My general practitioner is tired of hearing me whine about my back and I’m seeing a neurosurgeon in the morning. I had an MRI several months ago and I coulda sworn I sent the report to my rheumatologist but he says no. I sent it to him last week. He says looks like a bunch of degenarative changes. I had asked if he thought I should switch to a biologic instead of Arava. He said based on what he saw I probably don’t need Arava. Ok, that’s my back, what about the rest of me? I’m HLAb27 positive, rheumatoid negative. I have a sausage digit, enthesitis and nail changes consistent with psoriasis. I also have gut issues frequently and WAS confident in his diagnosis of psoriatic arthritis. I like fitting in a box!
I really don’t expect the neurosurgeon to say I need surgery. I have bone spurs pushing L4 forward over L5. At the time of the MRI it was grade 1, minimal but the pain has gotten worse so I’m assuming that’s worse. If you chip off bone spurs they tend to come back worse because your body thinks it’s an injury and it over repairs in folks like us. I’ve rambled on long enough. Writing about stuff lessens my anxiety. Maybe now I can sleep.
Fatfinger, it must be frustrating and disheartening for your doctor to revisit your diagnosis at this stage. Your symptoms have a cause and it would be helpful to have a diagnosis or diagnoses that explains them. Please let us know how you make out with the Neurologist. What are your next steps?
I’m not really sure what the rheumatologist is thinking. But this is what I believe he meant… Psoriatic arthritis is an inflammatory arthritis. My MRI did not show that. Changes more consistent with osteoarthritis. However, the way the neurosurgeon explained it to me was like this… Sacroiliac arthritis may or may not show up on scans. He suggested having steroid injections into those joints as opposed to lumbar injections. Lumbar injections have had little to no effect in my pain. I was having some sciatica and the last 1 did help that. Having SI joint injections would be diagnostic of inflammation there if the pain is better afterward.
I think everyone in the US is so scared of narcotic abuse that if you complain of pain and they give you something and you say it doesn’t help enough then they believe that you’re just after pain pills when in reality I just wanna know WTH is wrong with me. I mentioned before that I had MRI of both wrists years ago and there were erosions. I mentioned this to the newer rheumatologist and he sends me for wrist xrays which are much less sensitive and from what I’ve read you’d have to have 40% of the bone eroded to be able to see it on xray. It’s as if he’s not trying to find what’s wrong but trying to prove nothing is wrong.
More and more medical facilities are, I have read, adopting a “go slow” appproach, particularly with older patients. This is worrisome. I understand going slowly with therapies, given concerns with side effects, the need to assess the therapeutic effectiveness of treatments before adopting new ones, and the uncertainty which attends any diagnosis. But there is no justification for “going slow” in diagnosing the condition, unless they are just throwing Hippocrates out the window when it comes to Medicare patients to save money, which is morally offensive.
I don’t understand either why it is the patient’s responsibility to facilitate communication between the caregivers. That seems to me entirely the professionals’ responsibility.
I hate to say it, given the possible hassles, but I’d dump these losers pronto.