Sally, thank you!
It's really important in my "mental" and physical state to be affirmed in my thoughts.

This DO is a rheumatologist and board certified. But, the one I have now is a MD.

I am having both NCS and EMG. They said it will take an hour, and are focusing on the calves. If the twitches are benign and a result of anxiety, I need to know that. If they aren't, well, I REALLY need to know that.

RASally, do you have any idea if dmards help slow the progression on the nerves for those affected?

Thank you so much! I'm trying hard to advocate for myself and it's not a natural feeling.

Bcatz, there's osteopaths and there's osteopaths. As you may know, they get training in osteopathic manipulation which is similar to chiropractic, as well as regular medicine. Some of them really believe in the manipulative part of it, others just put up with it, being at an osteopathic college because that's where they got in, rather than at a regular medical school.

If this one is board-certified in rheumatology she is most likely practicing evidence-based medicine. (Others do mainly manipulation.) The fact that she's in an office with MDs is a good sign also that she's not primarily pushing woo.

There are people who will tell you that osteopathic training makes the graduates more hands-on and better in tune with people than many MDs are. I'm sure they run the gamut, like everyone else.

I personally wouldn't go to someone specifically because they were a DO, nor would I avoid them. I'm with Sally- go see! Don't burn your bridges with the other one yet, but the new one may be a better fit.

I wouldn't worry about the alphabet soup so much as their skillset. If shes being recommended by someone close to the Arthritis Society she must be impressive to have floated to the top of the list.

I have mechanical issues and would love a Dr dually trained to help those as well. I so want a Dr that believes mind/body work together and one usually affects the other. Physiatrists have similar training as a DO and a neuro. They're qualified in EMG training and some do pain mgmt. The one I went to didn't do mechanics so I never went back. You never know til you try.

It never ceases to amaze me how some of us follow the same path with similar issues at the same time.

My soft tissue involvement is sky-rocketing. Muscle wasting in calves. My neuropathy has moved to center stage. It used to be irritating, but now its effecting my day to day functioning. I'm also getting EMG/NCS to see how much damage has happened /is occurring. Waking up 4wks ago unable to use my right hand has thrown me for a loop. Supposedly labs were on track and Remicade finally working. Inflammation explodes and takes my arm. Drs are working together & can't explain it.

Within 8hrs of my nerves being entrapped, the vomiting and anxiety went wide open. I couldn't go a day without a panic attack. Food taste horrible. I KNOW the nerve entrapment helped set things off. It was like all of my senses were hypersensitive and the volume was turned to 15. My arm felt disconnected from my body since its not receiving brain commands. Or too sensitive to touch. Or bugs crawling. Nerves are wicked. One of the worst experiences ever. Neuro says the 5 trapped nerves wouldn't cause my mind/body to react this way but rheumy says it could. I'm finally feeling sane again after a month. They will never convince me they were two separate issues that just happened to occur simultaneously. I call bullshit!

Neuro treatment seems to be less than nil. I get to wait for my arm to come back. Nerve glide stretches and muscle retraining to release the nerves is the only treatment offered other than massage.

So yes, my neuro issues set off anxiety like I've never known. I did suffer from panic disorder about 20yrs ago but never like I experienced this past month.

Good luck and hopefully you'll get some answers after the nerve testing.

Emerald

I would go and see what the DO is all about. Cannot hurt. Do your research and ask lots of questions.

Keep us posted on this - interesting development with DO vs MD.

Linda

I've noticed the same as Alto is speaking of. DOs can practice in different ways. I've had DOs in the past, & my PM doctor is a DO. each has their own way.
Sure sounds like you need to start with consults.
So why not make this your first & hopefully she's a good match.

I have Neuropathy. Originally from spinal but this it's now it's more wide spread.
Went over this in another discussion but originally when I went for an EMG it was right after my DX of RA.
Neurologist stated RA can cause Nueropathy.
Im just feeling the neuropathy spreading last 6wks to 8 wks.
For months on & off my big toe would join in. There's also the fact I can't put any pressure on my foot at any given time. Yet xrays appear to show no further joint problems. Leads me to believe perhaps the tendons are involved.
Nerves, tendons etc.... can set off the muscles.

Being off RA treatment for the better half of a year could not have helped. Orencia being slow acting it's hard to say if treatment will help these other Problems.
Yet I do think on bad days or flares it's worse.
I was DXed with Fibro last appointment with a new RA doctor. Before that DX he examined me from head to toe undressed in the dreaded paper gown. Exam was done standing & sitting. ROM checked in joints, muscles palpated.....never had an exam like this before.
Appointments coming up early August so I'll be asking questions about this subject of other possible problems caused by RA.
I have no doubt RA contributes.
Let's see what these doctors say. Both deal with these areas.
One being my Rheumy ones my PM doctor.
Hopefully I get some answers.
I'm learning as discussed often here RA goes way beyond the joints.
There's no doubt in my mind it's a chain reaction for other problems in areas such as muscles, nerves, tendons etc....
Oddly enough during shoulder decompression the surgeon found arthritis, bursitis, tendinitis, bone spurs.... Mind you much like the neck surgery much more found then expected. No test indicated the real shape either were in. This was all prior to my DX of RA.
We need these diagnostic tests of course yet doctors tend to use a test such as an MRI as gospel when it should be "part" of diagnostic not all.
I'm sharing much of this to remind you to follow your instincts, listen to your body. Avoid DID ( doctor induced depression).
God forbid they look past anxiety & depression for possible causes.
So yep at this point sure sounds like you have nothing to loose by getting another point of view.
Wishing you the best of luck.
Sammy

Thank you!

I've set a consult with the DO Rheumatologist. I'm very interested in the idea of someone seeing the whole picture (like my T2 diabetes I got when on pred, my RA, that my liver hates Enbrel and I need to be treated, and finally, my anxiety).

I just got back from my neurologist NCS/EMG. I wanted it done so much I was unphased by the pain. The NCS was all normal.
And the EMG found the fasciculations. The neurologist does this himself although a tech does the NCS. He found the twitches in one calf and even in my lower back.(didn't know I had them there) So, RASally, I got the FULL EMG. I was stabbed by the needle many times but eagerly waited for the declaration on each stab, including lifting legs, "stepping on the gas", etc. When he told me to relax, he had to tell me again. I guess I was tense.
EMG dx was benign fasciculation only. He noted TENDON issues - SAMMY!!!
Asked me how much longer I needed to wait for treatment because my tendons are AT RISK in the condition they are in. The left ankle has an Achilles tendon issue, and there's a "sock" tendon of some kind and he said that the pulling I feel is tendon related to that...and needs either protected or treated. That was his unofficial/not my specialty recommendation.

I asked the doctor about future neurological impact from RA. It's rampant, but he said that people wait to long to get to the neuro. He can help in many cases with pain and there are treatments that can calm the nerves down. But he admitted that it's often symptom management when the RA drugs aren't effective.

Sally, I kept pinching myself that he was so blunt with his details. He made me listen to my own twitches too. It was interesting. As I was laying on the table before the NCS, I asked if I would get the full testing vs just a few places. The tech said it was up to me, but that the doctor had noted both legs, which meant up to the thigh. I would have been ok but I'm so grateful for your suggesting it.

It really concerns me that the nerves and tendons can be affected ESPECIALLY when not treated. I told him that the rheum said my RA was inactive to which he said, "if your tendons are in pain and you haven't done anything to merit it, then perhaps you should revisit your doctor on that". He wasn't rude about my rheum doc. But I got the message.

It's validation.
It's a shame you need another doctor to validate your concerns when the one responsible for treating your disease sweeps your concerns & complaints under the rug.
Yes it's refreshing to hear a doctor place blame where it belongs.
It's negligent on your RA docs behalf.
Considering his statement about a possible time frame for treatment
It really is negligence.
So sad. So many patients have less then adequate care.
Not everyone is able to advocate or for that matter know the difference from fact & fiction with doctors.
Makes me wander how some people sleep at night.
If you think about it those few good doctors help more patients then they realize. By you sharing on groups like this it educates & helps others in more then one way.
You just confirmed one of my concerns.
I'm betting I'm not the only one.
So thank you & thank goodness you had a winner there with your choice of Neuros.
How nice Sally helped you & in return you helped others.
So wish we had an area to post advice & such like Sally shared with you on that EMG.
Maybe in the future.
Sammy

Hey bcatz,
Glad you had further testing and that it validated your RA when your RD was dismissing you saying your RA is inactive :(
We seronegative RA sufferers NEED this validation!
I have a RD appt. tomorrow. Have been on the plaquenil for about a month. Off the prednisone for 2 weeks. Often forget my second dose of plaquenil...not feeling great, Very tired. Have had a boatload of stressful events in the past 2 weeks so who knows what is what?
Wishing you all the best
We'll see what he says at my appt. tomorrow.