Need help!

[nanascraps]

Hi! I am 35 years old and for the past year I have been having severe fatigue, muscle pain and joint pain. I have gone to my GP who ran some basic labs (CBC, Metabolic profile etc) everything is normal. He then sent me to a neurologist and he did an EMG and he said I have diabetic neuropathy. I have been insulin diabetic for 13 years now. Just within the las 3-4 months the joints in my hands PIP and MCP hurt really bad and are swollen and the skin on the joints have turned kind of red. The space in between the knuckles are really swollen also. I looked up RA and it sounds like that is what I may have. I also looked up SLE and I fit a lot of those symptoms also. The thing that is throwing me off is the discoloration of my skin on the knickles. Does anyone with RA have this? My GP is sending me to the Rheumatologist next week.

[mae734]

I am afraid  because I have this pen in my shoulder, but want to find out why I am in pain, do you be shock to death?

[nanascraps]

Well he said he is strongly leaning towards SLE, but that a lot of symptoms also point towards RA. Friday I went to the lab and had 6 vials of blood drawn. He did a lot of antibody tests and tests that I saw on the Lupus.org website. He also had them x-ray my feet, ankles, knees, wrists, hands and neck. If anything shows up on any of the tests or x-rays he said he will call me if not he will see me back in 4 weeks.

[txsilver]

If it is RA, they do not always start you out with the heavier drugs and not always with steroids first.  Many doctors take a more conservative approach and start with low NSAIDs, then DMARDs and so on until they find the point at which you get relief.  It takes awhile.  We are still working on finding the right combo.  I spent 2 yrs trying to get a dx and now it has been 8 months and we are still trying to get my meds right.

[napalm]

BTW,about the steroid therapy,maybe if it turned out to be an auto-immune disease ,steroids are not the only cure...there are other types of medications called ;Diseasde modifying Anti-Rheumatic Drugs "DMARDs" which have the required effects of steroids but only they work SLOWER and they don't have the same side effects as steroids, examples for these medications are ; methotrexate injections , sulfasalazine, hydroquin, leflunomide..etc..so your diabetes wouldn't be an obstacle in the way of ur treatment..regards

[nanascraps]

I am leaving work right now for the rheumatologist. I will let you know tomorrow what he had to say. Wish me luck!

[napalm]

ofcourse SLE can cause joints to swll (a sign of inflammation in joints).. about the diabetic neuropathy i am not sure,this can cause joints to swell too but with minimal pain causin something called Charcot joint which is very destructive to the join..hope ur rheumatologist will figure it out,hope to hear from you

[nanascraps]

I looked up on the web pictures of the discoid rash and mine isn't bad like those. I guess it could be though. It is about the size of a quarter. I also looked up images of early RA in the hands and my hands look exactly like those. I just hope this Dr will be able to figure me out. No one else has been able to. They just keep telling me it is diabetic neuropathy. But now with my knuckles swollen maybe they will be able to determine something else. Would SLE cause the joints to swell? I know it said that is can cause swelling in the legs, feet and hands. Which I have big time especially in the legs and feet. But the joints?

[napalm]

The weekly fever could be indicator of other infections associated with SLE or RA,like urinary tract infection,lung infections..also the patch on ur face are u sure it's not discoid with fluid inside?

[nanascraps]

What is a SI injection? Reading on RA I see that the first thing they give you is steroids. Being a diabetic I can't take any steroids. I had a really bad allergic reaction to a medication about a year ago with hives and rash and the Dr gave me a pill pack of steroids and told me to try it and keep track of my blood sugars. Well within 1 day of being on them my blood sugars shot up to almost 500! I have a lot of problems with diabetic neuropathy in my legs and feet already and now the pain in my joints is just making it worse. I work at a desk job so that helps with the pain in the legs and feet but what is really the worst is the pain in my hands, fingers and wrists. I type all day and some days it is just unbearable. I can't even grip a pen. Well today is my appt and I have such high hopes that he can give me some answers!

[msfergy]

I seem to always be fatigue, my bottoms of my feet are always red and palms of my hands. Still working on my leg problem, had a SI Joint injection yesturday and waiting to see how it turns out.

[nanascraps]

I have a lot of symptoms of SLE also. When I looked up "butterfly rash" my face doesn't look like that at all. My face is very red and ruddy though. I also have a patch on the right side of my face  near my ear that is really red, dry and has a few sores on it. What is really scaring me though is that my lymph nodes in my neck have been sore and swollen for almost a month now. I went to my GP about a week ago because of it and she said my thyroid felt swollen also so she sent me for some thyroid panels and an ultrasound on my thyroid. The ultrasound was normal and she said my lab work was "inconclusive" and gave me a copy to give to my Endo ( I am a type 1 diabetic x 13 years). I also run a fever of about 99-100 degrees every couple of days. I go to the rheumatologist tomorrow. I am so hopeful that he will be able to give me a diagnosis of something! I feel like I am always whining. My family is very supportive but I feel bad that I can't do all the things I used to do. Thanks for listening to me!

[napalm]

flares maybe a sign of SLE ,do you have a rash on you cheecks?..either way the treatment is very similar to RA and both disease can cause serious extra-articular symptoms on other organs (heart,kidneys,lungs).. I hope you get better soon

[nanascraps]

Thanks! I am so anxious to go to the Rheumatologist! Hopefully he can give me some answers to what is going on with me. :)

[txsilver]

Yes, very normal.  You can "flare" for a day, a week or, heaven forbid, longer.  "good" days can mean less pain than "bad" days and still mean a lot of pain.  Fatigue is your bonus 2 for 1, it's a package deal.  :)

[nanascraps]

I'll let you know! I have another question. I have been reading the posts on this site and everyone talks about "flares". I am so confused about this. For the past year I have felt really "bad". Say in an average week I will feel ok (sometimes good) for like 2-3 days then I feel really bad the rest of the week. Is this normal for RA? The pain and fatigue never go away completley it just eases up a little on the good days.

[txsilver]

Red, swollen knuckles can certainly be a sign of RA.  I have RA, but not that symptom - but I am not presenting in the classic fashion, either.  I am glad you are getting in to see a rheumatologist.  Let us know what he says.