I need information of a hospital I can go to to get help

My new pcp believes I have rheumatoid arthritis as I do. My father had it. The other specialists I went to one half-way supported it but all the others said it was fibromyalgia.  
It began in August when my fingers began to go numb and my wrists hurt.  I thought I simply had carpal tunnel syndrome and wore braces, my back pain had slowly worsened after being taken off Celebrex during the Vioxx scare (I have mild heart problems), from time to time my back (two mild bulging discs would really hurt me and my old pcp would prescribe vicuprofen for pain). Then one morning I got up or tried to get up out of bed, I was very stiff, could not really walk, and sitting on the toilets my knees just killed me. After that my fingers swelled, as did my ankles and knees. I was sent to a few specialist, one was my old back surgeon.  I tried to tell my old pcp that as these other symptoms emerged my back ceased hurting. My new pcp put me on methotrexate 14 weekly injection, I became better then I broke out in pimple like sores on my forearms with a few bigger spots but one morning I was trying to look at my back to see if I was broken out there, I had this brusing, brown and lighter toward the middle that looks kinda like a road map, the diameter was about like that of a pie plate. My pcp put me on plaquenel, I took one a day for 7 days then on the 3 day of taking two a day I broke out in a terrible itching rash. I then had flu like symptoms with fever that ranger around 100 to 101.7, I devloped a cough, and coughup up blood twice.  I then began taking Benadryl and I swear I starting getting better almost immediately.  I believe it was inside of me, I ate a lemon square and it burned my mouth, my esophagus and my stomach.  I was taking Levaquin but after taking the Benadryl my chest cleared up rapidly. Normally with bronchitis I cough up phelgm for at least a month and go through two rounds of antibiotics. Not this time. I have taken one more shot of methotrexate from dosage down from 14 to 10. I want to go to a hospital where I can find out what is wrong with me, get treatment and get pain medication. The pain does not allow me to sleep and is unrelenting, I take 1 to 2 Norco every 4 hours, my pcp gave me 30 percocet for break through pain during the plaquenil incident. I live in Arkansas and receiving pain meds is almost impossible. My new pcp has it posted all over his office as do most, that chronic pain patients will not be served.But my Norcp are not working like they were.  I want to go to a hospital that has a good rheumatology department and find out what I have and get it treated. The pain is about to drive me insane, I try so hard to think of positive things and practice imagery, etc but I cannot take much more. I also am agoraphobic since the 70's and have seen a shrink and counselor all that time. I had to quit my job of 20 years, and I really have no life but just dealing with pain. Please help me.

[Kevin Pho, MD]

Difficult to suggest treatment without evaluation.

It may be possible that the symptoms may be side-effects from the relatively powerful rheumatology medications that you are taking.  This also can be considered if the symptoms improved with the Benadryl.  

As for chronic pain control - typically a long-acting narcotic is ideal, with shorter acting medications (i.e. Percocet) for breakthrough.  Taking Norco every 4 hours with Percocet seems like a less-than-ideal regimen.  A referral to a major acacdemic medical center to see a pain specialist and rheumatologist is recommended.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Belledonna]

Hi Shellee
    I can tell you where I went ....when I read DR.Steve Paget's
book The Handbook of Rheumatoid Arthritis, I knew I had it although a local rheumatologist had ignored all my symptoms and diagnosed me with polyarthritis, incorrectly.I went to HSS Hospital in New York City because the only rhematologist (other than the first one I went to) who could see me here had a 4 month wait list. You want to get the right meds as soon as possible.
    However, you  also need to have a local Rheumatologist who can see you every few months(3 or 4) and you need to have bloodwork regularly.
     You should not have to have all the pain you are describing. However,there are other ways of managing pain than taking strong meds.Some people find relief with accupuncture. Water therapy is very helpful. Relaxation exercses and massage  is also good if suggested by your physician.
     Look into all the articles on inflammation which suggest that diet(eating the right foods which reduce inflammation) is esential. I believe it is. Also , you might benefit from reading articles by Dr. Andrew Weil --he is a very knowlegeable mind -body doctor.
     I knwo that the supplement Glucosimine helps me but even more helpful to me (as helpful as my Naproxen for OA)
is FIsh Oil.Hope this helps you.Look up Rheumatology under the categories on the HSS website.