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What Is The Treatment For Rheumatoid Arthritis And Fibromyalgia?

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Posted on Wed, 22 Jan 2014
Question: what are the chances my RA is something else? My sisters Rheumatologist diagnosed me with Lupus in 1992, my sister was diagnosed the year before. After a genetic study as USFMC we found I did not have Lupus and he changed it to Fibromyalgia in 1995. I quit going to see him as I was feeling better after 6 months of plaquenial and methotrexate. In 1999 I had a flare up, went to a new Rhuemy and loved her. She said I had RA in addition to the fibromyalgia and began aggressively treating me with methotrexate, prednezone and vicodin for pain. When I felt well I quit all meds and got by comfortably. I have had 3 major flare ups since, 2003, 2006 and finally 2010 when my doctor put me on Remicade. I go every 4 weeks for 7viles of remicade a B12 shot and this last time a steroid shot that has put 10 of the 30 pounds I have fought to lose back on. I am now suffering with debilitating leg and arm cramps, cramp like closing in my throat, extreme dry red eyes being treated with restasis. I am only 59 and feel like I am facing early onset alzheimers - I am forgetting things daily although my work routine does pretty well I have literally fallen asleep while writing an email. My ana titer is 1:320 and there was another high number along with a bad kidney number...I missed a treatment and stretched to 6 weeks and felt horrible. Am I going to get better? I have modified my diet, do light excersizes and ride my bike. HELP.
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Answered by Dr. Dr. Alokkalyani (1 hour later)
Brief Answer: Chance of SLE and RA is still there Detailed Answer: Hi this is Dr Alok Sorry for your suffering As there are many questions, I would like to take them one by one.. 1. As you said your were diagnosed as SLE in 1992, I would like to know, on what basis you were diagnosed? What was the clinical feature and what was the investigation? Genetic study is not required for SLE. It is diagnosed on the basis of clinical features and blood study only. As your ANA level is very high I would like to know-- do you have facial rashes, which increase on sun exposure? Do you have oral ulcer?, do you have hair fall? do you have history of fluid accumulation in lungs or around heart? What is your routine blood test (Hb, TLC, DLC and Kidney Test?) 2. regarding RA, flare are common, Methotrexate, remicade are very good medicines. Steroid is some time necessary in flare. Again RA is a diagnosis of clinical features and some basic investigations 3. Your dry eyes may be a complication of RA I advice to you discuss with your doctor to relook about the possibility of SLE Mean while continue medications and do a lot of exercises. How is your sleep? if you are not able to relax or sleep proper-- your pain and aches can be increased Hope this will help Please don’t hesitate to contact, if you have further queries..
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Dr. Alokkalyani (7 hours later)
The DX for lupus was based on my ANA & I had several symptoms my sister had except for the butterfly rash. As I said my sister & I registered in a program for genetic studies at San Francisco medical school that confirmed her lupus & said I did not have it. I am on sleeping med, Xanax, cymbalta & still don't sleep comfortably. The muscle cramping is the latest and I am very concerned & tired of it, My Rhumy (I really love) says it is part of the RA package.
doctor
Answered by Dr. Dr. Alokkalyani (1 hour later)
Brief Answer: exercise and other medications can help you Detailed Answer: hi, Ok, If SLE is rule out, than we have to concentrate on RA and fibromyalgia. I think you need to do exercise including brisk walking and take balanced diet. Also I advice you to discuss with your doctor to change your medicine for cramps and poor sleep as there are some other medicines available to control them.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Dr. Alokkalyani

Rheumatologist

Practicing since :1999

Answered : 519 Questions

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What Is The Treatment For Rheumatoid Arthritis And Fibromyalgia?

Brief Answer: Chance of SLE and RA is still there Detailed Answer: Hi this is Dr Alok Sorry for your suffering As there are many questions, I would like to take them one by one.. 1. As you said your were diagnosed as SLE in 1992, I would like to know, on what basis you were diagnosed? What was the clinical feature and what was the investigation? Genetic study is not required for SLE. It is diagnosed on the basis of clinical features and blood study only. As your ANA level is very high I would like to know-- do you have facial rashes, which increase on sun exposure? Do you have oral ulcer?, do you have hair fall? do you have history of fluid accumulation in lungs or around heart? What is your routine blood test (Hb, TLC, DLC and Kidney Test?) 2. regarding RA, flare are common, Methotrexate, remicade are very good medicines. Steroid is some time necessary in flare. Again RA is a diagnosis of clinical features and some basic investigations 3. Your dry eyes may be a complication of RA I advice to you discuss with your doctor to relook about the possibility of SLE Mean while continue medications and do a lot of exercises. How is your sleep? if you are not able to relax or sleep proper-- your pain and aches can be increased Hope this will help Please don’t hesitate to contact, if you have further queries..