positive …

How RA Feels

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RA starts in the feet as often as in the hands.                                                           Mine had started in my feet long before I was given a diagnosis.  My feet came to feel like dense bricks. The whole main part of my feet, all those little joints, were swollen and in pain. The three middle toes on each foot were swollen and would have sporadic shooting pains. I had a hard time walking. My hands have almost equal billing. Knuckles are enlarged and always have some degree of swelling. I use a simple rubber square jar opener to do the job of opening  jars and bottles.  I keep scissors around the house. They make it so much easier to open many things. Symmetry is a hallmark symptom of RA.  Left foot and right foot. Middle three toes each side. Any synovial joint in the body can be affected. My left jaw (mandible) joints …

RA Progress, Thanks to medical research

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It was 1965 and time to do his urine test to determine  his insulin dose. He was diabetic. He followed procedure carefully.  He went into the bathroom and closed the door. He picked up his urinal and proceeded to fill it. He left the bathroom and handed the urinal to the nurse.  She took it into the bathroom. She dipped her measuring tape into her patient’s urine. She waited as it changed color. She held it up to the chart. A 2+. She went back to the nurses’ station and drew up the units of regular insulin designated for a 2+ test result. She administered the insulin to her patient.  Diabetic management in the 60s.  Blood glucose meters had not been invented yet. During that same time, there was not a lot of relief for rheumatoid arthritis. Prednisone was new. Methotrexate for RA and all the biologics were a long way into the future. RA  progressed relentlessly until a person was totally crippled and in constant pain. Death would be the only relief. Rheumatoid arthritis is still not an …

How an RA Book Helped

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When I was diagnosed with RA, I was too sick to understand the long term implications. I was grateful at the time to put a label on the devastating attack on my body. I love books and have always looked to books for solutions as well as for pleasure. Soon after my diagnosis, I purchased the book, The First Year Rheumatoid Arthritis by M.E.A. McNeil. With RA there is a major shift in your life. What to do? How to cope? What to think? It is overwhelming. This book set me on the right course. It helped me organize. The most important thing it did for me was define my attitude toward RA. I developed my medical team. I understood I was the manager. I started journaling daily and also logging in my symptoms. I researched the drugs I was on and created files for them. I researched lab tests and understood what they meant and kept a log. I asked my doctors questions and received solid answers. I knew the first few years were critical. I knew …

Have you ever felt stranded?

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Have you ever felt stranded?  Sick …Painfully so…But did not know who to call. Maybe too sick to figure it out. This happens a lot to those of us with autoimmune disorders. I am seeing many doctors, each a specialist who oversees a section of my body.  For me, I have a rheumatologist, an oncologist, an endocrinologist, an ENT Doc, an internist and a podiatrist. However, there is no one who looks at the total me. This week I am in trouble. Things just are not working well enough. The protocols that are to be followed when I am in trouble are not working.  What do you do when your painful issue does not fall into the neat little slot of a specialty? When you are plainly worried that all is going to hell?  Who do you call? Unfortunately, not GHOSTBUSTERS. Here’s what I did. Then I will tell you about my remedy for my next crisis of indecision. It was decided through C-T scans and visits to my endocrinologist and an ENT Doc that …

RA tools-Massage

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In the proper spirit of being the manager for my RA, I thought about what tool I could use to help manage my RA. Top on my list was massage:  Helps the pain-tense muscles to relax. Stimulates the lymphatics. And best of all is a thoroughly relaxing experience. Today I had an hour massage at ABQ Medical Massage Therapy. It was an Oncology Massage. I have several cancers as well as RA and they do open a few doors. The massage was given by Sean, a senior student. I was directed to a quiet room. Asked if the room temperature was okay. Offered water. And directed to disrobe to my comfort level. I go to my panties. Lay down on the table which was warm and cozy. Covered up with a sheet and a light blanket. When Sean returned, he adjusted my head pillow and placed a pillow under my knees. Quiet music. Sean worked his magic as he worked my body into relaxation. Peaceful bliss. I felt pampered and happy. When I was diagnosed …

RA: how to cope with more bad news

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RA: how to cope with more bad news   For 80%, RA will be a progressive disease. That means for those who are being drug managed, the drugs will eventually not work anymore. That means for those lucky enough to have remissions, their disease will flare and incrementally get worse. That means for those with constantly active inflammation, like myself, the disease will continue to get worse.                     This week my bad news is that my disease is getting worse                                                                           and there are no more magic pills.                                                                                       …

Adapt and survive definitely not easy

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You might wake up well rested, feeling pretty good. Out of bed.  Start moving.  Your middle toe starts hurting.    A piercing pain shoots through the bottom of a foot.  Just keeps going until every joint in your body in inflamed and in pain. All had been well this last week. Lots done. Exercise class included. Pain level at a simmer. No need for the narcotics. Pleasant. Then blindsided!      Unpredictable!    Discouraging! Now,  it is just hard to exist. Fatigue has joined the rest.  Fatigue feels like an overwhelming exhaustion that makes thinking or doing hard to do. Just simply surviving is hard to do. Each of those joints supporting the 28 bones in each foot cry out for attention. Their chorus is joined by the joints supporting the 27 bones in each hand. Then there are the ankles, the wrists, the shoulders, elbows, and the joints  of the chest bones. To stop is to adapt. There is no choice, not really.  Time for a rest day, a veg out day, time out. …

A few symptoms of RA

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The only certain thing about Rheumatoid Arthritis is its unpredictable nature. It affects each of us differently and our response to treatment is also unique.  It is  a disease that is considered hard to diagnose. The one who can do it most efficiently is a rheumatologist. Characteristic of RA is small joint involvement.  That is why the joints of the fingers, hands, toes, feet, wrists are frequently affected. Also characteristic of RA is bilateral involvement. That is why the middle finger of the left hand and the middle finger of the right hand might be involved.  Bilateral. Both feet. Both hands. Both ankles. I had problems with my feet for a long time. My primary doctor thought I was too old to have RA. Treatment was delayed and now I have foot damage. I have a hard time walking. When my RA became extremely acute, the pain started in my left shoulder. Soon both hands as well as both feet were affected. And on it goes to most of the joints in my body. How …