Dear Doctor,
I am a 56 year old woman with a history of Hypothyroidism. I had back surgery (1974) - herniated disc, hysterectomy (1995) - ovarian cysts, Trigger thumb surgery (left hand- 2002) and carpal tunnel surgery (right hand - 2003.)
I take Synthroid, Toprol, Foltx, Fosomax, Calcium and a Multivitamin.
In January I saw my Doctor for stiffness in my hands and finger joints. I wake up several times a night with my hands feeling "hot", stiff and swollen. Sometimes they hurt all day, sometimes it goes away by afternoon. In addition I had a trigger thumb on right hand and middle finger on left hand.
My Doc sent me to a Physiatrist who suggested it might be Rhuematoid Arthritis. He ordered lab work and Occupational therapy, which I did for 2 weeks. After 2 weeks, the therapist thought I no longer needed therapy and on the "QT" said she did not think I had RA because my hands did not have the typical appearance of the disease.
In the meantime, I saw a hand surgeon who injected cortisone into my thumb and finger. He also mentioned that I have Dupuytren's Contracture. The injections made a huge difference and I beleive the OT may have helped as well.
I had a follow up appointment with my Doctor this week and I recieved the results of the lab work. Most of the labs are ok, but my Rheumatoid Factor is 15, Sed Rate is 21 and ANA is 1:80 with a Nucleolar Pattern.
Doctor, when I look up the ANA information on the internet, most of the time, the Nucleolar pattern is associated with Scleroderma. This scares me to death! There are other diseases which fall into the autoimmune catagory, but the Nucleolar pattern seems to always be listed with Scleroderma. I am wondering if the pattern sometimes occurs with other illnesses (hopefully not as serious as Scleroderma). I am hoping you have some encouraging information for me.
In your opinion, what would my next steps be? And finally,what do you recommend I bring up in future discussions with my doctor?
Thank you for listening to me and reading my long letter. I appreciated any insightyou can give me.