ANOTHER "is this arthritis" question from me

[ktgrok]

So, the synovitis is back in my right hand, I think just mostly the index finger. It seems to be aggravated by reading on my phone, plus pulling weeds, etc. It's not excruciating, but I do notice it every time I use that finger for much of anything - opening a bag, turning a key in a door, pulling weeds (um...I don't learn), etc. It isn't as bad as last time, when I went to the orthopedist, as at that point just typing hurt badly and I can still do that. 

However...given that it comes back, and that my mom has a variation of inflammatory arthritis (RA negative) that started in her fingers, as does my aunt, and my son has two autoimmune diseases......should I, once I feel safe going, make an appointment with a rheumatologist? The regular doctor and the ortho said it was nothing, just take some heavy duty ibuprofen. Except I can't do that, because of my gastric surgery. I can take some, normal/low does, on occaision, but not a week of high dose like the wanted. I did take one aleve last night as it was hurting and I knew I'd be laying sod today and need that hand. 

I've had transient pain in my knee (that was relieved when my back issues got better in physical therapy). I've had similar pain in my big toes from time to time. I've had an xray of my hands last year, and there was some minor start of what looked like osteoarthritis which he felt was unrelated, and just a diagnosis of acute synovitis. But it happens off and on, and yes is triggered by overuse. Or, just repetitive use I guess, as I'm not sure that holding my phone to read a book is truly overuse? Maybe? My mom's started in the same finger, when she worked a job making phone calls all day and was dialing with that finger. She shifted to using another finger, and it happened in that one too....SO similar to what I have happen. But hers was very progressive (she also was a heavy smoker). Mine obviously is not. 

So, is this just normal for mid 40's? (has happened on and off since late thirties though at least). Or see rheumatologist? (I have that woman thing where you are always afraid a doctor will laugh and say you are being a big baby and wonder why you came in)

Oh, the times it was checked I did have some elevated inflammatory marker - I think sed rate, that was non sepcific and could just be that yeah, something was inflamed. RA negative every time checked. And it definitely is worse with overuse, which seems more like my mom's version than RA. (hers is most similar to psoriatic arthritis, but without psoriasis)

[Pawz4me]

Here you need a referral to get a rheumy appointment.

Before I was diagnosed with RA I had stenosing tenosynovitis (trigger finger), but it was in multiple fingers on each hand, and was much worse during the night/in the mornings, and it was a constant thing--every morning. Activity as I began to move around each morning made it better.

[PeterPan]

If you think it's going the direction of your mom, with inflammation but not the RA diagnosis, then what you need are other options that you can tolerate for anti-inflammatories, right? Have you thought about turmeric? Are there prescription meds they use for inflammation for people who can't tolerate ibuprofen? 

[ktgrok]

1 minute ago, PeterPan said:

If you think it's going the direction of your mom, with inflammation but not the RA diagnosis, then what you need are other options that you can tolerate for anti-inflammatories, right? Have you thought about turmeric? Are there prescription meds they use for inflammation for people who can't tolerate ibuprofen? 

I've taken curcumin/turmeric in the past, not sure it helped. At one point years ago I tried MSM, that did seem to help. 

There are biologic medications that are used but those have other side effects. 

[Pawz4me]

1 minute ago, PeterPan said:

If you think it's going the direction of your mom, with inflammation but not the RA diagnosis, then what you need are other options that you can tolerate for anti-inflammatories, right? Have you thought about turmeric? Are there prescription meds they use for inflammation for people who can't tolerate ibuprofen? 

For RA steroids are usually the anti-inflammatory of choice.

For osteo I know people who have good results from Celebrex (celecoxib).

Biologic medicines are generally only prescribed after a patient has tried and failed methotrexate and at least one other DMARD. I went through methotrexate and leflunomide before I was put on a biologic.

[PeterPan]

4 minutes ago, Ktgrok said:

I've taken curcumin/turmeric in the past, not sure it helped. At one point years ago I tried MSM, that did seem to help. 

Yeah, I take a pretty stiff amount of turmeric (3-4 capsules a day spaced out of a really strong one) and I still get these occasional things like you're saying of a finger just is painful. It's enough to keep down inflammation in my lungs, but doesn't stop the pain in my back or the issue with my fingers. But on my ds, where it definitely was following a pattern of synovitis on occasion (a knee, hip), the turmeric was enough to clear it right up. But it does seem to me if you've exhausted those options you're left with prescriptions.

I've heard about low inflammation diets and never had the gump to try one. 

Is there someone else, a different doctor, who would care about helping you get inflammation under control, or is the rheumy still the best choice if the type you have going on is what your mother has? For me with the asthma, the bigwig pulmonologist never really found me interesting. He was just here's a scrip, you're mild, whatever. 

[Junie]

Yes, I think you should get an appointment with a rheumy.

And, yes, there are other medications.

If you want to try supplements in the meantime, I have had a little bit of success in the past with bromelain (an extract from pineapple).

[*****]

I know you said you have felt it from using your phone a lot.  I had inflammation in my tall finger for over a year and I suspect it may be arthritis coming on (I sprained this finger as a kid).  My chiro suggested an ergonomic mouse, as I have been on the computer quite a bit lately.  I never knew there was such a thing.  I haven't bought one yet because I would like to try it out at the store, which has been impossible lately.  But I  am using my other hand more and changing my diet (did a water fast, stopped dairy and wheat). So yes, I would agree yours may be aggravated by more phone use.  Also, when I went to my chiro for other issues, he used a laser on my finger. This was during the same week that I did the above changes.  It has been 2 weeks and I am not feeling any pain, nor is it glitchy in my joint.  I am not sure which change did it , or if it has been a combination, but I hope the pain stays away! 

[PeterPan]

4 hours ago, ***** said:

My chiro suggested an ergonomic mouse,

I use a Wacom Bamboo pad as a mouse, have done it for years. Looks like now you can get other brands for as low as $40. https://www.amazon.com/StarG640-Ultrathin-Graphics-Battery-Free-Pressure/dp/B078YR2MTF/ref=sr_1_5?dchild=1&keywords=wacom+bamboo&qid=1591271320&sr=8-5  I'm on an imac, so technically I could be using their magic trackpad thing. I actually like this better. Mine is probably a big bigger than a half sheet of paper, and it has a couple programmable physical buttons. Probably the actual trackpad surface is 4X6. You don't have to use the stylus but can use your finger(s), and you can go into the settings and set it, just like a mouse, to do all the gestures. And on an imac (not sure about pc), you can customize those. My dh's fingers don't move so nimbly, so we we through each gesture and customized for what he actually could do comfortably. You can do that with both the apple trackpad and the drawing tablet products.

20 hours ago, Junie said:

I have had a little bit of success in the past with bromelain

Ooo, I didn't realize it was helping with the arthritis, though I should have. I started taking serrazimes as well based on the advice here on the boards. It *definitely* helps the arthritis in my back, because if I stop taking it I notice. I take 4 a day, don't know if I could go down at this point. I still get those occasional finger pain flare-ups, but it could be I would be getting *more* I don't know. I'm definitely not stopping it to find out, lol.

This is the one I take https://www.amazon.com/Supplements-Serrazimes-Systemic-Proteolytic-Capsules/dp/B0013OZA2K/ref=sr_1_2?dchild=1&keywords=serrazymes&qid=1591271904&sr=8-2  I'm not saying it's better than another, but it was a sensible price and noticeably works for my back. But the arthritis in my back is your really traditional osteo or whatever, shows up on xrays, responds to PT. Not sure if it would help the synovitis/inflammation kind or not.

Edited June 4, 2020 by PeterPan

[*****]

3 hours ago, PeterPan said:

I use a Wacom Bamboo pad as a mouse,

 

To be able to use it like a mouse as well as to draw with it sounds like a great idea, thanks!  Hmmmm, I couldn't think of what I wanted for Mother's Day, now I know what to ask for!  😉

Ktgrok, you mentioned taking MSM.  I have heard that is good to take.  Can you share any positives or negatives about MSM or maybe what it did do for you?  Thanks.

[ktgrok]

25 minutes ago, ***** said:

 

To be able to use it like a mouse as well as to draw with it sounds like a great idea, thanks!  Hmmmm, I couldn't think of what I wanted for Mother's Day, now I know what to ask for!  😉

Ktgrok, you mentioned taking MSM.  I have heard that is good to take.  Can you share any positives or negatives about MSM or maybe what it did do for you?  Thanks.

Seemed to help with pain short term,although i don't think studies back that up. 

[*****]

 

 

9 hours ago, PeterPan said:

I use a Wacom Bamboo pad as a mouse, have done it for years. Looks like now you can get other brands for as low as $40. https://www.amazon.com/StarG640-Ultrathin-Graphics-Battery-Free-Pressure/dp/B078YR2MTF/ref=sr_1_5?dchild=1&keywords=wacom+bamboo&qid=1591271320&sr=8-5 

Peter Pan, I tried to edit my post to add one more question, but it wasn't doing anything even when I gave a reason and hit submit button several times.  It has nothing to do with the real question on this thread either, so thought I would pm you, but that isn't working either!  So I will ask anyway, not meaning to hijack this thread!  (Others who are looking for help regarding arthritis pain may find any of these topics helpful is what I am always hoping for...)

We will need to get a new computer soon and I thought about getting a touchscreen due to the pain issues in my fingers, thinking that would be better than a mouse.  But if I purchase a tablet like you recommended, would I necessarily need a touch screen?  I guess it helps to be able to enlarge/shrink items quickly, and perhaps there are other benefits that I am not aware of.  I recently started to tutor online, so having the tablet would be helpful for quick writing as well as to use as a mouse...just wondered if you had any feedback, thanks! 

[prairiewindmomma]

I will circle back to:

1. Do you have morning stiffness exceeding 30 minutes?

2. Do you have bilateral symmetrical joints being affected?

3. Is more than one joint being affected in your fingers?

4. On days when you do nothing with your hands (ha! I know as a mom that's like never, but you know what I mean--non joint intensive stuff), do you have issues?

5. Is your daily life being impacted beyond annoyance? IE--are you ready to take heavy hitting meds? I'll be honest, almost no insurance company will pay for a biologic before trying and failing methotrexate, and a rheumy worth their salt will put you on plaquenil first, possibly in combo with mtx.  None of the RA meds are without their own forms of toxicity and risk, so you've got to say that the improvement in your quality of life is worth it.  For me, it absolutely is, but I'd do your soul searching now as you wait to get in for an appointment.

Those are the questions the rheumy should be asking you. Osteo is a part of life in your 40s, I think (at least in polling my friends).  I would focus on what qualitative stuff you are hoping to have improved. 

The questions I would ask would be:

1. Is there a chance this is early RA?

2. Are there medicines I can take that would be DMARDs that could slow/prevent progression? (And I would be prepared for them to mention plaquenil. And if they do, and if you want to take it, get a baseline EKG first.)

3. Are there joint protective things I should be doing now?

 

 

[PeterPan]

3 hours ago, ***** said:

 

 

Peter Pan, I tried to edit my post to add one more question, but it wasn't doing anything even when I gave a reason and hit submit button several times.  It has nothing to do with the real question on this thread either, so thought I would pm you, but that isn't working either!  So I will ask anyway, not meaning to hijack this thread!  (Others who are looking for help regarding arthritis pain may find any of these topics helpful is what I am always hoping for...)

We will need to get a new computer soon and I thought about getting a touchscreen due to the pain issues in my fingers, thinking that would be better than a mouse.  But if I purchase a tablet like you recommended, would I necessarily need a touch screen?  I guess it helps to be able to enlarge/shrink items quickly, and perhaps there are other benefits that I am not aware of.  I recently started to tutor online, so having the tablet would be helpful for quick writing as well as to use as a mouse...just wondered if you had any feedback, thanks! 

My tablet is quite old, so I don't fiddle with writing on it much. But yes, you could definitely work on writing with the stylus. For making the screen larger smaller, on a mac you can do CMD+ and CMD-  to zoom/shrink. Maybe you'd be happier on an ipad pro? I think just go to the store and try things and see what you think. 

[prairiewindmomma]

https://www.amazon.com/ajustable-teléfono-escritorio-avanzado-aluminio/dp/B0744DM3Y3?ref_=s9_apbd_otopr_hd_bw_b7ijcPL&pf_rd_r=FRXVC6BEJCXK91DAKCKD&pf_rd_p=bb646115-7988-56b6-9d58-4231047a5f21&pf_rd_s=merchandised-search-10&pf_rd_t=BROWSE&pf_rd_i=7073961011

This is the telephone stand I use, fwiw.  I absolutely cannot hold my phone all day. (Can people really do that? I never know what is normal.)