Let’s delve into some crucial topics brought up by my newsletter readers: how to handle the wait for your rheumatology appointments, the mystery of morning stiffness, and dealing with joint pain.
Palindromic Arthritis: A Closer Look
One of the most intriguing conditions I frequently encounter is palindromic arthritis. This type of inflammatory arthritis comes and goes, causing intense but short-lived joint inflammation and pain. It tends to affect the joints of your hands, fingers, knees, and shoulders. Unlike gout or CPPD (pseudogout), which can have similar symptoms, palindromic arthritis doesn’t involve crystals in the joint fluid. Instead, it affects the structures around the joint, like tendons and ligaments.
You might be wondering, “Is palindromic arthritis the same as rheumatoid arthritis?” Well, no, but it can sometimes lead to RA. Studies suggest that 25-70% of people with palindromic arthritis may go on to develop rheumatoid arthritis. Most of these patients have positive rheumatoid factors and anti-CCP antibodies, which can increase their risk.
Managing the Wait for Rheumatology Appointments
We all know that getting in to see a rheumatologist can take forever. So, what can you do in the meantime? First, make sure you’ve exhausted all options to get seen sooner. Ask to be put on the clinic’s cancellation list, and see if there’s another doctor in the practice who can see you sooner. Flexibility is key here, folks!
Another option is to look into cash pay consults. These out-of-network appointments can get you in front of a specialist more quickly. Yes, they can be pricey—ranging from $300 to over $1,000—but they can be a valuable stop-gap while waiting for your in-network appointment.
How Primary Care Doctors Can Help
Don’t forget to involve your primary care doctor (PCP) while you wait for your specialist appointment. Schedule a follow-up specifically to let them know about the wait time and to discuss short-term solutions. Your PCP can help monitor your kidneys, gut, and heart while you take anti-inflammatory medications. They can also prescribe prednisone if needed, call the specialist for advice, or even expedite your appointment. If your symptoms are severe enough, discussing short-term disability might also be worthwhile.
Morning Stiffness: Easing Joint Pain
Morning stiffness is a hallmark of inflammatory conditions like RA or lupus, but even those without an autoimmune condition may experience it if they have osteoarthritis. The reasons behind this stiffness vary. In autoimmune conditions, it’s related to our nervous, immune, and musculoskeletal systems. In osteoarthritis, the stiffness is due to mechanical joint factors.
In OA, the cartilage lining the bones of the joint wears down. After a night of lying down, the unlined cartilage can gel together, causing stiffness when you start to move. This can happen after any period of inactivity, like sitting in a movie theater for two hours.
So, what can you do about morning stiffness and joint pain? One simple tip is to add a series of stretches when you get up in the morning. Whether in bed or right as you get up, moving your joints helps warm them up and re-lubricate them, easing the stiffness.
You might also find a hot shower or putting your hands in warm water helpful. Another tip I got from a patient is to put on an extra blanket or two in the morning to warm up your body. Most of us sleep better in a cold environment, but this can leave us feeling wooden in the morning. So, covering up with blankets as you read in bed can help you ease into the day.
And don’t forget to think about the night before. Overworking your hands or other joints before laying down can set you up for a tough morning. Consider using an electric toothbrush with a wide handle or changing when and how often you wash your hair to give your hand arthritis a break.
Hope these insights and tips help you navigate your journey with rheumatoid arthritis and related conditions. Remember, working closely with your healthcare provider is crucial for managing your symptoms and getting the care you need.
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