I thought the docs could remove the joint capsule and fuse them if it got bad....did he mention anything like this down the road?

Your RA presents similar to mine. What fun!

He said he'd like to keep it conservative. Yeah, me too. I shudder at the surgical options. He did not mention specifics about surgery. I probably would have started wimpering and covering my ears.

I have gotten through all this by thinking to myself "You're not injured, you just hurt, so don't be a wimp." That's not quite so true anymore.

I want to go back to my rheumy right now and say "SEE! Told you I was hurting!!!"

I envy the seropositive. Well, you guys know what I mean. You have your red headed step children... Well we're the seronegative whipping boys and girls.

I would think about getting a second opinion from a Rheumatologist who doesn't go just by blood tests.
Just my 10 cents worth.

I hear ya Angelpuss. I had to go through 3 in 3 months to get my current rheumy. I have to give him this, he has treated me despite some reluctance. Yes, he seems like a blood work guy, but he has put me on the usual, MTX, plaquenil, prednisone, etc.

However, there is still that wishy washy air of skepticism. The subtle changing of opinion every visit. You know, "You have mild RA", to, "Welllllll..." and then the "I'm not sure" grimace.

I have stopped listening to anything after "Welllllll..."

Sorry to hear about all this. It is awful to be treated that way. I hope your new orthotics work as well for you as mine have worked for me. Good luck,
Lynne

Thanks Lynne.

Does anyone else have experience or advice with either toe issues or orthotics?

ugh- wishy washy RD's when it comes to sero-negative RA
I hear you and I can definitely relate.
Since I presented so severely- lost 28 lbs. in 2 weeks, no range of motion, frozen joints, extreme swelling, excruciating SYMMETRICAL pain, red, hot, sweating joints...despite being negative for RF factor I was dx with RA.
So immediately built up to highest dose of MTX and then upped prednisone to 40 mgs.
Within 3 months became functional as opposed to invalid.
Continued to improve.
Liver enzymes elevated- taken off mtx and felt no worse off then on. Did not go back on.
RD became skeptical
My mild to moderate daily pain was pooh poohed
I was reminded at every visit how much better I was since "that first day"
I was always feeling my best at the qrtly visits and looked well.
In between...agree with dr. oh if I compare onset- who could complain yet I don't feel good, I don't feel pre-RA
Then I had a flare and I took pictures of swelling and kept a journal of my pain.
Suddenly he became alert and prescribed prednisone and now plaquenil.
I know in my heart I have RA.

My Rheumy is aware that damage can happen (all kinds, even bone) without severe swelling. NOT SURE WHY YOURS DOESNT.

My rheumys opinion is there is no such thing as "MILD" RA. There are no accurate predictive tests than can predict how any one case of RA will progress or how fast. Your doc does not have a crystal ball... If he thinks he does fire him!

The more current trend in treatment is to treat all cases the same AGGRESSIVELY cause they can't tell until its to late who needed MILD or aggressive treatment. You wait until its obvious on an X-ray and its too late.

If you have a confirmed diagnosis of RA you need to be on MTX or Arava with CRPs consistently under 3. If DMARD doesn't do it you should be on a biologic, enbrel, humira, simponi, orencia, Actemra - most of us try them in that order.

MILD is a term that most Up-to-date rheumys don't use anymore.

PS a negative RF does not rule out RA, it is an inconclusive result. Only testing positive means anything. I was seronegative for the first two years, am now sero positive. I had bone errosions and tendon damage I'm my metarsal foot joints and toes in year two, before testing positive for RF. Ask for new Anti-ccp test, may help prove it.

Make sure you are getting a CRP test for inflamation (sed rate test sucks) and wean off your prednisone before your bloodwork... It masks the inflamation in your blood as well.

My diagnosis was made based on physical exam. I had obvious symmetrical polyarthritis in lower and upper body. I had let it get quite bad before getting help... Like 8 months into daily symptoms.

Confoosed -- Yes I can relate. My RA was finally diagnosed when I had surgeries on both feet for neuromas but the actual findings were RA nodules, synovitis, and capsulitis.
I also have a hammer toe, and I continue to have pain and tenderness under all metatarsal heads.
I'm seeing the podiatrist again soon. I'm not sure what he can offer me -- cortisone injections? Orthotics? I would not be excited about another surgery at this point.
Meanwhile, I stick my feet in ice water for pain relief.

Magie, Lynn, Thinks, Lynne, Angel, and bcatz,

Thank you for your responses. I really appreciate you all.

Lynn, I've been wondering for a while what my rheumy really focuses on on a daily basis. I think osteo, and I think he is out of touch on modern RA thinking. He is an older doctor, maybe flirting with retirement. But I could be wrong. I too went for months with very little treatment. My PCP's PA scratched his head when steroids worked for my "plantar faciitis", which quickly became polyarthralgia and bursitis.

After a lot of time on my feet this weekend all of my toes feel like they want to pop off. I think one of the little suckers is trying to go claw toe on me.

In any case, thanks you guys. Actually seeing damage is stressful, as you know.