Hi Sybil,
Thanks so much for replying -- in answer to your last question, both. Fibro has been mentioned by my general practitioner but rheumy did not. My main question is this --if all my bloodwork is "fine" (no elevated RH factor, ANAs, no inflammatory markers), then how do I know I have a form of inflammatory arthritis? Rheumy did not discuss this w/ me. Since my scalp is not psoriasis, does that rule out PsA for me? And, if I don't have an inflammatory arthritis, should I be taking such a strong drug?
I do have severe fatigue for sure - I teach and I literally slept through my spring break in April, sleeping up to 18 or 20 hours a day! Fatigue has improved some but now I'm on summer break, so there's that. I have joint pain in feet, knees, hip, lower back (sometimes). ALWAYS in the morning and on bad days all day long. The pain is not off the charts by any means, I'm not debilitated or in need of a cane, etc. But, yes, daily stiffness and pain, somedays worse than others. I hobble in the mornings and I hobble around a bit after getting up from being sedentary. I have lost lots of flexibility and have to sit to put on shoes, etc.
I was given prednisone at appt 1 (2 weeks worth - lowish dose) and had NO pain. It was amazing. I believe that means there's inflammation, correct?
But, yes, he was quite vague, has only been in practice a couple of years (was not the doc I was supposed to see), and at appt 1 didn't explain much or ask too many questions. Appointment 2 he said blood work looks good (meaning negative RH, negative CR - whatever for inflammation). He said X-rays looked fine (feet and hands - I told him I also had low back pain and my worst pain in pelvic joints, but those weren't x'rayed.
After he said that he just looked at me, as if we were done. I asked what about the swollen joints on my big toes. He said thats a very common osteoarthritis joint. I felt like he was getting ready to dismiss me.
At that point, I launched into some symptoms and things that he had not asked about during visit 1. I reminded him of my grandmother with RA, my sister with lupus and psoriasis, dad with psoriasis and Reactive arthritis. Told him I'd been tested for the HL 27 (?) gene years ago (when I suffered a bout with very similar symptoms). I told him I had read about PsA and that tendonitis had been a huge issue for me (plantar fasciitis in '07, I think - I brought podiatrist notes- and a bad case of tennis elbow that only resolved with PT). I told him I never thought I had psoriasis; however, I had an extremely itchy/sore scalp and had had sores on scalp for years. I also asked about nodules (very small) on first joint of my fingers. I reminded him of my crushing fatigue.
Finally, he did seem to be listening. He looked at my scalp and said it did look like psoriasis to him. Really? I was skeptical, mainly b/c I felt I was practically self diagnosing here. He said yes it's dry and flaky but would you feel better seeing a derm to confirm? He looked at my fingers (small nodules at first joint on index finger) again and said that joint is also often involved in PsA.
At that point he looked at me and said, ready to try medication? And, he proceeded to prescribe the methotrexate. Told me about not drinking and liver and said it takes a couple months to work.
I left feeling like I had a "working diagnosis" of PsA - when the derm ruled out scalp psoriasis, I felt like I was at square one.
At the point, I began to wonder if I should be taking the drugs.
I'm sorry, I know I'm rambling terribly. I just feel frustrated all over again. I have a sick kitty and am extra tired. The struggle is real. I certainly appreciate the feedback here b/c I feel it's more than I've gotten for my 2 rheumy appt and from my GP.
Thank you!