I am in desperate need for some answers and pain relief. I am a 42 year old female diagnosed with Psoriatic Arthritis
and Fibromyalgia 3 years ago. In regards XXXXX XXXXX I have skin problems on my hands and foot that were horrible. Dermatologist said Psoriasis. She sent me to Rheumatologist because i have also had horrible joint pain since I was a child that has come and gone over the years. For the past 3 years the joint pain has been significant. Rheumatologist diagnosed me with PsA. (I have nail pitting as well). I have been treated with Methotrexate and Enbrel, Humeria and now they started me on Remicade. * I've only had 1 infusion of Remicade so far. The reason for switching was that while I did get some relief from the joint pain, it wasn't as much relief as we had hoped. In addition, I still had elevated Sed rates and C Reative Protein. However, my skin has cleared dramatically.
In addition to this, I have been diagnosed with Fibromyalgia. I have horrible muscle and nerve pain in my chest, back and neck. I have just muscle pain in my knees and elbow area. It might be important to note that 3 1/2 years ago I had a horrible case of shigles on my right side that was in the dermatone that went from my chest and back. Now, this "fibro" pain is in the same area and it feels exactly like the shingles pain. However, it does cross over to the left side sometimes.
It may be important to note as well, that I became a below the knee amputee 11 years ago. This was after a MVA when I was 18 in wich I crushed my talus bone. After many surgeries to try to fix it until the age of 30, I was forced to have a below the knee amputation. I sufffered lots of pain during those years, and now since the amputation, I have had horrible phantom pain.
The final component is Fatigue
. It is awful. Sometimes I could sleep for 12 hours and still be tired.
SO, that is my history. Currently, I am frustrated because I have had 3 new Rheumatoligists at the practice that I go to in 3 years. Because of this, I went 2 weeks ago for a consultation with a Rheumatologist at a different practice. He breifly went over my history with me without having my records and did a breif physical exam. In this short period of time, he said that he is not convinced that I have PsA. Rather he thought it was more Fibromyalgia and Psoriasis. (I thought this was crazy because my skin cleared up dramatically and my joints were feeling better on the immunosuppresants) So, he ordered a bunch of blood work, and Xrays of my shoulders, back, hips and hands. I follow up with him next week, at wich time he will have my records from my current rheumatology practice.
In the meantime, I was proactive and I got the results of the tests he ordered. The Xrays showed I have DJD in my Back, Hips and Shoulders. One hip being worse that the other, one shoulder being worse than the other. It also said there is disc space narrowing in my spine, greatest at L4/L5. (Note: I also have had a herited disc at L4/L5 for many years and for the past year my SI Joint has been horrible with pain. I did months of PT for teh SI joint and finally had to get a steriod injection in it this summer. It has become very painful again) There were no negative finding in my hands. So, these X Ray results are confusing, because I looked up DJD and it says that is Osteoarthritis and from what I found on the internet, not symptomatic of PsA.
The Blood work showed my Sed Rate is still elevated at 35, my Complement Total (CH50) is high at >60, and My BUN/CREATININE is slightly elevated at 22.3. My DNA AB (DS) CRITH, TITER is elevated at 1:80. I looked up the last test and it said that is a definate indicator of Lupus. So, I am just more confused.
My Urinalysis showed Calcium Oxalate Crystals being Moderate at (6-15/HPF).
Finally, I had a catscan done 1 1/2 months ago of my abdomen, (because I was having severe abdominal pain, and they found a large strangulated hernia. I had surgery for it). The reason I mention this is that the catscan showed arthritic changes in my spine as compared to my previous catscan in April 2010.(this scan was done in an emergency situation to diagnose my ruptured appendix) **My Surgeon believes that surgery and healing process is what lead to the weakened abdominal muscles and thus the strangulated hernia 1 1/2 months ago. IMPT: Because of this surgery, I have been off the Methotrexate and Remicade and my skin and joints are so much worse. I am ready to start treatment back up, but I wanted to wait to go over these results with the Rheumatologist I had the Consult with.
The med's I am on for my pain, In addition to the immunosuppresants are Cymbalta 120mg. and Neurontin 1200mg. I also take medications to help with sleep 100 mg. Trazadone and Klonipin .5mg.
This is my history and my present situation. If someone could please give me your opinion of what I may have, I would appreciate it. Do you think I have PsA? Fibro and or something else?