Progression of PR to RA

[Lesleyvanessa]

Hi - does anyone on here know exactly how the Consultant decides when a person has gone from PR to RA and just as important how do I know myself??! - the signs and symptoms/blood results etc. - last time I saw him, my consultant told me to get in touch with my GP if I saw signs of synovial fluid in my finger joints but I do not seem to get ANY visible inflamation ever with any of my attacks and I am really worried that I will not be able to spot the 'signs' - whatever they may be?? especially if I decide to put off treatment for as long as possible - would be grateful for any info from anyone - especially those that have been through the experience
many thanks
Lesley

[Alaskan]

IMO only......... You probably wont notice much of a change, maybe some deformation of the finger(s) and or joints. The only way I know is a blood test and read the count.

Curious, why would you want to prolong getting treatment until you have too?

Curt

[Lesleyvanessa]

Hi Curt
thanks for your reply
As I have PR and not RA (yet!) my Consultant tells me there will be no destruction of bones going on - so I am mostly concerned at the moment with keeping pain levels right down and quality of life - also am trying to keep a very close eye for if and when it does become RA, as I realise that I will HAVE to start these meds. immediately - but for the moment I have a choice - do I start taking drugs which are extremely powerful and hard on the body, risking any one of many considerable side effects (the consultant's words not mine)- if I can control the pain (with painkillers) and work around any disability or do I put off the serious chemo type drugs until either I feel the symptoms cannot be controlled any more by painkillers alone or, most importantly, I start to develop full RA and do not have a choice any more - this has been my particular dilemma - the Consultant has told me that it is extremely important, once RA develops, to start treatment as it is very benificial but he does not believe that taking the strong meds whilst having PR will stop or slow down getting RA - in other words you will either go on to get RA or you won't, whatever treatment you have with your PR.
Suffice to say I still have not finally decided whether to take the meds sooner rather than later - my decision keeps changing whenever I have really bad days and then again when I have better days! (I never get a remission so far)
Lesley

[maudiemae57]

Hi Lesley,

I read your post, I'm sorta new to this site and was diagnosed with PR about 2 months ago so I'm still learning. I think one of the things you might not be thinking about is, the med's you take now may lead to periods without pain. From what I understand a person may go a week, a month, three months or even up to six months or a year without any pain or "flair-ups". And when you do have a flair-up it might not be as painful or last as long.
Four weeks ago I started taking 200mg a day of Hydroxychloraquine aka Plaquenil, it takes 6 - 8 weeks to kick in and start working. I think it's one of the first drugs a lot of people start out on. I'm still waiting for it to start working because believe me, I want this pain gone! I don't care for how long, I just want some pain free days. For me, I'd perfer this med. over pain killers. Over the counter pain relievers don't hardly touch my pain.
As for RA, whos know's if you'll ever develope it (let's hope not!) but a blood test at least once a year should be enough to alert you to it's onset. ~MM

[fulltimemum]

Hi, I asked the same question to my Rheumatologist and she told me that RA is not silent!!! She said that I will know if there is a progression because the flares (and pain) will continue for an extended period of time.

I too, have chosen not take any meds until it is absolutely necessary - in my mind, if my PR progresses to RA. I decided that while my PR was not causing damage, I had time to look at natural alternatives in dealing with my PR and soothing my immune system. I am allergic to all anti-inflammatories and given that panadol doesn't even touch the pain, this keeps me very motivated in trying to stick with my acid/alkaline diet, herbs and natural remedies prescribed by a naturopath and regular exercise. At this stage, I am feeling very in control of my PR and as soon as I go off my diet, I immediately get a flare the next day.

I am so, so happy that I have chosen to explore natural options first in reducing my flares. I believe that if I had gone on Plaquenil straight away, I wouldn't have realised that diet, natural remedies and exercices play a significant role in contributing to my flares. I know everyone's journey is so different, but I would encourage you to look at all your options first and see if they make a difference for you too. I went to my local library and got out every book there was on RA and read and read. And from there, worked out what I needed to do to combat PR without the drugs. In particular, I also see a doctor who specialises in evironmental and women's health and she has been so amazing in encouraging me to work with natural remedies.

All the best with everything.

[Lesleyvanessa]

Thanks Maudiemae for your response and I do hope that the plaquenil starts working soon - from what I have read/researched it is the mildest of the DMARDS and a lot of people say that it helps them in varying degress

Thanks fulltimemum for all the info - it is certainly worth me looking into - I have been trying to find if there is a naturopath within a reasonable distance to me but so far the nearest seems to be Cromer (Norfolk) and that is about 40 miles away - so not really feasible - but I shall keep trying - do they advise you on exactly what to eat and not to eat etc and do you know if perhaps other alternative types would do the same - ie homeopaths etc - i don't know much about alternative treatments as you might probably guess

many thanks
Lesley

[Lance]

My Rheumatologist told me that I am most likely to get ra due to a positive rh factor found in my blood work. My pr is migratory and maybe auto immune disease related along with genetic rh factor I have tried the plaquenil and other drugs I haven't been very responsive to treatments other than prednisone and pain killers. She also said that pr doesn't always turn into ra I think that we must do our own research and talk about symptoms to help find a cure. For me limiting activities that cause joint stress and and taking extra prednisone as soon as I have the slightest indication of flare up is what I do. I need a better treatment maybe I will find it here . Thanx