So, I am currently taking mtx, prednisone, and diclofenac but they have stopped being effective. My feet are suffering the most, and as a Chef, this is taking away from my ability to work. I have an appointment with my Rheumy tomorrow. I want to ask for an MRI on my feet to see what exactly is going on with them. Had anyone else been successful with this request of their Rheumy?
Thank you for any responses!
Yes, my rheumatologist ordered an MRI for my foot and it was helpful in figuring out what was causing my foot pain. It was, of course, the inflammation. I think you should ask for one.
My feet are still painful, and I’ve managed to get my best relief from wearing really good hiking boots. The ones I got are so comfortable and supportive that I don’t need my orthotics in them. For me, the key seems to be to almost immobilize my feet by strapping them into the rigid but padded “shell” of the boot. I’m past fashion considerations!
I’m so sorry you are in an occupation which requires you to be on your feet so much. That’s really hard.
My PsA started with awful pain in my feet - misdiagnosed for 18 months. I could barely walk at time and was bedridden for 2 weeks. The pain was so bad that I didn't want to leave my desk at work to walk to the bathroom. I had an MRI and it showed inflammation in the tendons and no joint damage. My feet hardly swelled - not noticeable but the pain was awful. I dunked my feet in a big bucket of ice water for quite a long time. On meds now and they are much better. I still used ice water when they hurt a lot.
MrI's are but a tool to diagnose the symptoms of PsA and to help with localised treatment. The problem is you are not being treated properly or aggressively enough. Get the book Psoriatic Arthritis(Facts) by Dafna D Goldman (amazon) and educate yourself, get angry, become assertive with your treaters before you lose everything. Anything else is short term relief.
Chef, just thought of something else. Like Frances, it was the pain in my feet which finally led to a PsA diagnosis. And like hers, my feet didn’t swell that much, despite the fact that they were very sore. The MRI revealed inflammation, and it also showed swelling INSIDE the bones. Only an MRI can detect that. I’d be making a strong case to your rheumie for an MRI, as well as for the most aggressive treatment they can give you. Your livelihood depends on it. You can’t afford to have permanent damage in your hands and feet.
Good luck with the appointment. Let us know how it went!
Getting and MRI is one thing getting someone to read it with experience in what they need to be looking for is another. The most success for MRI's seem to be when they are done with and with out contrast and STIR sequence otherwise the turn out to be nothing more than a very expensive X-ray with a false normal. Even if you do have inflammation with your feet, it can be so miniscule (while causing major pain), it may not be seen. Then you have a whole new problem.
You apparently have been Diagnosed, so a what NEXT discussion may be more in order. More "information" may or may not change your treatment plan. I don't mean to sound discouraging but if your Doc is not willing to move forward with more aggressive treatment (and some referals as a chef you need some adaptive footwear etc) more information may not be likely to change his mind.
Also depending on your Rheumy an in office ultrasound may be in order. http://www.clinexprheumatol.org/abstract.asp?a=6296
My doc has been using for about a year now with some pretty good success..............
First, thank you all for your supportive words and helpful insight! I would be lost without you all!
Update|
Ok so I just got back from the Rheumy. He wants to put me into a clinical study called Spirit P 1. I plan on researching in depth tonight. For now, the meds stay the same, with the edition of Tramadol, which I’m not really happy with, as I don’t like to take narcotic pain meds.
Has anyone participated in a clinical trial?
Ixekizumab is one of the new generation drugs its pretty well proven as this is a Phase 3 study. Its a pretty cool study IF you don't get the placebo....... They are comparing two different regimens to Humira an nothing. You must have a with it doc. They have only been enrolling for a short period. I would guess only around 40 will be on the placebo....
Phase 3 studies are pretty cool if you are going to be in one. PsA is a really good one as they drugs have already been proven for RA or chrons or something and they are just trying to expand their market. You will get great care and lost of tests and remember when i said getting things read by someone who knows what they are looking for? Get copies. Your studies will be looked at through a very narrow focus.
I take tramadol and don't notice any pain relief. It does however, help with my extreme fatigue - it keeps me awake and that's what I use it for. My sister was also prescribed tramadol for Lupus and she doesn't get any pain relief from it either.
ChefWithPSA said:
First, thank you all for your supportive words and helpful insight! I would be lost without you all!
Update|
Ok so I just got back from the Rheumy. He wants to put me into a clinical study called Spirit P 1. I plan on researching in depth tonight. For now, the meds stay the same, with the edition of Tramadol, which I'm not really happy with, as I don't like to take narcotic pain meds.
Has anyone participated in a clinical trial?
Tramadol worked well for me as long as I took it consistently. Popping one only when the pain got too much for me did nothing. But that’s so for most pain control I think.
So, chef, what’s cooking with respect to the MRI?
The MRI’s will be performed as a part of the clinical trial" along with both hands, which also are swollen and painful. Can’t start until June 11, so just need to get through the next 3 weeks… Fingers painfully crossed…
That is great news about the MRI. If you are in a clinical trial, it will be read by someone who knows how to do it properly.
You will get through the next three weeks. Think positively.
Tramadol is non-narcotic if that helps any Chef. I get good pain relief from Naproxene 500 mg 2Xday and Tylenol 1000 mg 3Xday. Also non-narcotic. But as Seenie says consistancy is key.
I don't want to get into a Tramadol debate, It is considered an
opiaiid as opposed to an opiate. iIts a synthetic. supposedly it won't give you a high, so you won't get hooked. Thats true you won't get addicted, but you most certainly will get dependent. Its easier to get off morphine. There have been serious attempts to get it off the market, Stadol is gone and so should this one.
I'm not saying there isn't a need for these things short term, there is. But the synthetics have proven to have as many if not more problems tha any pain med
I did not know this. Thanks for the update Lamb.
This new drug, Ixekizumab, is very interesting. I'll be tracking it's progress. Thanks Lamb !
tntlamb said:
Ixekizumab is one of the new generation drugs its pretty well proven as this is a Phase 3 study. Its a pretty cool study IF you don't get the placebo....... They are comparing two different regimens to Humira an nothing. You must have a with it doc. They have only been enrolling for a short period. I would guess only around 40 will be on the placebo....
Phase 3 studies are pretty cool if you are going to be in one. PsA is a really good one as they drugs have already been proven for RA or chrons or something and they are just trying to expand their market. You will get great care and lost of tests and remember when i said getting things read by someone who knows what they are looking for? Get copies. Your studies will be looked at through a very narrow focus.
Ixekizumab and the two other IL17 blockers are pretty awesome on psoriasis. I'm not sure how they do on PsA..
I am not really happy with the Tramadol situation. I am the Chef at a private school and need to get through the end of the school year (3 weeks). Then I can enter the study. Eight weeks of summer will be spent getting my health back! Aqua therapy, weight loss, etc. I know I can fight this thing.
GOOD for you, we'll be with you.
I'm planning little get PsA together. We have a sommlier (seenie) now we a have chef. and bootlegger (me) Al we need is a very rich person with a large airplane to get everybody to the same spot.
Glad you have 8 weeks to get back on track! Good luck and keep us posted.
ChefWithPSA said:
I am not really happy with the Tramadol situation. I am the Chef at a private school and need to get through the end of the school year (3 weeks). Then I can enter the study. Eight weeks of summer will be spent getting my health back! Aqua therapy, weight loss, etc. I know I can fight this thing.