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Suggest Treatment For Acute Joints Pain When Diagnosed With Rheumatoid Arthritis
Question: Hi Docotr,
My wife is suffering from the the Rheumatoid Arthritis. She was diagnosed in year 2007. But the problem was not acute and it was very on and off. She was not on medication but not very regular But last few months, there is acute pain in joints at times even after taking the pain killer like Dynapar. There is no deformity till now.She is on regular medication from last 3 months but remission of pain and inflammation is very frequent and pain is almost regular.
Please suggest.
Regards,
XXXX
My wife is suffering from the the Rheumatoid Arthritis. She was diagnosed in year 2007. But the problem was not acute and it was very on and off. She was not on medication but not very regular But last few months, there is acute pain in joints at times even after taking the pain killer like Dynapar. There is no deformity till now.She is on regular medication from last 3 months but remission of pain and inflammation is very frequent and pain is almost regular.
Please suggest.
Regards,
XXXX
Brief Answer:
Rheumatoid Arthritis
Detailed Answer:
Good morning XXXXXXX
Thank you for writing on health care magic
I have gone through your history and it seems like the disease is evolving. A lot of times patients start with intermittent arthritis, that is on and off which becomes persistent after a few years and starts causing pain and swelling. I would like to know a few more queries here:
1. That is good there is no deformity. Has her RHeumatoid FActor and Anti CCP been checked yet?
2. What was her recent ESR, CRP?
3. How does she feel in the mornings when she wakes up??
4. Is there any swelling also or just pains?
5. Any history of oral ulcers/excessive hair fall/dryness of eyes/dryness of mouth
6. Who is looking after your wife at present? Do let me know your location as well?The treatment doesnt seem from a rheumatologist as the doses you are taking are very sub optimal and there is a very less chance they would provide any relief.
Do let me know these queries and I would guide you further from here
REgards
Dr Naval
Rheumatoid Arthritis
Detailed Answer:
Good morning XXXXXXX
Thank you for writing on health care magic
I have gone through your history and it seems like the disease is evolving. A lot of times patients start with intermittent arthritis, that is on and off which becomes persistent after a few years and starts causing pain and swelling. I would like to know a few more queries here:
1. That is good there is no deformity. Has her RHeumatoid FActor and Anti CCP been checked yet?
2. What was her recent ESR, CRP?
3. How does she feel in the mornings when she wakes up??
4. Is there any swelling also or just pains?
5. Any history of oral ulcers/excessive hair fall/dryness of eyes/dryness of mouth
6. Who is looking after your wife at present? Do let me know your location as well?The treatment doesnt seem from a rheumatologist as the doses you are taking are very sub optimal and there is a very less chance they would provide any relief.
Do let me know these queries and I would guide you further from here
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Naval,
She is located in XXXXXXX whereas I am staying in XXXXXXX She will be in XXXXXXX for a very short period of time from 16th January 2016. May I know your location or contact details of rehumatologist in Faridabad/Ahmedabad.
1. His RH factor value 7.5 . In another report it has shown positive and Anti CCCP was 42.10 units/ L when checked in 2008.
2. Recent ESR & CRP done six month back. If remember correctly it was above the prescribed limits However. The report of ESR & CCP latest one will be updated tomorrow. doctor advised for Blood count, differential count and blood indices and smear study ( RBC &WBC) was normal but SGPT 28.7 U/l , Creantinine 1.1 mg/dl and Uric acid 5.2 mg/dl
3.She has more pain and sickness in morning particularly in morning when she wakes up. It get reduced during the day.
4. There is swelling as well.
5. hair fall is very moderate. no other problem. Despite of house hold work, she does not feel much hunger but still eats four times as she needs to take tablets.
6. Dr. Parth XXXXXXX MS Orhto in XXXXXXX
Pleasse suggest your fast reply will be highly appreciated.
regards, XXXXXXX
Doctor,
One thing i forgot to write about medication is that it for 2 months so far and there was break of three to four days two week before.
Please consider this fact as not mentioned earlier. May I request which medical dose is sub optimal.
Regards,
XXXX
She is located in XXXXXXX whereas I am staying in XXXXXXX She will be in XXXXXXX for a very short period of time from 16th January 2016. May I know your location or contact details of rehumatologist in Faridabad/Ahmedabad.
1. His RH factor value 7.5 . In another report it has shown positive and Anti CCCP was 42.10 units/ L when checked in 2008.
2. Recent ESR & CRP done six month back. If remember correctly it was above the prescribed limits However. The report of ESR & CCP latest one will be updated tomorrow. doctor advised for Blood count, differential count and blood indices and smear study ( RBC &WBC) was normal but SGPT 28.7 U/l , Creantinine 1.1 mg/dl and Uric acid 5.2 mg/dl
3.She has more pain and sickness in morning particularly in morning when she wakes up. It get reduced during the day.
4. There is swelling as well.
5. hair fall is very moderate. no other problem. Despite of house hold work, she does not feel much hunger but still eats four times as she needs to take tablets.
6. Dr. Parth XXXXXXX MS Orhto in XXXXXXX
Pleasse suggest your fast reply will be highly appreciated.
regards, XXXXXXX
Doctor,
One thing i forgot to write about medication is that it for 2 months so far and there was break of three to four days two week before.
Please consider this fact as not mentioned earlier. May I request which medical dose is sub optimal.
Regards,
XXXX
Brief Answer:
Rheumatoid Arthritis Management
Detailed Answer:
Good afternoon XXXXXXX
Thank you for your response.
It looks like the disease is uncontrolled considering the symptoms you have mentioned. She will need a step up of the treatment which one can do after seeing the blood reports. Since her Liver function tests are ok, the optimal dose is usually 15 mg of folitrax once/week and lefra 20 mg. ( depending on her tolerance). but since they are strong medications I would recommend you visit a rheumatologist and let them adjust the medications for you.
In XXXXXXX she can visit Dr XXXXXXX Pandya. He is a famous rheumatologist there but the appointment is usually 3 months waiting. She can visit us in Medanta the next week she is coming and we can adjust her medicines till she has further follow up in XXXXXXX
Hope the information was useful
Do let me know for more queries and updated reports
REgards
Dr Naval
Rheumatoid Arthritis Management
Detailed Answer:
Good afternoon XXXXXXX
Thank you for your response.
It looks like the disease is uncontrolled considering the symptoms you have mentioned. She will need a step up of the treatment which one can do after seeing the blood reports. Since her Liver function tests are ok, the optimal dose is usually 15 mg of folitrax once/week and lefra 20 mg. ( depending on her tolerance). but since they are strong medications I would recommend you visit a rheumatologist and let them adjust the medications for you.
In XXXXXXX she can visit Dr XXXXXXX Pandya. He is a famous rheumatologist there but the appointment is usually 3 months waiting. She can visit us in Medanta the next week she is coming and we can adjust her medicines till she has further follow up in XXXXXXX
Hope the information was useful
Do let me know for more queries and updated reports
REgards
Dr Naval
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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