So, I just got my bloodwork back and I'm beginning this whole process. My ANA came back positive, which I had known for a while. It came back positive probably 10-12 years ago, I was sent to a rheumatologist but didn't really have any symptoms other than being a bit tired. Now, for my annual physical, I mentioned to my doctor than 2 of my knuckles are swollen for no reason (no injury) and now with the recent positive bloodwork, off to a rheumatologist I go. After reading this thread, I'm a bit terrified. I'm 44, other than my newly sore knuckles, sometimes my feet get sore (plantar fascitis sp?), and somewhat stiff hips, just recovered from some tears in my rotator cuff....I'm in the best shape I've ever been in....am in the middle the P90x fitness program, eating well, riding, etc. What questions should I be asking the rheumatologist when I go in 2 weeks? Do I need to get on meds now, before things get bad? (I rarely ever take an aspirin, so this is worrisome) Is there an age when this really starts to "kick in"? Can you have just a "low level" of RA? Any other resources?? TIA!
Dune, what about rheumatoid factor? Was that tested, and if so, what was the result? I thought ANA was more of a lupus indicator, but I could be wrong. I don't trust my memory so much any more!
Assuming it is RA, the "best practice" these days is to be aggressive on meds from the very beginning so you do not have joint damage. I was diagnosed in January 1998 after nearly a year of symptoms, already had some joint damage, but thanks to an excellent rheumatologist, I have not had further damage.
Yes, the drugs are powerful and scary, but you absolutely do not want joint damage, because then you are talking surgery to fix, possibly replacement, and those outcomes are never going to be as good as avoiding the damage in the first place if at all possible. The way I look at it is, even if the drugs shorten my life (which may or may not happen), I am LIVING my life thanks to them. Had my doctor not been aggressive with meds, I have no doubt that I would be unable to work, unable to use my hands, and unable to walk by now. Instead I work a high stress, more than full time job that I love, I have my horses (with compromises), I still bike (one of my passions, also still do-able with compromises), and I'm glad to be alive rather than spending my days thinking "someone please just shoot me."
As for your question regarding what age RA "kicks in," it varies so much. For me it was 39, for many it is early childhood, for some it's 20's...it can be any time.
As for resources, the Arthritis Foundation is a great one. They have lots of on line information and membership gets you their every other month magazine. There are on line support groups that have gotten me through a lot of bad patches--my favorite is the one on About.com. I've been a member there since the late 90's.
If there's something more you need to know, please ask, either in this thread or via PM if you prefer.
I got the info via a nurse over the phone, so can't remember the specifics, BUT I do remember the positive ANA, tested for lupus and that's negative and then some other test that indicates RA. So I'm getting xrays of the bad knuckles this week and next week I'll meet with the rheumatologist. I just want to go in fully prepared and ask the right questions....thanks!
As far as questions to ask I would say to make sure you feel comfortable with whatever treatment you and your doctor decide on and most importantly WHY. Generally, as was mentioned, the protocol is to start relatively agressive treatment right away in an effort to prevent damage. That is a good thing. They may suggest you use prednisone or something similar initially and if you tolerate it and it will only be for a short time that can be handy. If it were me I would be wary of any doctor relying on prednisone long term but that is also something to talk over with your doctor.
You may also want to ask the doctor if he/she has any suggestions as to your activity levels. Also make sure you discuss what your treatment goals are and make sure you and the doc can get on the same page for that.
you might check out rawarrior.com It is a helpful site and has some good resources.
Sending lots of jingles your way and if there is anything I can do please feel free to send me a PM.