Dx/Tx

Diagnoses

• Raynauds – 1974
• Rheumatoid Arthritis, possible SLE - 2007
• bilateral: trochanteric bursitis, chronic rotator cuff tendinopathy, plantar fasciitis, achilles tendonitis, tennis & golfers elbow:  ∞  itis
• Migraines – 2008
• Peripheral Neuropathy – 2009
• Undifferentiated Sponyloarthropathy – 2010

Treatment

• Exercise
• Physical Therapy
• TENS
• Medication
  • DMARDs:
    • Plaquenil (Hydroxychloroquine) 200 mg po bid
    • Azulfidine (Sulfasalazine) 1 g po tid
    • Methotrexate 25 mg (1cc) sq qw
  • BRM:
    • Cimzia 200mg sq q2w
  • NSAID:
    • Feldene (Piroxicam) 20 mg po qd
  • Steroid:
    • Prednisone 20, 15, 10, 15 mg
  • Other:
    • Calan SR (Verapamil ER) 300 240 mg po qd
    • Prilosec (Omeprazole) 20 mg po qd
    • Folic Acid 2 mg po qd (needed due to the mtx)
    • assorted OTC vitamins
    • Tylenol 1000 mg po qid prn (rarely needed, thanks to the biologic)
• Custom orthotics

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The rheumatologist originally said mixed connective tissue disease, possible SLE.  Two months later, he said that a CCP of 175 meant definitely rheumatoid arthritis and started me on my first DMARD.  After a year and a half I changed doctors; the new rheumy repeated all labs and added a zillion others.  CCP had returned to normal, and my diagnosis returned to mixed connective tissue disease.  After a few months of further observation, the diagnosis was changed back to rheumatoid arthritis.  After an additional year of observations, she suggested that it’s looking like undifferentiated sponyloarthropathy (instead? too?). 

discontinued meds:

• Enbrel
• Humira
• Ibuprofen
• Mobic
• DayPro
• Solaraze Gel (topical diclofenac)
• Maxalt

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