Wheel of Wellness

I saw the Rheumatologist yesterday finally.  Very nice guy.  I feel comfortable with him and I think he’ll get to the root of the matter, whatever it is.  He’s not one to jump to a diagnosis, which I like, and he doesn’t ignore what I’m telling him either.

I had to do some extra tests while I was there.

There was one for people who complain about dry eyes to see how much natural tears you do produce which was very weird and irritating.  They actually put paper strips in your eyes and you close your eyes for five minutes and then they measure the water stains.  Anyway, apparently my eyes are not as dry as I think they are.

Also, I had to have some chest x-rays because I complained of increasing shortness of breath with activity particularly involving inclines and stairs.  That’s something my GP hadn’t ever worried enough about in the last two years.
He said that the bloodwork that my GP had ordered prior to my trip to England had pretty much come back o.k. except my erythrocyte sedimentation rate (ESR).  He told me that someone my age should have about a 30 but my Sed rate came back at like 112.  Now J had warned me that this particular test wasn’t always accurate so I wasn’t alarmed.  In fact, the Rheumy himself told me that the test was known to be problematic; if it isn’t performed correctly by the lab, the results can be inaccurate and even if it is, the results don’t always mean that the inflamation is particular to anything in particular.  In fact, the results could have been skewed by my gallbladder issue.

So, he reordered that particular test plus ordered a C-reactive protien (CRP test), which is supposed to be more specific or something in pin-pointing inflamation present in the body — apparently if inflamation is one of the symptoms, fibromyalgia is not likely the culprit and it’s likely to be another disorder, syndrome, disease.

Because many of these illnesses are really diagnosed by process of elimination, my Rheumy has three illnesses he’s considering ahead of fibromyalgia:

• Lupus (which he indicated he’s doubtful it is)
  

  Lupus (systemic lupus erythematosus, or SLE) is a chronic disease that can cause inflammation, pain, and tissue damage throughout the body. Lupus is an autoimmune disease, in which a person’s immune system attacks its own tissues as though they were foreign substances.

  […]

  Lupus symptoms vary widely, and they come and go. Common symptoms are fatigue, joint pain or swelling (arthritis), fever, and skin rash (especially with sun exposure). Mouth sores and hair loss may occur. Over time, people with lupus develop nervous system symptoms, most commonly migraine headaches. Periods of time when symptoms worsen are called relapses or flares. Periods of time when symptoms improve are called remissions. Lupus symptoms rarely disappear completely. [www.webmd.com]

• Sjögren’s Syndrome
  

  Sjögren’s syndrome (pronounced “show-grins”) is a disorder in which the immune system attacks the body’s moisture-producing glands, such as the tear and saliva glands. These glands may become scarred and damaged, and exceptional dryness in the eyes and mouth (sicca syndrome) may develop. Sjögren’s syndrome may also cause fatigue, pain in the joints, and problems with the function of vital organs, such as the lungs, kidneys, and nerves.

  […]

  Commonly, people with Sjögren’s syndrome may notice:

  • Joint and muscle pain.
  • Exceptionally dry skin with decreased sweat production.
  • Vaginal dryness, causing discomfort, itching, and painful intercourse.
  • Burning sensation (heartburn) in the chest or throat caused by abnormal backflow of acid and other digestive juices.
  • Dry nose and throat, which can lead to sinus infections, bronchitis, and pneumonia.
  • A yeast infection in the mouth (thrush).
  • Increased fatigue.
  • Skin rashes, bumps, and bruises that can be sensitive to light.

  [www.webmd.com]

• Takayasu’s Arteritis (this is the one he seemed most interest in though it’s extremely rare)
  

  Takayasu’s arteritis is an uncommon condition in which inflammation damages large and medium-sized blood vessels. The vessels most commonly affected are the branches of the aorta (the main blood vessel that leaves the heart), including the blood vessels that supply blood to the arms and travel through the neck to provide blood to the brain. The aorta itself is also often affected.

  Less commonly, arteries that provide blood to the heart, intestines, kidneys and legs may be involved.

  Inflammation of large blood vessels may cause segments of the vessels to weaken and stretch, resulting in an aneurysm (bulging blood vessel). Vessels also can become narrowed or even completely blocked (called an occlusion).

  […]

  Approximately half of all people with Takayasu’s arteritis will have a sense of generalized illness. This may include low grade fevers, swollen glands, anemia, dizziness, night sweats, muscle aches or arthritis.

  The changes that occur in Takayasu’s arteritis often are gradual, allowing alternate (collateral) routes of blood flow to develop. These alternate routes often are smaller “side roads.” The collateral vessels may not be able to carry as much blood as the normal vessels.

  In general, however, the blood flow that occurs beyond an area of narrowing is almost always adequate to allow tissues to survive. In rare cases, if collateral blood vessels are not available in sufficient quantity, the tissue that is supplied with blood and oxygen by those vessels will die.

  Narrowing of blood vessels to the arms or legs may cause fatigue, pain or aching due to reduced blood supply-especially during activities such as shampooing the hair, exercising or walking. It is much less common for decreased blood flow to cause a stroke or a heart attack. In some people, decreased blood flow to the intestines may lead to abdominal pain, especially after meals.

  Decreased blood flow to the kidneys may cause high blood pressure, but rarely causes kidney failure.

  Some people with Takayasu’s arteritis may not have any symptoms. Their diagnosis may be discovered when their doctor attempts to take their blood pressure and has trouble getting a reading in one or both arms. Similarly, a doctor may notice that the strength of pulses in the wrists, neck, or groin may not be equal, or the pulse on one side may be absent. [www.webmd.com]

So, they drew some more blood and told me to come back in three weeks.  Here’s the thing.  I know I was feeling particularly crappy yesterday — the plumbing was all backed up for days, I told them I’d been having a migraine…last night I was having some weird pain in my lower back, which I assume is either associated with PMS or the backed up plumbing…I can’t help but think that somehow that’s going to result in an elevated Sed rate again.

Heck, I feel crappy today.  Migraine, back pain, stomachache.  I’m all stressed out about seeing the surgeon.

tags: Rheumatology, Takayasu's Arteritis, Sjögren's Syndrome, Lupus, Lupus, ESR, CRP, fibromyalgia

3 comments

1. on August 2, 2006 at 10:17 am

   Tamara said:

   Glad you liked the doc. Lots to figure out, huh? Good luck with the surgeon!

2. on August 3, 2006 at 2:22 pm

   txdave22 said:

   I am new to the site and would like to ask a favor.

   If you have had some experience with certain foods helping your arthitic condition, please take a look at my blog and comment on the article about foods and arthritis.

   I’m trying to help by getting first-hand experience with foods and arthritis that I can then report back to my readers.

   Thanks dave http://backbebetter.blogspot.com

3. on August 5, 2006 at 7:14 am

   Billy Bones said:

   Well i think its agood decision of yours to go for a Rheumatologist.

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