Consultant care

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Hello. I have osteoarthritis in many joints which are causing me considerable pain at times. I was diagnosed by a Rheumatologist. The reason I saw her was because a blood test I'd had at my GP surgery showed I had a raised Rheumatoid Factor however that wasn't one off and further blood tests showed it within normal limits. Today I see the Rheumatologist again and I have been forewarned she will more than likely discharge me. Does anyone see a consultant for their osteoarthritis? My GP is very good and sympathetic but in view of the pain I'm having I wondered I'd a consultant may be more appropriate.

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  • Posted

    The RA Consultant will work closely with the OA consultant as they will cross refer pateients.   Did you have x-rays and ultra-sound? If so when you see RA consultatnt ask if the pain you are experiencing is due to OA rather than RA and if so, ask her to write a referral either to your GP or to the OA guy to get help. 
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    • Posted

      Thank you sparkle for you quick reply which is very helpful in view of my appointment being this afternoon. I've had X-rays, lots of them and the show I have osteoarthritis but not RA. It sounds from what you're saying is that there is a consultant for OA which would help me enormously. Thanks again.
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  • Posted

    The problem is, research has shown that OA is only treatable with exercise/physical therapy/manual therapy, pain medication and surgery.

    Until such time as you need surgery - if ever - the surgeon isn't much use to you. Wrong skill set.

    Your GP will prescribe pain relief.

    The person therefore most suited to being an OA consultant would be a physical therapist. Yet the health system isn't geared up to provide care in this way.

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  • Posted

    Hi Matron. I was diagnosed with OA of the spine plus most of my other joints more than ten years ago by a rheumatologist. Since then I have only seen my GP's, some of whom listen to me and some don't. They merely say I cannot have a new spine!!! Just keep taking the tablets!!  frown As if i don't know this. I have had my pain meds upgraded to Tramadol as Codeine and paracetamol were not helping and the codeine caused lots probs including a great deal of abdominal pain. I was also taking diclofenac but they have removed from regular prescription as the Doc's said they're unsafe for elderly folk like me! (72) lol sad So what next? My spine problem is definitely worsening with age, I can't walk more than a couple of yards without severe pain and discomfort. I bought a mobility scooter and a wheely walker. These help but I now find the back pain is worse after use of either of them. I have to lie down after taking some Tramadol until the pain and cramps ease off. It also seems that every time I see a different Doc at my surgery, they try to get me to stop taking at least one of the tablets I use regularly. I think this is because surgery's are under pressure to do this to reduce medication costs to the NHS! Next time I go I intend to ask for immediate Euthanasia so as not to be a burden on the British health service or the government! frown At the moment I am really p***** off with pain and feeling ill all the time, getting more and more depressed and angry! I think I live in the wrong post code area as not much available here for oldies. Even the local council cannot afford the sheltered homes for us and are talking about selling them to private enterprize! We all know what happens then I think. rolleyes

     Sorry about my rant but I've had all this on my mind for a long time. My home help says I need to be more assertive with the Doc's! I think I'd be taken off their list and sent elswhere if I was. Hope you fare better where you live Matron.

    Best wishes, Ellie UK

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    • Posted

      ellie I have read your post and it made me think how our NHS is failing patients. I have been very lucky because I have an excellent GP (so popular you often have to wait 3 weeks to see her) who listens and never makes me feel rushed. Whenever a painkiller doesn't work she is happy to try something new. I had my rheumatology appointment today and I was given steroid injections in 3 joints and I have to return later for another and a scan of my hands. At my last appointment I was told I would be discharged at this appointment but because they think there is a possibility I have Rheumatoid arthritis (in my hands) hence the scan and another appointment following that. 
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    • Posted

      Thanks for your reply Matron. I had some blood tests 3/4 weeks ago but when I phoned for results the nurse said all had come back 'normal'. I'm having a trans vaginal and abdominal scan next Monday to check for ovarian cancer as my mother had it and passed away at 70. I nearly had to beg for these tests, the male gp's I've seen previously did not take me seriously. I believe they thought me an hysterical hypochondriac! The lady GP I saw last time did listen in spite of running late and being extremely busy that day. I have really bad low back/coccyx pain, water works probs which is why I went to see Doc again. Struggling to walk, do housework/stand etc for more than a few minutes then have to lie down. She's quite good and thorough if a little impatient! Fingers crossed my problem is "just" OA and nothing worse. I'll be glad when next weeks scans are over now and I can make another appontment with her all being well. She's a bit elusive! Wonder why?  Ellie UK
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    • Posted

      ellie I'm horrified to read the GP' reaction to you wanting to let you have that blood test. GP practice is all about prevention. Why don't you change your GP practice? I wouldn't stand for that.
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    • Posted

      I don't change Practice as it's local to my home and I don't have transport other than my mobility scooter. From what I've heard from others in this region it's no different at other surgeries. Post code lottery medicine and it seems we are a 'poor' area for funding. The cuts in NHS budget are always held to blame for shortcomings in hospitals and GP surgery's as they have to account for everything they spend now. It seems all,  'some' of the doctor's think of, costs to the surgery. I intend to ask if they'll put me down next time, It will help their budget don't you think? lol frowntwistedwink
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  • Posted

    PS. I forgot to add, I hope the GP's and local council read this and other post's on these forums. Time they all realised we don't WANT to be ill and chronic pain, it just happened unfortunately. No respector of governments or councils is PAIN!
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  • Posted

    Hello Matron, I have spoken to you before about Nefopam.  I have been to see my consultant today for my right knee and have been told i need a partial knee replacement because of Osteoarthritis. I have had my left knee replaced twice and i am only 59. 

    A consultant would not be able to prescribe you medication that is down to the GP, i asked today as i am on a number of meds and still in a lot of pain. Your GP will only refer you if you answer specific questions on a form and you pass the criteria. GP's are reluctant to refer patients, and i have read recently that GP's are being offered cash bonuses to not refer people.

    I have just been taken off Naproxen for my Osteoarthris in the lower spine because of long term use is not recommended due to stomach ulcers. I am now taking Nefopam, Gaberpentin and Codeine at night to help me sleep plus parecetamol if needed. However i declined another operation at the moment due to not wanting to go through more rehabilatation. I have been offered steriod injections and have been given 6 weeks to think it over. You say you have had steriod injections in some joints, have you had one in your knee at all? If so can you tell me how it was please. I have also had shortwave therapy which had no effect. My consultant said that without an operation all they can do is treat the symptoms ie pain with meds or injections. In years to come sssstem cell treatment will be available, i think it will be to late for myself. I think it is being trialed in America but not available yet. It does sound promising for future generations.

    I hope the injections help you and would be interested to know how it goes.

    Elizabeth.  

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    • Posted

      Hello elizabeth it's good to hear from you again. I understand now that consultants don't prescribe and fortunately I have a lovely GP who will prescribe what I need. I saw her in September and she reviewed all of my drugs and prescribed stronger medication as well. One morning I'd woken up and I couldn't move for the pain. I think I must have been laid in an awkward position so she decided I needed something if I was ever suffering like that again. I had the steroid injections in my knees as well as my shoulder and last night and this morning I don't have pain. My hands and feet still hurt but at least 2 joints feel ok. 

      You have a big decision to make and it's not easy. OA is a cruel disease one day they may come up with a cure but definitely not in my life time. Keep in touch elizabeth.

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  • Posted

    Hello Matron, I have spoken to you before about Nefopam.  I have been to see my consultant today for my right knee and have been told i need a partial knee replacement because of Osteoarthritis. I have had my left knee replaced twice and i am only 59. 

    A consultant would not be able to prescribe you medication that is down to the GP, i asked today as i am on a number of meds and still in a lot of pain. Your GP will only refer you if you answer specific questions on a form and you pass the criteria. GP's are reluctant to refer patients, and i have read recently that GP's are being offered cash bonuses to not refer people.

    I have just been taken off Naproxen for my Osteoarthris in the lower spine because of long term use is not recommended due to stomach ulcers. I am now taking Nefopam, Gaberpentin and Codeine at night to help me sleep plus parecetamol if needed. However i declined another operation at the moment due to not wanting to go through more rehabilatation. I have been offered steriod injections and have been given 6 weeks to think it over. You say you have had steriod injections in some joints, have you had one in your knee at all? If so can you tell me how it was please. I have also had shortwave therapy which had no effect. My consultant said that without an operation all they can do is treat the symptoms ie pain with meds or injections. In years to come sssstem cell treatment will be available, i think it will be to late for myself. I think it is being trialed in America but not available yet. It does sound promising for future generations.

    I hope the injections help you and would be interested to know how it goes.

    Elizabeth.  

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  • Posted

    Hi 

    The stem cell treatment has progressed to a massive clinical trial across Europe which is due to start before Xmas this year. Being co-ordinated across Europe by Ireland.   Arthritis UK web sites have details.  There are other things in development also which follow 3 trains of thought, depending on RA or OA. a) stem cell treatments to re-grow cartilege b) drugs to alter the chemical process within the joint c) a thing in the neck which controls the vagus nerve response to inflammation.   All are at clinical trial stage so major changes will take place in next 5 years.  These are all being done by Rheumatologists - not all are fixated by surgery and some are working on cures, working across disciplines. 

    BIggest thing is to get to lower end of your bmi scale - this makes big difference as every 1lb of weight is multiplied 20x on knee joint. Over the counter Voltarol is similar to naproxen but is topical so doesnt knaker your stomach.  

    Hope this cheers.

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    • Posted

      sparkle that is promising news. I regularly look on the Arthritis UK website but I haven't seen that information. I'll take a look. I have put on weight recently because I'm not as mobile and a 17 night cruise didn't help! Thanks again.
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