I wasn't clear that I would like to ask you all, is your RA pain equal on both sides, and worse in the morning?
Does it actually get "better" as the day goes on?

Maybe I should ask you to think of how it was before you were on your meds....
My pain is there when I wake up but it gets worse as the goes by.
It hurts if I do nothing or anything or too much.
although it does hurt more when I sit or stay in one position --but it's not worse in the morning.

Since that last doc, years ago made it sound like I must not have RA if my pain is not worse in the morning......that is one reason I am asking; plus a friend who has RA and is a nurse was surprised when I told her what that other doc had said about the pain being on both sides and worse in the morning.

Everybody's RA experience is different. I have a great deal of pain and stiffness in the morning, but it is often worse at the end of the day after sitting at my desk at work all day. I have pain on both sides, but usually one side is worse than the other, and it isn't always the same side.

Both the pain a.m. or p.m., and equal or unequal pain on each side, is influenced too, by your perception. I know my afternoon pain bothers me much more because I am tired and because some of my medications have worn off. There are lots of reasons that we may feel more pain or stiffness in one side or the other too (dominant side; amount of use; previous damage to joints, ligaments, tendons,etc.)

Don't worry if your RA is atypical. I know rheumatologists see a lot of variation. Just be honest and let the doc figure out what treatment will work best for you.

Good luck on your appointment. I hope you develop a good relationship with your doctor. It sure helps a lot.

Yes, my rheumy did both blood work and xrays on my first appointment. Before meds, my pain was so bad all day that I can't say if it was worse in the morning. It is worse now in the evenings, but I think that is because I take Prednisone in the mornings and it has started to wear off by late evening. Just like blukygrl, I have pain in both sides, but one is always worse than the other. Have a good appointment. I hope they give you some fast relief!

Mine ordered xrays to check for bone loss (pitting of the bones), and lung xrays. Also blood work to check my CCP antibody score. (Only RA ppl have CCP antibodies. A score of 60 means you have aggressive RA. Mine was 158. Higher is more aggressive). Then he checked my hands and feet and arms and legs re movement and flexibility. Took blood pressure. They will hook you up with an eye doc too sometimes bcz some meds can damage your retinas...but you only have to go once every 3 months at first, then less. They will have you get blood work once a month at first and then less often later...to make sure your liver is ok and everything.

My doc started me on meds immediately.(methotrexate, plaquenil, leucovorin calcium). I take prednisone too when I have bad flares.

Mine has always been worst in the am as a general rule, but I can get flares in the middle of the day, or at night, mostly from being in stressful situations.

My RA has NEVER EVER been symmetrical. EVER. Not even once. And I am RF negative.
(Diagnosed 2005, had symptoms since August 2002often wanted to just die during those 3 years. Ugh.)

Some meds are bad for the liver but they are always coming up with new meds.

BEST advise I can give you for swelling and pain is one word...ICE. I put a bunch of ice cubes in a zip lock and shove it into my hand braces or my knee braces and leave it there til it completely melts. Hurts like crazy once that ice hits and the swelling starts to go down...but it hurts so good bcz when you feel that pain, you know its working. That usually works after a few hours...replace the ice as needed. Ice is now my best friend. :) I like those icy gel packs too for at night because (1) they wont leak all over your bed like ice will through a zip lock sometimes, and (2) you can freeze them in any shape you want. I have like, 6 of those in my freezer.

Vitamins help me too...especially B12 for stress.

I hope this info helps!
Glad you are finally getting help...its amazing how well my meds work for me. I swim too, and that helps a lot too.

First off good luck with your appointment tomorrow! You have nothing to fear. It is always a good idea to write down symptoms as well as questions you want to aqddress with the doctor. Every case of RA is different. Most people that have RA have some form of other pecially women. The rheumie may want to do a bone density test to form a baseline for you going forward. I love my rheumie, but not all relationships are as good as mine. Be sure to voice your opinions and have done your research before the appointment. The docotr will want to run tests, especially blood workup to help determine the right protocol of treatment.

It is important that you realize no treatment even if it works will be of immediate help. All meds take time. Be sure to have a list of meds that you currently take. Take the time you need 3with the doc. I often wait up to an hour before I get taken for my appointments, but once the doc is in with me I am never rushed and always get mytions addressed.

Good luck. Your rhuemie will be a very important person going forward in your life. Make sure it is a doc you feel comfortable with. Always feel like an equal and a consider the doc your partner in your treatment!

thanks, all.....and yes it is helpful ......you have been loads of info for me and it is nice to have people to ask.
Ice though? ouch. even though I am a hot blooded person when it comes to pain I always try heat..maybe that explains why it doesn't really help. But it feels good LOL..(the heat)
I had tendon injuries a couple years ago and had to do ice....the physical therapist I had then taught me (since I hate using ICE so much), that if I put a bit of water in with my ice it is not quite as awful)
I guess I should give that a go again. So , thanks. (and I saw your post , onthemend101, about how many icepacks and aides you have and I feel the same way; I have splints for every thing and in left and right sizes) More than Walgreens, like you. LOL
and blukygrl, your post here makes sense to me about how we have different perceptions as well as dominant side , etc.
makes sense to me.
the comment I see from onthemend about lung xrays, makes me want to ask do any of you have lung involvement?
I think I really do. Several years ago , I had a lung xray that the docs could not explain to me (interstitial infiltrates)
and now, with this dx, I am thinking , okay now it makes sense...and when I take prednisone for the pain I can breathe right. hmmm.

I hated the ice at first too. As soon as it would start to send that pain up or down the tendon I'd take it off bcz it hurt. But my doc told me to leave it on, so I bit the bullet and kept it on. If you get past that first bit of pain, and then it starts to spread, and it hurts like crazy...wait it out...pretty soon your knee is numb and you can walk again. Then the next time you do it you actually anticipate the pain of it working. Does anyone else feel that way or am I as nutty as an almond joy? ;)

When we go into remission we should open up a medical supply place for a month. :)

I have no lung involvement. Need to get another xray soon though. Haven't had one for years. Are you sure you don't have asthma? I think prednisone makes breathing easier for asthmatics, but I'm not positive about that. Usually the organs are the last thing RA affects. (Usually...haha...as if anything about RA is predictable.) Just trying to help you not worry about it...ask hyour doc if maybe it's asthma, though.

Please keep us posted!

Hi ThisToo,
Good luck with your appointment.
Everyone's RA is differnt. Mine can be symmetrical or not. The mornings have never been worse for me.
My Rheumy who is very thorough and in his own words a "worry wort"
did more blood tests, a chest, abdomen, pelvis CT scan with contrast to make sure there was nothing else causing the pain and a full bone scan with contrast to assess degeneration, also Xrays of both hands and feet. After he had all this, he then sent me for a bone density test. This was all done before he prescribed any RA meds except Prednisone.
Good luck and let us know how your appointment goes.
Gentle hugs

If any doctor you see doesn't take you seriously, then he/she is not the doctor for you. Think about going to the doctor as an interview in which you are hiring someone to help you with a task. You might have to go through several "interviews" until you get the right fit. You are hiring the doctor to help you manage your health. He works for you. You do not have to impress him, you have the right to ask questions, you have the right to ask him to educate you. The two of you should be partners in the management of your health. I say all these things because I am a nurse and get so irritated with doctors who have their huge egos and think that patients should fall at their feet. To help patients put things in proper perspective regarding their physicians, I've asked: "If you went to a mechanic to fix your car and he didn't do a good job would you go to that mechanic for 20 years because you didn't want to hurt his feelings by going to a new mechanic?"

With all that said, I am very lucky to have found the rheumatologist I have now, but he is my second. The first guy walked and talked like a duck: quack, quack. My current RA doc scheduled a ultrasound of my liver before even considering a drug therapy and thank God he did because it showed I have a fatty liver that is damaged from years of drug therapy for my diabetes. Because I have a damaged liver and diabetes, I cannot take many of the front-line drugs for my RA. I currently take sulfasalazine and am due to start Enbrel injections this week. These were not my first meds... it's a slow progression to find what works.

To determine the different kinds of arthritis I have, my doctor conducted an in depth interview with me regarding my health since childhood. My RA doesn't show up in my blood - I am "seronegative" but it lights a bone scan up like a christmas tree. Interestingly enough, my scan for osteo was negative ... with osteoarthritis your bones look like swiss cheese.

If you take anything from my post, please know that you are not interviewing ... but the doctor is. Choose wisely and best wishes on your journey to finding the right doctor for you! God bless you!

omg , GREAT replies folks...thanks again. @Chelley, I copied your reply and saved it in my folder..I think it is great advice for anyone about any health issues.
The fact you are a nurse means a lot. I had gone to an ortho doc a few years back for a bad tendon injury and he was just a huge ASS. No other word for it. He dismissed me (nearly sure) because of my hx of depression but I wasn't talking about it; he had his staff dig until they made me talk about it. It ended up after much agony to be a really bad injury . He literally took my splint and threw it across the room. Talk about ego. I was stunned.
He kept saying "I'm a SURGEON" like WTH. Funny, another doc I went to after that, had the same experience with that one.
I liked my new doc..not sure if he's doing things the good way for me......now that I read your post I wish he'd have ordered a liver test too; come to think of it he ordered a liver panel.
He is thinking that I do have RA and is ruling out Lupus...he did order those xrays but the xray place said I need to make an appt.
he ordered lots of bloodwork but veins were not cooperating.
so I have to go back and get those done. He did write me more prednisone told me take when needed and an anti maleria drug.....??
and diclonfenac however you spell that.
He did a fairly good hx but not back to childhood.