Re: First visit with RD
Some days doc's are in a rush and you never know why...giving a speech somewhere, hospital fund raiser, personal stuff...who knows. But it does happen. Don't judge her by this first appointment.
Wait on the blood work. A negative rheumatoid factor is inconsequential.....25% of those with Ra are negative. A negative ANA is not a big deal either as the ANA can go up and down and from many different things...including medications. What she is now running are the more sensitive tests.
But having battled with autoimmune for the past 35 years, I know how frustrating it can be as I'm still sero negative. I had bad OA for years and years and got upgraded to having RA 7 years ago but just last month, my doc admitted I probably had Ra all along but a rare form that hits soft tissues instead of joints. I've battled tendinitis in just about every joint in my body for the past 35 years. It Ra tendinitis...no way to test for it. But it all went away when I started a biologic drug for Ra and when they had to stop it for surgery, the joints stayed okay but all the tendinitis came back. Surprise! BTW, my Ra was finally diagnosed by MRI...it picked up the swollen synovial membrane around my wrist.
The problem with autoimmune disorders is they know about a lot of them but they don't have good tests for any of them. For Ra, they have "criteria" where you have to 4 out of 7(and only 1 is blood work) and I think lupus is 6 out of 10 criteria. That is how they diagnose these things....how many do you have, what they are and what category does it fit it.
The best way to figure it all out is to find a doc you do like and stick it out with them while they put the puzzle together.
Bruising around a joint can come from different things too. I had a wrist that kept bruising and it turned out to be a sharp bone spur that was right under a blood vessel and it kept breaking it open when I moved. Tendons can get so swollen they will get small tears in the tendon or the tendon sheath and that produces bruising as well. Vasculitis is a remote possibility but that tends to make you really sick as it doesn't just hit a joint or 2 but tends to affect the entire body and when it affects the brain, you know it. And your Sed Rate should be sky high with that as well as the CRP.
It's a tough, tough field to work in. So many people just don't present with anything concrete and it becomes a waiting game until you know enough to make a firm diagnosis. My doc is wonderful but he kept injecting those darn tendons until my entire body started to freeze up and still, no Ra diagnosis....he simply had never seen anything like what I have so he didn't know. But as soon as 1 joint swelled up and turned red, I was in the MRI machine and getting diagnosed. The Ra tendinitis came from cause and effect...stopped the meds and it all came back. Shocked me for sure...him too.
So hang in there and see what comes from the tests. If she rushes you again, then consider finding someone else unless you feel strong enough to confront her on it. Then you get copies of all your test results and go looking. It's hard finding a good doc who takes their time with you. I found one and will never let go! He's worth his weight in gold....even if he did miss a diagnosis for way too many years.