Wow what a thorough evaluation. He was a very
nice doctor who didn't mind answering questions.
He asked if we minded that an intern sit in.
First of all he checked all her joints had her do
various muscle-joint movements to see how her
range of motion was, then he took out the hammer
to check reflexes. Then he evaluated her current
symptoms to those he saw, and ordered more
blood work and he was concerned that she may
have an underactive thyroid. So, based on his
evaluation, but not getting the other blood test
results yet he is thinking that it can be numerous
things rather than just one problem:
!. Undifferentiated connective tissue disease
He wants her to continue on the plaquenil,
prednisone, and trilisate, and to add
skelaxin (muscle relaxant)
also he wants her to stop the gold injections because
he seems to think that she doesn't have rheumatoid
arthritis even though her ra factor was high?
we are confused !!!!
this is a totally different diagnosis ????
Undifferentiated Connective Tissue Disease means that it could be MANY different ones all wrapped up into one. It basically means that your mom fits into different autoimmune diseases.. like Lupus, Scleroderma, Raynauds, etc. Basically if a person was to draw up your mom's symptoms on a chart, and you made circles it would be like this. One heading would be SLE and then her symptoms. Overlapping that would be Scleroderma and then overlapping again would be the Rheumatoid factor. So basically what it means is that she has overlapping disease processes. This is a much better diagnosis than the prior ones, that other Rheumy didn't even know what he was talking about! I am not completely convinced that your mom has Fibro, just from what you have said but perhaps? I am unsure how he came to that conclusion!
The Osteo's can be from the Prednisone. It can cause bones to become brittle. Make sure your mom is taking a calcium magnesium supplement every day to ensure good bone structure.
I think why he is taking her off of the Gold injections is to "see what happens" with her blood work and body. That way, he can better assess her for the Rheumatoid Arthritis. Its all good girlfriend!!
I am so glad that this one is on the ball. Remember one time I think I mentioned an overlapping syndrome? Well that is what is going on with her. Basically he will watch her well and treat her and see how she does. It sounds like you are in capable hands!! Woohoo. Take care Deb!
we are confused though because we though she has lupus?
I guess that lupus is a connective tissue disease ?
I don't understand why he is separating all her symptoms into
I don't understand the fibro either, but I know muscle pain goes
along with lupus.
He took out 5 vials so maybe he can better pinpoint the diagnosis.
Also her reflexes weren't good and that is what prompted him to
say about her thyroid.
Lupus is only part of her diagnosis as far as I can tell. This doesn't mean that she doesn't have Lupus- just that there is MORE going on than just the Lupus. It means that she is complex, and has a number of autoimmune problems going on here. No worries Deb, he may be able to isolate things better, undifferenciated Connective Tissue disease doesn't mean that he has no clue what is going on, but he has packed every diagnosis into one package. She still definitely has Lupus, but he probably thinks that she has Scleroderma, Raynauds Phenomenon, Rheumatoid Arthritis. Like I said, its an "overlap" disease process. The Undifferentiated part doesn't really mean that its not pin pointed, but more that she has an overlap of many symptoms that are part of the above diseases that I said. Don't worry- she still has Lupus that is causing lots of issues! Hopefully he can diagnose the definitive Scleroderma.. then it may be called "Mixed connective tissue disease" meaning that there is a number of things too. Who knows! Let's wait for the blood work. Try and get a hold of it k? Then I can have a peek and see whats going on. I am glad that this Rheumy actually cares though!!