I just returned from my first appointment with a rheumatologist at my area's Medical University. WOW what a different experience this was from the one that I had with the private practice rheumy back in January!
This rheumy said that he takes into account the entire picture, not just lab results. He ordered more labs, but said that based on my previous positive ANA and SSB, in conjunction with the dry mouth & eyes, that he believes that it's probably Sjogren's. He's being very proactive and has already placed orders for a pulmonary function test and a lip biopsy.
Although I don't have a definitive diagnosis yet, I at least feel like this rheumy is listening to me rather than brushing me off and treating me like an overly anxious nincompoop!
i really hate being brushed off. i seen a doc that said he did not think i had sjogrens even though the pa did, and said just to use eye drops, biotene for mouth and lots of hand lotion and as for the over all joint and muscle pain, well he gave me a sample of some meds and said give it a try. got home and found out what he gave me was antidepression pills. i did not take them and was angry thinking he thinks this is all in my head. grrrrrrr. i have been put on prednisone from another doc for the over all pain. after prednisone the pain eventually comes back. going to new reum who treats sjogrens and even if test do not come back possitive for sj he trys treating the symptoms, so we will see.
I don’t test positive for SSA or SSB yet. My doctor is more than happy to treat my symptoms as I have another autoimmune disease. Interestingly, even without testing positive, I have developed neuropathy related to Sjogren’s, small fiber neuropathy.
I don’t test positive for anything, so I am very thankful that I have a doctor who does not rely solely on lab tests.
That's not why he prescribed antidepressants. Antidepressants are among the most effective medications in controlling fatigue and pain from auto-immune disorders out there. In fact one of the SSRIs (Milnacipran) was developed specifically for FMS. First line medications for SS include antidepressants and even use a combination of SSRIs and tricyclics.
Incidentally SS is very MUCH in your head as your ductless glands are controlled by the very brain centers effected by anti-depressant medications. As Stoney has sadly learned small fiber neuropathy one of the forms of very severe SS also comes from the head. (the tests are are real bear)
Its YOUR responsibility to ask why and wherefore of every medication and treatment your doctor prescribes. Chances are if you second guess based on what you think you know or got from Dr. Google, you will likley be wrong.
I don't know what all went on with your doctor, but to say he wasn't willing to treat you isn't right. And whoever prescribed prednisone for suspected SS should have a practice review. THE LAST thing you mess with with SS is the adrenals until you know the who what and where of the disease function.
yellow rose said:
i really hate being brushed off. i seen a doc that said he did not think i had sjogrens even though the pa did, and said just to use eye drops, biotene for mouth and lots of hand lotion and as for the over all joint and muscle pain, well he gave me a sample of some meds and said give it a try. got home and found out what he gave me was antidepression pills. i did not take them and was angry thinking he thinks this is all in my head. grrrrrrr. i have been put on prednisone from another doc for the over all pain. after prednisone the pain eventually comes back. going to new reum who treats sjogrens and even if test do not come back possitive for sj he trys treating the symptoms, so we will see.
I have to admit, initially I wasn't at all impressed with my Rhuematologist. His bed-side manner is awful, but I have to admit I feel better than I have in years. The chronic fatigue has eased quite a bit. I thought he was a little whacky when he prescribed an anti-depressant, but it has helped tremendously. I'm still "tired" but it's the kind of "tired" associated with working two jobs, not that debilitating fatigue. My eyes have improved with Occuvite and Omega 3, but not close to 100%. Is see the eye doc this weekend.
There's help out there if you get someone that will listen. The Rhyematolgist in my area wouldn't even see me because I cancelled an appointment with her three years ago. Seriously? If that's the type of doctor she is, I don't want to be seen by her. I'll stick with the doctor that is helping me . . . even if I have to deal with his bed-side manner!
The anti-depressants have helped me more than I could have imagined. I was not 'depressed' but desperate for help with Sjogrens, so I gave them a try. Less than a month after starting the prescription, I feel like I can live a normal life at this point. I still get tired, but not that horrendous chronic fatigue. I can accomplish so much more. The anti-depressants increase the seratonin (sp?) levels, which have resulted in much more restful sleep and help with the aches while sleeping. I feel human again and I am forever grateful to my doctor!
tj1 said:
That's not why he prescribed antidepressants. Antidepressants are among the most effective medications in controlling fatigue and pain from auto-immune disorders out there. In fact one of the SSRIs (Milnacipran) was developed specifically for FMS. First line medications for SS include antidepressants and even use a combination of SSRIs and tricyclics.
Incidentally SS is very MUCH in your head as your ductless glands are controlled by the very brain centers effected by anti-depressant medications. As Stoney has sadly learned small fiber neuropathy one of the forms of very severe SS also comes from the head. (the tests are are real bear)
Its YOUR responsibility to ask why and wherefore of every medication and treatment your doctor prescribes. Chances are if you second guess based on what you think you know or got from Dr. Google, you will likley be wrong.
I don't know what all went on with your doctor, but to say he wasn't willing to treat you isn't right. And whoever prescribed prednisone for suspected SS should have a practice review. THE LAST thing you mess with with SS is the adrenals until you know the who what and where of the disease function.
yellow rose said:
i really hate being brushed off. i seen a doc that said he did not think i had sjogrens even though the pa did, and said just to use eye drops, biotene for mouth and lots of hand lotion and as for the over all joint and muscle pain, well he gave me a sample of some meds and said give it a try. got home and found out what he gave me was antidepression pills. i did not take them and was angry thinking he thinks this is all in my head. grrrrrrr. i have been put on prednisone from another doc for the over all pain. after prednisone the pain eventually comes back. going to new reum who treats sjogrens and even if test do not come back possitive for sj he trys treating the symptoms, so we will see.
That's funny….my doc went to Plaquenil first and has not so much as whispered the word anti-depressant. Not complaining, just curious. I never heard someone say that they & ssri's are the first meds used. I have peripheral nerve damage from SS but the neuro went with Gralise for that. Hhmm…..