Every now and then...

[KiaKat]

I don't totally lose my shit during a blood draw.

BG: I've had joint pain for most of my life. Generally I ignore it, go on with my day, and chalk it up to being a rather aggressive teenage athlete. If it gets really bad, I pop a couple OTC pain pills and carry on. Every now and then, it lays me flat. Usually it's a reaction to me having done something stupid (like run nine miles when my long run should be six), and sometimes it's totally random, with no apparent cause.

I've been skiing all winter, and it's been great fun. I have a season's pass to the local mountain, and I couldn't be happier. Last week, all those years of training kicked in, and I nailed a run perfectly. Then did it again. Then (after asking permission) destroyed the training course set up for the high school students. Then raced a couple people who thought they were bigger and older and therefore they could beat me (hah!).

Felt pretty good for a couple days, if tired and sore. Then the joints flared. Not just one joint, or one set of joints, but both shoulders and both knees. My usual routine of overload on naproxen for a couple days didn't do shite, so off I went to the doc.

Who immediately ordered x-rays and a full blood panel, including inflammation factors and rheumatoid factors.

*cue record screeching*

So here I am, in relatively serious pain, just hoping for a couple of PT sessions and some serious Rx-level anti-inflammatories, and I'm being told that I might have rheumatoid arthritis. Great.

The blood panels are fasting, so I was nil by mouth after midnight. Tests were a little before noon, so I'm hungry, tired (pain keeps me from sleeping), in pain, freaking out, and generally not in a good head space. And I haven't had caffeine.

The tech takes me back and goes to seat me in a standard seat. I um and haw for a moment, and start to ask if I can be put in the recliner. He anticipated what I was going to say, and immediately shifted me to the other room. Got me settled, gave me a few fingers to hold, and distracted me thoroughly. He also reminded me to breathe, which is something I tend to forget about when I'm mid-panic.

So here's to you, awesome phlebotomy tech. You totally get it, and you're freaking incredible at your job. I hope they give all the kids to you, because if you made me giggle, you'd make a kid totally crack up.

And here's to hoping it's not RA, and that my doc is just being overly cautious.

[KiaKat]

P.S. It's not RA. Test came back within normal ranges (though inflammation was on the high side of normal), so doc referred me to physical therapy. I'm looking forward to knowing what it's like to not have constant pain.

[MoonCat]

Glad it's not RA! I hope the physical therapy helps.

[Sapphire Silk]

P.S. It's not RA. Test came back within normal ranges (though inflammation was on the high side of normal), so doc referred me to physical therapy. I'm looking forward to knowing what it's like to not have constant pain.

Let me know when you find out. I can't remember what that feels like.

Getting old sucks.

[KiaKat]

Getting old really sucks. Therapist cleared me for skiing, but not running. Dammit wanna RUN.

Stupid knees.

[Sapphire Silk]

Getting old really sucks. Therapist cleared me for skiing, but not running. Dammit wanna RUN.

Stupid knees.

Running is high impact. Skiing is not. We do light jogging in Tae Kwon Do as part of our warm up. I can do about 3 laps and I have to drop out and power walk. Between my knees and my exercise induced asthma, I'm just not able to keep up.

[KiaKat]

PT cleared me for running a couple weeks ago - I've been tearing up the treadmill since! Can't wait for the trails to stop being flooded so I can hit those, too.

But.. PT also things I have a torn labrum or rotator cuff. Had an MRI yesterday, just waiting to hear back from, well, anyone, at this point.

[EvilEmpryss]

Did they test you for fibromyalgia? Your pain variances sound kinda like mine: low-level background pain that's always there but flares up sometimes to kill-me-now levels for no apparent reason and negative for other things like arthritis and lupus.

Regardless, I'm right there with you on the blood draws. Having a phlebotomist who understands the freakout and can head it off is a rare thing. There's a special place in my heart for those people.

[KiaKat]

The pain is very localized to specific joints, and most of it cleared with a couple weeks of PT. Fibro isn't on the table right now, I think it's probably something more injury-like.

[Seshat]

Having a phlebotomist who understands the freakout and can head it off is a rare thing. There's a special place in my heart for those people.

Worth their weight in copper*.


* getting to be more valuable than gold, these days.

[wolfie]

Did they test you for fibromyalgia?

I am not a doctor (and I don't play one on TV), but I was under the impression that it was not possible to test for Fibromyalgia. It's a diagnosis of exclusion - i.e. "we've tested for everything else that could cause those symptoms, and it wasn't any of them, so it must be Fibro".

[Seshat]

I am not a doctor (and I don't play one on TV), but I was under the impression that it was not possible to test for Fibromyalgia. It's a diagnosis of exclusion.

I'm a fibro patient.

The pain specialist listened to me, and my medical history. Then he had me lie on a table, face down. Applied very specific degrees of pressure to several very specific locations on my body.

The first one, I jumped and yelped REALLY LOUDLY. It HURT! The rest, I was ready for. Hurt no less, but at least I didn't scare patients in the neighbouring rooms.

It's an inadequate diagnostic tool; and was originally designed for use to determine who to use in a particular fibromyalgia study. But apparently with the right pressure in the right spots, fibro patients will react with involuntary pain responses for <some percentage> of the locations.

Last time I researched it, the reason it's inadequate is that it gives too many false negatives. (IE: too many patients who otherwise seem to have fibro and who respond positively to fibro treatments, don't pass the test.)


So the nature of my diagnosis:
* My symptom pattern matches fibro.
* Blood tests and other non-invasive/mildly-invasive tests show no indications for anything else likely.
* I pass the test described above.
* During an 8-week pain management program (two days a week, outpatient, but full-time days); the pain-specialised physiotherapists, psychologists, occupational therapists and doctors observed my body reacting like a fibro patient, and not like one of the other pain-patient types.
* Fibro therapies bring me some relief.

So ... kind of a diagnosis of exclusion, but also a diagnosis of observation, and there is an inadequate-but-useable fibro-specific diagnostic test.

Yes, this is anecdotal evidence over a statistical universe of one; but it's what I have to offer.

[KiaKat]

The unofficial diagnosis is severe chronic tendinitis. I have to wait for the specialist to read it for the official diagnosis and treatment recommendations, and to find out if there's anything the tendinitis is hiding (soft tissue tear, damage, bone spurs, etc).

Here's hoping I get the official before the weekend. I really don't want to go into work on Saturday and be yelled at because I'm not carrying 48lb cases of bubbly wine.

[Sapphire Silk]

I am not a doctor (and I don't play one on TV), but I was under the impression that it was not possible to test for Fibromyalgia. It's a diagnosis of exclusion - i.e. "we've tested for everything else that could cause those symptoms, and it wasn't any of them, so it must be Fibro".

There's a screening for it, though it is a small part of the picture. Fibro patients often seen many doctors before they get a diagnosis, and some physicians challenge the validity of it.

Hell, I once listened to two docs in the hospital bitching that the patient needed a psych referral for her pain issues, which just pissed me off (I was there to see a hospice patient, not the woman they were discussing, unfortunately, so I wasn't in a position to say something to them).

[Seshat]

Sapphire, have I told you recently that I'd love to have you in my medical team?


A psych referral can be valid for pain issues: one of the observed symptoms of fibromyalgia is neurological. Put a neurotypical person under an MRI, provide a mild pain stimulus, a small section of the brain lights up. Do the same for a fibro patient; you get neural fireworks. Looks almost like an epileptic fit.

Soooo..... they tried Epilim* on fibro patients. It helps reduce the excessive pain, for a significant percentage of us.
(*an epilepsy medication. Sapphire Silk doubtless already knows that, but some of the rest of you won't. )

..... the rest of my post is deleted because damnit, I started ranting.