Denial? Second Opinion?

General
21

thanks!

Stoney said:

Maemae- I think this question was for me. My labs were absolutely normal, and the rheumy did no imaging at all. She did a thorough exam. I had multiple fingers that were swollen, plus psoriasis on my knees. I was started on just NSAIDs, and when I progressed to more joints and severe fatigue, I had a DMARD added in. A good doctor doesn't depend on just labs. PsA is often seronegative.

Maemae said:

But what did you XRays and labs show at diagnosis?

22

I have had this disease since high school ish. My X rays and MRIs have been normal until recently. When I was in my teens, I was called a quack. Guess, they can’t call me that anymore.

23


SO sorry for the road you've had. =-(
mataribot said:

I have had this disease since high school ish. My X rays and MRIs have been normal until recently. When I was in my teens, I was called a quack. Guess, they can't call me that anymore.
24

I think a second opinion is great. I got a second opinion on chiropractic care and he told I'd been adjusted for no reason for year, no wonder I wasn't better. If nothing else, maybe your second opinion will be what you need to help you in the "grieving process" as one person put it on here.

25

Thanks tntlamb (and Surferette). It's only through reading this informative forum that I have learned a lot, and will be getting another opinion on all things PsA related.

tntlamb said:

Respectfully your first Rheumy sounds like an Idiot. The swelling occurs at the entheses. Permanent damage can happen in DAYS. A sausage toe is VERY SERIOUS. Take pictures to document for you next Rheumy.
Jazzy said:

I can relate to your post Maemae. I want concrete evidence or a single blood test that would say a definite YES I definitely have PSA before commencing any medication. (Interestingly I work in the medical field also, but doing cardiac ultrasound). As there are no definitive blood tests, what I am going to do is get another opinion from a different Rheumy. The first one diagnosed me on history and bloods alone, without any physical exam or xrays. My concern is permanent damage - this I want to avoid at all costs, so it's worth it to get another opinion. The first Rheumy said there would be no permanent damage, and didn't start DMARDS, as he said it's not the joints being damaged but tendons/ligaments that are inflammed. Bit worried about my bulging and sore big toe joint at the moment though :/

26

My inflammatory labs were normal and my first X-rays were to obtain a baseline. After having ONE flare, I had some joint degeneration in a PIP and DIP on one finger. My inflammatory markers are always normal even though every tendon and joint could be red, swollen, hard and tender. I do have an elevated rheumatoid factor and I’m HLA b27 positive.

My diagnosis is based solely on physical exam and phm. What I wouldn’t give for an elevated sed rate when I flare. Maybe then my doc would stop trying to add fibro to my list of diagnoses.



Maemae said:

But what did you XRays and labs show at diagnosis?