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Suggest Treatment For Painful Fingers And Limbs With Elevated Sedimentation Rate
My 38 year old daughter has severe debilitating pain in her fingers and toes that radiates up her limbs. Her labs were supposedly not significant though her sed rate was high, the first time she was tested for RA is was positive, the 2nd time negative. Prednisone does relieve her pain for about 6 weeks and if she uses her body the pain returns. The rheumatolist we saw was unhelpful and not available for further consult until mid December. My daughter is very depressed about this and in severe pain. Thank you for any suggestions. Ginny
Thu, 18 Jan 2018
hi thanks for the question
YOUR DAUGHTER IS SUFFERING FROM JOINT PAINS OF HAND AND FEET
ALSO HER ESR RATE WAS HIGH
IF I WAS THE TREATING DOCTOR I WOULD HAVE ALSO CONSIDERED RA AS FIRST DIAGNOSIS AND EVALUATED HER
AS PER INFORMATION GIVEN FIRST WAS TESTED FOR RA WAS POSITIVE LATER WAS NEGATIVE
IT WOULD HAS BEEN BETTER IF YOU WOULD HAVE TOLD WHICH TEST WAS DONE AND HOW MUCH LATER SECOND TEST WAS DONE
I GUESS IT WAS RHEUMATOID FACTOR ASSAY WHICH WAS DONE BUT ANTI-CCP ANTIBODY TEST IS MOST SPECIFIC FOR RA
ROLE OF STEROIDS IN ACUTE WORSENING OF DISEASE OR IN LATER STAGE OF DISEASE
IN YOUR DAUGHTER'S CASE AS SHE IS ON STEROIDS THAT MEANS HER DISEASE IS ADVANCED
WHEN JOINT DEFORMITIES ARE BECOME SO SEVERE IN RA THEN GENERALLY JOINT REPLACEMENT SURGERIES, CORRECTION OF DEFORMITIES ARE DONE.
IN MY OPINION YOU SHOULD CONSULT AN ORTHOPAEDIC SURGEON ALSO TO EVALUATE HER AND ASSES POSSIBLITY OF JOINT REPLACEMENT WHICH MIGHT RELIEVE HER PAIN ALONG WITH DRUGS FOR RA.
GOOD LUCK
YOUR DAUGHTER IS SUFFERING FROM JOINT PAINS OF HAND AND FEET
ALSO HER ESR RATE WAS HIGH
IF I WAS THE TREATING DOCTOR I WOULD HAVE ALSO CONSIDERED RA AS FIRST DIAGNOSIS AND EVALUATED HER
AS PER INFORMATION GIVEN FIRST WAS TESTED FOR RA WAS POSITIVE LATER WAS NEGATIVE
IT WOULD HAS BEEN BETTER IF YOU WOULD HAVE TOLD WHICH TEST WAS DONE AND HOW MUCH LATER SECOND TEST WAS DONE
I GUESS IT WAS RHEUMATOID FACTOR ASSAY WHICH WAS DONE BUT ANTI-CCP ANTIBODY TEST IS MOST SPECIFIC FOR RA
ROLE OF STEROIDS IN ACUTE WORSENING OF DISEASE OR IN LATER STAGE OF DISEASE
IN YOUR DAUGHTER'S CASE AS SHE IS ON STEROIDS THAT MEANS HER DISEASE IS ADVANCED
WHEN JOINT DEFORMITIES ARE BECOME SO SEVERE IN RA THEN GENERALLY JOINT REPLACEMENT SURGERIES, CORRECTION OF DEFORMITIES ARE DONE.
IN MY OPINION YOU SHOULD CONSULT AN ORTHOPAEDIC SURGEON ALSO TO EVALUATE HER AND ASSES POSSIBLITY OF JOINT REPLACEMENT WHICH MIGHT RELIEVE HER PAIN ALONG WITH DRUGS FOR RA.
GOOD LUCK
I find this answer helpful
Hi Ginny
Some further blood tests like CRP, Anti CCP,maybe required to confirm rheumatoid arthritis.There are specific disease modifying drugs like methotrexate,HCQ (hydroxy chloroquine)etc which your rheumatologist may consider if not prescribed yet and if rheumatoid is confirmed.Also x-rays of hand n feet must be taken to evaluate any destruction of joints.
Meantime, depend on physical therapy, heat,massage, mild exercises...Avoid cold exposures of hands and feet.take Aleve , an OTC med.twice a day after meals for pain relief .Consult back with rheumatologist
Some further blood tests like CRP, Anti CCP,maybe required to confirm rheumatoid arthritis.There are specific disease modifying drugs like methotrexate,HCQ (hydroxy chloroquine)etc which your rheumatologist may consider if not prescribed yet and if rheumatoid is confirmed.Also x-rays of hand n feet must be taken to evaluate any destruction of joints.
Meantime, depend on physical therapy, heat,massage, mild exercises...Avoid cold exposures of hands and feet.take Aleve , an OTC med.twice a day after meals for pain relief .Consult back with rheumatologist
I find this answer helpful
Hello,
I have studied your case with diligence.
NSAIDs, DMARDs (disease-modifying anti-rheumatic drugs) are prescribed in severe cases.
As you have RA test positive prognosis is not too good.
Newer biologics have role in RA.
long term prednisolone has many side effects.
I have lot of experience of patient of RA and long term results with allopathic medication are not satisfactory,so consult me directly for further assistence.
There is good role of diet and achieve correction through it,for details you can directly contact on my profile
http://doctor.YYYYYYYYYYYYYYYYYYYY.com/doctors/dr-vaibhav-YYYYYYi/63503
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health.
Take care.
I find this answer helpful
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