Is it unusual for my Rheumy to go from seeing me once every 3 months to once ever 2 weeks?

Hi everyone, this is my first post.

I was wondering how concerned I should be with my Rheumy now wanting to see me every two weeks. I was seeing her every 3 months. On my last visit (thursday June 14th) I had an x-ray of my back. I had asked for it because on the middle of my back has started hurting, before this, I just had pain in my neck shoulders and lower back, not the middle of my back. I was Dx with PsA Spondylitis in Nov. 2011 and have had a total of 8 injections of Enbrel.

I'm still pretty new to all this, so I don't know what to make of it.

Joel

well it is a bit unusal to see her every 2 weeks but she probably wants to go over the rays wirh you. I see my rheum every 6 months and have 4month appts 3 month apptsIt just depends on how I feel . I see my GP alot. It helps me cope. Sounds like she is thourough.

Middle back pain if there is no injury is caused by either the upper or lower back (usually) this is most commonly c 6-7 and L4-5. But with spondylitis this could also be the start of some ankylosis of the si. That is the most unlikley, and not necessarily a bad thing. The latest from the surgeons is to put screws in each side to do the same. So the worst is you save
thirty grand. All most everbody gets pain relief from ankylosis, you just want to work on your posture constantly. You want to have a better view of the world than your shoes. If the xrays were negative ( and they all most always are I don't even bother any more) I would guess your doc felt around did some range of motion stuff and such looking for inflamation and didn't find anything significant, thus the two week appointment.

This is most likley GREAT NEWS. Either the Enbrel is starting to work ( for some reason this stuff happens all on one side or the other, if it hits both sides it usually hits the same spot on both sides) on one side is losing the inflamation causing mechanical pain to mid back. With PsA another common pain is caused by intercostal inflammation. In the front, you think its a heart attack, in the back its mid back pain. This is almost always eliminated long ter with some injections.

In two weeks she will know. I'm betting on the enbrel........ Thanks for joining!!!!! (sorry you had too)

Hey, Major!

When you go, why not just ask her? Should lead to an interesting conversation. It sounds to me as if you have a very thorough and caring rheumatologist. Lucky you!

Seenie

Major, you know I'm not ignoring you, just that we already talked about this in the Chat room! Keep your appointments, and listen to everything your Rheum says, and remember no booze with MX! I'm pullling for you, BUD!

Hi Lamb,

Sorry to jump in but could you please give a bit more info on the chest pains? I've been getting them lately, quick sharp twinges that last a short time, in the front and back. Had an EKG done: normal. Is that the pattern of PsA chest/back pain? I'm just curious and trying to figure out why it's happening all of a sudden.



tntlamb said:

Middle back pain if there is no injury is caused by either the upper or lower back (usually) this is most commonly c 6-7 and L4-5. But with spondylitis this could also be the start of some ankylosis of the si. That is the most unlikley, and not necessarily a bad thing. The latest from the surgeons is to put screws in each side to do the same. So the worst is you save
thirty grand. All most everbody gets pain relief from ankylosis, you just want to work on your posture constantly. You want to have a better view of the world than your shoes. If the xrays were negative ( and they all most always are I don't even bother any more) I would guess your doc felt around did some range of motion stuff and such looking for inflamation and didn't find anything significant, thus the two week appointment.

This is most likley GREAT NEWS. Either the Enbrel is starting to work ( for some reason this stuff happens all on one side or the other, if it hits both sides it usually hits the same spot on both sides) on one side is losing the inflamation causing mechanical pain to mid back. With PsA another common pain is caused by intercostal inflammation. In the front, you think its a heart attack, in the back its mid back pain. This is almost always eliminated long ter with some injections.

In two weeks she will know. I'm betting on the enbrel........ Thanks for joining!!!!! (sorry you had too)

Sorry, having a bad night and will explain better later (had a great day and over did _ cooked for over 50 one of my favorites to do) heres alink which I know every one hates for an answer:

http://www.gotpaindocs.com/intercstl_neurlga.htm

Its not the best but the pictures are great! Also Pet its been known to be a meloxicam SE. Didn't you recently have a go with that?

How are you feeling Major?

Hi SK,

thank you for asking:)

Yesterday (Wed) I took my 4th Enbrel injection. I still have foot, neck lower back pain. Oh and my left thigh hurts and hips hurt. Guess it hasn't started to work yet. Oh by the way, in the Yoga lesson, she was very addiment with me to not do body movements if they caused pain. She told me to listen to my body. She even stopped me a few times when I broke the rule.

Major, she sounds very wise!

The chest pains are getting me too! I had to pull over on Friday because it was so sharp and severe, I could no longer steer. It took about 3 minutes to go away and I had to breathe very shallowly as it hurt like the dickens to take deep breaths. I had these last year, prior to the flare and dx and got a stress test and chest xrays which all came back normal. They strike with no warning and are pretty disconcerting. Last year they occured on the left side, front part of the ribcage and shoulder. Other times the center of the chest is where it occured. Last Fr. it was on the right side, both front and back ribcage. Ouch!



Petunia Girl said:

Hi Lamb,

Sorry to jump in but could you please give a bit more info on the chest pains? I've been getting them lately, quick sharp twinges that last a short time, in the front and back. Had an EKG done: normal. Is that the pattern of PsA chest/back pain? I'm just curious and trying to figure out why it's happening all of a sudden.



tntlamb said:

Middle back pain if there is no injury is caused by either the upper or lower back (usually) this is most commonly c 6-7 and L4-5. But with spondylitis this could also be the start of some ankylosis of the si. That is the most unlikley, and not necessarily a bad thing. The latest from the surgeons is to put screws in each side to do the same. So the worst is you save
thirty grand. All most everbody gets pain relief from ankylosis, you just want to work on your posture constantly. You want to have a better view of the world than your shoes. If the xrays were negative ( and they all most always are I don't even bother any more) I would guess your doc felt around did some range of motion stuff and such looking for inflamation and didn't find anything significant, thus the two week appointment.

This is most likley GREAT NEWS. Either the Enbrel is starting to work ( for some reason this stuff happens all on one side or the other, if it hits both sides it usually hits the same spot on both sides) on one side is losing the inflamation causing mechanical pain to mid back. With PsA another common pain is caused by intercostal inflammation. In the front, you think its a heart attack, in the back its mid back pain. This is almost always eliminated long ter with some injections.

In two weeks she will know. I'm betting on the enbrel........ Thanks for joining!!!!! (sorry you had too)

Costal chondritis, a painful condition in which there is inflammation of the cartilage in the ribs, frequently near the site where they join the sternum injection of a local anesthetic and a steroid, can often help.


Does this sound like you?

http://www.medhelp.org/posts/Arthritis/intercostal-chronditits/show/706455

Note the other things it could have been... Not something to mess around with. My first go round with the Heart guys and similar feeling pain did indeed turn out be Heart Failure. Fortunatly we have one of the countries top heart failure programs here (I constantly laugh at on of the Bill boards promoting the hospital its at, we are having a hospital war in town, that "Says leads the Nation with lowest readmission Rate for heart failure"

In any event heart failure IS an inflammatory disease and can BE PsA the Docs saw some psoriasis and sent me to a dermo Who I had an appointment with anyway) for some "spots" who sent me to the Rheumy. having had an ablation for WPW several years before, we could have gone a lot of wrong directions. Went back to the cardiologist a few months later with "Chest Pain" fortunatly for me i called him before going to the ER or I would have been in the cath lab just because of my "risk Factors" he saw me assured me AGAIN it was not really my heart shot me up and sent me out the door pain free.

Thanks lamb! Figures...there's even a name for it. Good irony in the hospital billboard - gotta love it!

I get inflammation in the tendons of the ribcage and this gives me pain in the back and chest. My current treatment is working and these pains have gone away.

Petunia Girl said:

Hi Lamb,

Sorry to jump in but could you please give a bit more info on the chest pains? I've been getting them lately, quick sharp twinges that last a short time, in the front and back. Had an EKG done: normal. Is that the pattern of PsA chest/back pain? I'm just curious and trying to figure out why it's happening all of a sudden.



tntlamb said:

Middle back pain if there is no injury is caused by either the upper or lower back (usually) this is most commonly c 6-7 and L4-5. But with spondylitis this could also be the start of some ankylosis of the si. That is the most unlikley, and not necessarily a bad thing. The latest from the surgeons is to put screws in each side to do the same. So the worst is you save
thirty grand. All most everbody gets pain relief from ankylosis, you just want to work on your posture constantly. You want to have a better view of the world than your shoes. If the xrays were negative ( and they all most always are I don't even bother any more) I would guess your doc felt around did some range of motion stuff and such looking for inflamation and didn't find anything significant, thus the two week appointment.

This is most likley GREAT NEWS. Either the Enbrel is starting to work ( for some reason this stuff happens all on one side or the other, if it hits both sides it usually hits the same spot on both sides) on one side is losing the inflamation causing mechanical pain to mid back. With PsA another common pain is caused by intercostal inflammation. In the front, you think its a heart attack, in the back its mid back pain. This is almost always eliminated long ter with some injections.

In two weeks she will know. I'm betting on the enbrel........ Thanks for joining!!!!! (sorry you had too)

Thank you for the link,lamb. Not sure if this is what's going on cause my pain is only occasional. Sharp twinges. I'm starting to think it's fibro cause if I press a pressure point there, I can get a similar pain. Oh well, not the heart.

So, lamb, you did have heart failure? Or no? I'm not too sure from your post. Sounds like you didn't have to have surgery, thank God!

Sorry to hear of your recent flare. I'm guessing you over did it a *bit* by cooking for 50 guests! Are you feeling better now?

DMara, have you had your heart tested, just to rule out a heart problem? Cause that sounds scary as all get!!



tntlamb said:

Sorry, having a bad night and will explain better later (had a great day and over did _ cooked for over 50 one of my favorites to do) heres alink which I know every one hates for an answer:

http://www.gotpaindocs.com/intercstl_neurlga.htm

Its not the best but the pictures are great! Also Pet its been known to be a meloxicam SE. Didn't you recently have a go with that?

Hi, Allan! Thank you for your suggestion.

Yep, I think that's what it is - good old inflammation in the tendons of the ribcage. Why not? My other tendons are inflamed.

What kind of treatment are you currently on, if you don't mind my asking?

I'm back on enbrel with a low dose of prednisone. Also celebrex daily and osteo panadol.

My ribs are a constant problem, always drawing up in spasm, a big part of the 'undiagnosed attack' we discussed in length. It was also recently brought to my attention by a fellow secondary Sjogren's sufferer that right now the PsA and the Sj are battling for an upper hand, according to her Rheum in the UK. Who can know how the Raynaud's plays in besides cold exposure. So anyway, besides every other part of the body, sjogren's goes for the rib cage, add the fibro and all the ingredients of the overlap syndrome and who knows what is from what anymore. Lets not forget the disc and facet disease, myofacial pain syndrome... All I know that out of nowhere I feel like I have been hit by a truck, and that truck even backed up and ran over me again, to make sure it hadn't missed a spot! Just could be the A/C exposure! UGH!

Petunia Girl, DMara here, yes, I did the whole stress test and chest xrays last year. Everything was perfect so I'd chalked it up to anxiety due to our impending out-of-state move at the time. We're all settled in now, and post PsA dx, I'm learning how many body systems can indeed be affected. Thanks for the concerns.

Dmara



Petunia Girl said:

Thank you for the link,lamb. Not sure if this is what's going on cause my pain is only occasional. Sharp twinges. I'm starting to think it's fibro cause if I press a pressure point there, I can get a similar pain. Oh well, not the heart.

So, lamb, you did have heart failure? Or no? I'm not too sure from your post. Sounds like you didn't have to have surgery, thank God!

Sorry to hear of your recent flare. I'm guessing you over did it a *bit* by cooking for 50 guests! Are you feeling better now?

DMara, have you had your heart tested, just to rule out a heart problem? Cause that sounds scary as all get!!



tntlamb said:

Sorry, having a bad night and will explain better later (had a great day and over did _ cooked for over 50 one of my favorites to do) heres alink which I know every one hates for an answer:

http://www.gotpaindocs.com/intercstl_neurlga.htm

Its not the best but the pictures are great! Also Pet its been known to be a meloxicam SE. Didn't you recently have a go with that?