All posts tagged: Diagnosis

Elderly Onset Rheumatoid Arthritis

Blog: EORA, Elderly Onset Rheumatoid Arthritis As we get older, our youthful bodies start to lose some of the agility and endurance we have always expected of ourselves. We slow down. Late nights aren’t as fun as they used to be. Food choices change. Spicy food may suddenly seem too spicy. Climbing stairs isn’t quite as easy as it once was. Aging is a gradual process and we adjust to it as we go. Some of us feel lucky to be alive. We have friends and family who have died from cancer or heart disease. We may have the experience of surviving war, illness or accidents. And we have finally learned that we are not immortal. We see the calendar pages fly by and are starting to wonder about the condition of our maturing bodies. We look more closely at our medical insurance plan and we start making appointments with our primary care providers. We are prescribed the classic medications, a statin and maybe  a blood pressure pill. We promise ourselves to walk more and …

Rheumatoid arthritis classification criteria 2010

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 …

RA Labs

 Labs Labs are tools to help diagnose RA, distinguish it from other forms of arthritis, determine its severity and monitor key body functions for the liver and kidneys during treatment. Rheumatoid Factor (RF) Rheumatoid Factor is an autoantibody that is produced by the body’s immune system.  Autoantibodies, made by the B cells, attack a person’s own antibodies. The presence of Rheumatoid Factor  is an indicator of inflammatory and autoimmune activity. Elevated in about 80% of those diagnosed with RA. Some link the severity of RA with the degree of elevation. The RF may also be elevated in those with Lupus, endocarditis, cancer and a variety of other disorders. My RA is considered sero-negative as my RF factor was not elevated.

A few symptoms of RA

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 …

How the docs diagnose RA

The course of RA is unique to each of us.  My RA announced itself  to me as  big and boisterous.  Initially, I had sharp pain in my left shoulder.  I thought it was from swimming as shoulders do get a workout in lap swimming.  Quickly hands, fingers, wrists, ankles, feet and toes joined in.  I was in total pain and largely incapacitated.  I sought salvation to my problem in the ER, the only solution at the time. In 2010 the American College of Rheumatology(ACR) and the European League Against Rheumatism(EULAR) formed a working group to replace the 1987 ACR classification criteria for RA with up to date classification criteria. RA is at its most destructive in the first 2 years.  It needs to be caught early and treated aggressively.  The 2010 Rheumatoid Arthritis Classification Criteria became a big diagnostic help. The group came up with a 10 point system that covers four RA categories:  joint involvement, serology, acute-phase reactants, duration of symptoms.  The target population for this scoring must be patients who have at least …

Yep, RA is progressive

During the treatments for my cancers, my RA was uneventful.  Yes, I did have monthly flares that lasted just about 12 days.  Yes, I was always in a simmering level of pain.  I grinned and bore  it like a good Irish Catholic girl.  Instead, I  focused on surgery, radiation and life changing drugs.  I even completed a cancer rehab program. One day as I was starting a zumba class, my ankles screamed in a pain that was the equivalent of trying to dance on joints full of shattered glass. Determined,  I tried moving my feet differently (how many ways can you move your feet, you might ask).  After 10 seconds, I realized that it was futile.   I stopped.   Since then,  it has been downhill.  It was a steep hill, I might add. Although I am on Methotrexate (a life saver for me), Plaquenil, (Sulfasalazine did not work for me), meloxican, prednisone and  all the supporting drugs, I am still progressing.  All the little joints in my feet and my ankles are inflamed and …

Thyroid CA next step

Monday I visited my surgeon. She had my pathology report. I like to see her. She has so much positive energy. She is knowledgeable. She is very helpful. My cancer was not encapsulated and was within a mm of the border. not sure about this.My cancer was also in my lymph glands. So I will have a radioactive treatment. Next stop today was my endocrinologist. The radioactive treatment is complicated. Prep work is detailed and takes time. I will have to become extremely hypo active. I will be on a low iodine diet.  There is an injection called Thyroglobulin that costs $2500 that would cut the prep work to a much smaller time. My insurance will pay $1600 of it. I certainly am not able to pay the rest. In addition there will be the cost of the full body scan,  $300 under my plan. The drug company has an application for assistance. I filled it out and gave it to my Doc and she will give it to the person who will be getting authorizations. …

RA diagnosis reflection

Overwhelmed with pain I began my rheumatoid arthritis odyssey. I had no clue what was wrong. I was in such pain that I just wanted it to go away. I ended up in the ER and was sent to a rheumatologist. Poly-arthritis was certain. After many tests and a trial of 30mg of prednisone, I was diagnosed  with rheumatoid arthritis. My sedimentation rate and my c-reactive protein were off the charts. My left hand was swollen to almost double in size. It seemed to have started in my left shoulder. It quickly progressed to both hands, wrists, shoulders, ankles, feet, left elbow. Also my clavicle joints were affected./ I responded to prednisone. I do love prednisone as it does make me feel much better. That was part of the diagnosis. I did not have lupus, Hashimoto’s. RA is an auto immune disease. It is in the same family with lupus, multiple sclerosis, diabetes and many others. I have been tested for many and it came up RA. It’s possible to  have more than one auto …

Rheumatoid arthritis feet

My very first signs of Rheumatoid Arthritis were swollen, painful feet. On hindsight, it made sense to me. Johns Hopkins Arthritis Center says frequently RA starts in the small joints. The hands, the feet, the wrists are likely candidates as starting points. The foot has 26 bones. Many of those bones are small bones with small joints.  Imagine all those little guys in your feet each with joint lining inflamed and swollen. Ouch!