My doctor's appt, fibro, etc
#247982 - 02/22/06 08:07 PM
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lalala
Reged: 02/14/05
Posts: 2634
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Well, in addition, to the AWESOME pelvic exam and pap smear I had today (I'm being sarcastic, of course, but I took a lorazepam before the visit and it really helped me relax! I also wore colorful knee-hi socks and a sweater over my patient's gown so that helped me feel a bit more comfortable as well.), I also had SIX vials of blood taken from me. Not too bad.
My doctor said she wouldn't could give me a diagnosis of fibromylagia becuase there isn't a specific test for it and because it would require a diagnosis of exclusion. She said she felt she didn't know enough about it to give me those tests and come up with a diagnosis. She also wondered if it could be something else, like RA.
So she had me do bloodwork, set me up to see the rheumatologist on Tuesday, and gave me a prescription for 5 mg of amitryiptyline (Elavil) at bedtime to help me sleep and help with the pain. After I see the rheumatologist and go over the blood work with him, then I see my doctor to go over what the rheumy said. If they can't come up with anything, then they're sending me to a sleep medicine specialist.
I spent about an hour with my doctor today, and she really listened to me and let me read my list of symptoms and history of tests and diagnoses. I told her my worst fear was to hear that "It's all in your head." I said people, friends, family, and I know myself very well and I'm definitely not a hypochondriac and I'm definitely not getting anything out of being sick. She said that I'm a mystery, but that I seem to be doing all the right things when it comes to taking care of myself. She also said not to thank her until she and the specialists figure out what's wrong with me.
Here's what bloodwork was done (which I seem to be having done every two years):
Complete Blood Count
Sed Rate
Blood Chemistry
TIBC- This is a blood test that measures the total iron binding capacity (TIBC) as an indirect measure of transferrin. (medlineplus)
CPK - measures creatine phosphokinase an enzyme found predominantly in the heart, brain, and skeletal muscle...when the total CPK level is substantially elevated, it usually indicates injury or stress to one or more of these areas. (medlineplus)
TSH (thyroid)
RA Test (Every few years the docs think I have rheumatoid arthritis because I get pain and swelling in my hands, feet, and knees; however, last time, the RA factor test came back negative. We'll see how this one goes.)
I am so excited to see a rheumatologist! But what should I wear?
 Just kidding!
Thanks to all of you for being so supportive and encouraging me to advocate for myself. Whooo! I'm so glad this first step is over. I've been really depressed the past couple of weeks, missing a lot of work because I've been so fatigued and in so much pain. Now I feel like I have my doctor on my side and that's such a blessing! 
Edited by Maria! Maria! (02/23/06 09:34 AM)
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I'm so glad you've done this and even more glad that it went so well. I know you don't have answers yet but I think it's great your doctor really listened, was honest about her limitations, and is doing tests and referrals to get you on your way.
How clever of you to take lorazepam before your pelvic and pap! I had never thought of this, just always figured I had to grit my teeth and endure.
It's so interesting she gave you Elavil for sleep and pain. I hadn't heard of it being used for that, but I checked and there it was, right on MedicineNet - used for insomnia and chronic pain. You learn something new every day.
Good luck on Tuesday, please do let us know how it goes. Oh, and, what should you wear to see a rheumatologist? Something roomy, of course.
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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TOO FUNNY! I have a pap test today and had my GI test yesterday.
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Well, sounds like you are on the right track!! I think the colorful knee high socks would have been fun!!!
The Ra may run a couple of more test and may take some x-rays as well. It is possible to have RA and not test positive for the antibody. Hopefully the Elavil will help with your sleep. If your sleep improves, hopefully your pain level will also! I know my fibro pain is getting better from sleeping better. It doesn't help with the RA but I'm on "drugs" and physical therapy for that.
Good luck and keep us posted!!
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Taking it one day at a time.....
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I was wondering about the RA factor and if it can be missed in a test. I had this blood test done six years ago, I think, and it came out negative. My grandmother and my father have RA, so I was wondering if that puts me at a higher risk as well.
It's good to hear that your fibro pain is getting better because you're getting better sleep. I hope the Elavil helps, too. I think it might take a couple of weeks to work, though.
Thanks for your support! 
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Wow, you're getting all the fun tests done in one week!  Good luck at your pap test. I hope it goes by quickly. One of my doctors used to post a "Where's Waldo?" poster on her ceiling, so she would have her patients try to find him while she did the exam. 
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Thanks so much for your support, Sand! Yes, I was impressed with how honest my doctor was about her limitations. She said she also felt that it was good to get a "second set of eyes" to look over my symptoms.
One thing she asked me that I found interesting was if I've ever had psoriasis. I haven't. Now I wish I had asked her why. I wonder what she was thinking? Maybe she had a theory...
Quote:
Oh, and, what should you wear to see a rheumatologist? Something roomy, of course.
LOL!
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Ha! Must be the season for gyno exams, I had mine yesterday as well!
Your doctor seems to be handling the fibro diagnosis for you well. I think I had most of those tests run as well at some point, and Michelle is right, you can have RA even with a negative blood test. I would make sure they check your B12 levels as well, and maybe other thyroid tests if possible. TSH is the standard, but my hypothyroidism was not caught by two different doctors with just a TSH, since mine was on the high side of normal. My fibro doctor also tested my T3, T4, reverse T3, and thyroid antibodies which is how my hypothyroidism was found. Both the B12 levels and the thyroid stuff can contribute to fatigue problems, and the thyroid issues can cause sensitivity to cold.
Best of luck, and good luck with the rheumy next week! Keep us updated!
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Melissa
Friendship is thicker than blood. ~Rent
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It sounds like your doctor is on top of things and is caring. I have never heard of a sleep medicine specialist, maybe that's who I need to see.
I hope you get a diagnosis from the rheumy so you can get some rest and pain relief.
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Christie
~Hoping and Praying for Sleep!~
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Thank you! I'm writing down what you wrote about the thyroid tests and B12 levels. That's great to know and I will definitely ask my doctor about these tests at my next appointment. Yep, in addition to the fatigue, I really get uncomfortable and feel even worse when it's cold. Excellent info, Melitami. Thanks again!
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