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waterproof*
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Discussion Starter · #1 ·
Because my PCP yesterday said to me that he doesn't know what I have and "you're not fitting into any of the usual boxes" and ordered some more blood tests, and because my painful swollen knee and sore stiff back are not getting any better with rest.

So I hit teh goggle and I think I've figured it out. I sent his nurse this note (obvious personal stuff deleted):

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Hi,

I saw Dr PCP yesterday and he ordered some blood tests which we expect back Monday.

Meanwhile I've been doing some reading and came across an article that describes Reactive Arthritis / Reiter syndrome and I think it fits well with my history.

Would you show this to Dr PCP for his consideration?

I'd remind Dr PCP of these bits of my recent med history:
- Epididymitis (staph) diagnosed and treated January 9th - 14th by Dr Urologist. Treated with Levaquin
- Campylobacteriosos diagnosed and treated by Dr PCP starting March 5. Symptoms onset about Feb 26
- Right knee pain / swelling starting about March 10.
- Dr Ortho1 (you have correspondence from him in my file) Friday March 13 drained Right knee, injected depo-medrol / prednisone. Knee was immediately better.
- Weekend of March 14-17 I hiked in rugged terrain, Right knee was fine but left knee became swelled up and painful. I tried RICE for a week, no effect.
- March 25 Wednesday I saw Dr Ortho2, for Left knee; he prescribed blood tests which Dr PCP ordered yesterday.

Article:
http://emedicine.medscape.com/article/331347-overview

Selected quotes from the article above:
- Reactive arthritis usually develops 2-4 weeks after a genitourinary or gastrointestinal infection.
- Both postvenereal and postenteric forms of reactive arthritis may manifest initially as nongonococcal urethritis. Mild dysuria, mucopurulent discharge, prostatitis and epididymitis in men, and vaginal discharge and/or cervicitis in women are other possible manifestations.
- The onset of reactive arthritis is usually acute and characterized by malaise, fatigue, and fever. An asymmetrical, predominately lower-extremity, oligoarthritis is the major presenting symptom. Low-back pain occurs in 50% of patients.
- Corticosteroids:
These agents can be used as either intra-articular injection or systemic therapy.
Joint injections can produce long-lasting symptomatic improvement and help avoid the use of other systemic therapy.
- Antibiotics

The current concepts on the pathogenesis of reactive arthritis indicate that an infectious agent is the trigger of the disease, but antibiotic treatment does not change the course of the disease, even when a microorganism is isolated. In these cases, antibiotics are used to treat the underlying infection, but specific treatment guidelines for reactive arthritis are lacking. ... No evidence indicates that antibiotic therapy benefits enteric-related reactive arthritis or chronic reactive arthritis of any cause.
Quinolones have been studied because of their broad coverage, but no beneficial effect has been noted.

Dr PCP, this sure sounds like my case.

I don't know if there's any value in doing an HLA-B27 test in my case?

I do know that my right knee responded well and immediately to the prednisone injection and has been fine since.

Thanks for your consideration,
Creaky.

who never really meant for his RBR handle to be quite so literal.
 

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Fat'r + Slow'r than TMB
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10,083 Posts
Creakyknees said:
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vaginal discharge


You looking in the wrong books :D Sorry, little medical humor. Well Dr House, basically after all the research it says you are hosed and hopefully it will go away after a couple of Motrin......medicine is all smoke and mirrors til the body heals itself. Did I say that?


http://www.mayoclinic.com/health/reactive-arthritis/DS00486
 

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waterproof*
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41,611 Posts
Discussion Starter · #3 ·
no way man, no more nsaids for me, they just don't do it.

I'm asking for the drain and Prednisone.

it was magic on the right knee, it should work on the left.
 

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Registered
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I don't know if "PCP" is code or not, but you should be dealing with an infectious disease specialist if you aren't doing so already.

Good Luck with that.
Pauly
 

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Fat'r + Slow'r than TMB
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Pauly F said:
I don't know if "PCP" is code or not, but you should be dealing with an infectious disease specialist if you aren't doing so already.

Good Luck with that.
Pauly
Hmmm in the lounge you never know but I think PCP = primary care physician.....or not.
 

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Fat'r + Slow'r than TMB
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Creakyknees said:
no way man, no more nsaids for me, they just don't do it.

I'm asking for the drain and Prednisone.

it was magic on the right knee, it should work on the left.
Just don't too many of those injections or in a few years we will be calling you Newknees.
 

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waterproof*
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41,611 Posts
Discussion Starter · #8 ·
Jupiter: yeah everytime an ortho looks at my left knee, which had a patellar fracture in '87, he starts talking about knee replacement.

Coop: Does ice cream counter inflammation?
 

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Fat'r + Slow'r than TMB
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Creakyknees said:
Jupiter: yeah everytime an ortho looks at my left knee, which had a patellar fracture in '87, he starts talking about knee replacement.

Coop: Does ice cream counter inflammation?
Problem with a replacement at your age is they wear out, especially with your chosen level of activity. So it wouldn't be just one but one every few years. Once you start cutting it will never be the same.
 

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n00bsauce
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13,507 Posts
Your PCP ought to get a chuckle outa that Creaky. Just let the doc look at the blood test first and be a good little man. Talk about impatient, you've had knee problems for about 2 weeks. Whatdaya expect, a miracle? It's hardly strange that once one knee has a problem that the other knee develops a problem later. You were favoring your right knee and putting more of your weight on your already bad left knee.

BTW, resist a knee replacement as long as you can without doing damage that would make an eventual knee replacement more problematic. Significant advances have been made in joint replacement making it much more feasible to replace joints in younger people. That said, the longer you can wait (up to a point) the longer you may go without a second operation. You have to be the judge about quality of life issues and how much chronic pain you can withstand.
 

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waterproof*
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Discussion Starter · #12 ·
Mel Erickson said:
Your PCP ought to get a chuckle outa that Creaky. Just let the doc look at the blood test first and be a good little man. Talk about impatient, you've had knee problems for about 2 weeks. Whatdaya expect, a miracle? ....
never in a million years. that's not how I'm built.

and I'll bet you 10 Lounge Points (tm) that I'm right, even before the blood test comes back.




Mel Erickson said:
..
BTW, resist a knee replacement as long as you can without doing damage that would make an eventual knee replacement more problematic. ...
amen to that. having some dude hacksawing away on my femur is really high on my list of things I don't want.
 

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n00bsauce
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Creakyknees said:
and I'll bet you 10 Lounge Points (tm) that I'm right, even before the blood test comes back.
You're on! Who's gonna hold the bet?
 

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Failboat Captian
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6,527 Posts
My mother had TKR on both knees a couple of months ago. I was shocked at how quickly she recovered. She's 67 and has been cleared for tennis and jogging already.
 

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waterproof*
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Discussion Starter · #15 ·
JohnnyTooBad said:
My mother had TKR on both knees a couple of months ago. I was shocked at how quickly she recovered. She's 67 and has been cleared for tennis and jogging already.

yeah the xray tech yesterday, a nice lady I'd guess mid-50's said the same thing. She said "don't wait too long because it's more difficult as you get older" but it apparently went perfectly for her.
 

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Banned
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6,360 Posts
I have no idea, but...

....if it comes to that, a friend of mine just had a double TKR at 54 or 55, and he says he wishes he'd done it at least five years ago. He got the same advice--wait or you'll need two--and agrees it was probably correct, but the relief has been so great he says he'll take the chance.
Of course he works for the Gov, and all his bills are paid...
 

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Lemur-ing
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It's not lupus or sarcoidosis.

You're pregnant. HTH.
 

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eminence grease
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18,538 Posts
It's your bloated BMI, when are you going to wake up and listen to me?

That and Schistisomiasis from eating unpasteurized Neopolitan ice cream.

I have an ongoing battle with Pernio, be glad you don't have that.
 

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Misfit Toy
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23,428 Posts
Creakyknees said:
Coop: Does ice cream counter inflammation?
Gawd I hope so, I've been shoveling it down for a week now.......


///snap will be the 300 pound woman in the corner at Cooper's
 

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waterproof*
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Discussion Starter · #20 ·
of course the big downside, besides being unable to ride and barely able to get out of bed in the morning: no drinking.
 
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