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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 06:06 PM
Well ... I still believe a defining characteristic of reactive arthritis is that it is "triggered" by an infection. The symptoms are "acute pain" in the sense that the pain is relatively abrupt and very painful and in my case precipitated an ER visit.

People who have AS don't seem to present this way but maybe I'm wrong. They seem to go years without even a diagnosis, just vague complaints of pain that slowly and progressively gets worse. Maybe people who have been diagnosed with reactive arthritis and later were changed to AS can weigh in on this. I do understand how reactive arthritis can "morph" into AS because they are so similar. After the onset of reactive arthritis , the chronic form of reactive arthritis becomes virtually impossible to distinguish from AS. That's just my opinion.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 05:31 PM
??? Pains are more severe at the night (Immune system punishes you for going trough the daily activities but not attacking your body when it rests) --- doesn't make sense so please clarify

Let me explain it.Pains are more severe at the night = late evening, end of the day (not the time when you actually lie and sleep)

In case of RA immune system does not want to attack your joints but it wants you to stop using them because it thinks that it compromises the overall infection resistance. In case of RA immune system reacts to physical activity in the joints and produces pain to force you to reduce such activity. It does not want you to move as it thinks it is bad for you. Because you sleep at night and do not use your legs in case of RA you should be feeling little or no pain at all, as your body would not bother to remind you about any problem. However shell you get moving then immune system will start sending pain signals "stop". It might sound strange but in the past people were dying from STDs and food poisoning - such a harsh reaction of immune system, demanding to stop any physical activities and rest could be logically justified.

In case of SA immune system WANTS to harm joints. It is attacking joints because it thinks there is an infection within (HLA-B27 confused for an infection). As immune system "curing process" works mainly at night (time of rest) people with AS have more pain during the night or early morning as it is when immune system "cures" (attacks its own tissue). During the day immune system is more passive and it does not attack your own tissue that much. So it is very important to take "immune suppressant" medicines before getting to bed to reduce the impact. Also per my understanding it is advisable for people with SA to live as much active live style as possible to not give immune system much time to be in "curing" (self-attacking) mode.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 05:28 PM
Were your inflammation markers ever outside the normal range --- being "rock bottom" is the same as anywhere else within the standard range i.e. normal. Furthermore, it is my understanding that inflammation markers are not necessarily indicative of AS --- meaning they can be normal with AS, remission or not. So, all the stuff about the inflammation markers is meaningless.

What is more important is that your symptoms are "gone" or "improved"? I would say it makes some sense to discontinue Humira if you have a viral infection. Five weeks is like you have already discontinued it. The real question is when should you re-start it. Better ask your doctor.

Glad you are feeling better.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 05:19 PM
You just asked this question a week or so ago and got some answers: http://forums.spondylitis.org/ubbthreads.php?ubb=showflat&Number=281670#Post281670

You may also find this helpful: https://creakyjoints.org/education/ankylosing-spondylitis/remission/

And this: https://www.rheumatologyadvisor.com...ion-challenges-and-goals/article/749919/

And this: https://www.clinexprheumatol.org/article.asp?a=7492

There is, unfortunately, very little data out there on the issue of remission in AS, hence all the articles (some of which I cited) in which doctors are calling for more research on the issue. Personally, I don't think you've been on a biologic long enough and symptom-free long enough to know if you're in a true clinical remission. Given the risk, however small, that the drug may lose efficacy if you stop and restart it and the risk, however small, that a different biologic may not work for you at all, I would want more evidence of a sustained clinical remission before stopping treatment. But I'm not you.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 03:50 PM
Has anyone tried the new Citrate-free Humira? I didn't realize it was out until someone mentioned it on a uveitis forum that I follow. No citrate means less pain during and after the injection.

According to the Humira website, changes include thinner needle, less liquid to inject (but still the same amount of adalimumab as before), and no latex in the needle cover for both the pen and the prefilled syringe.

https://www.humira.com/citrate-free
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 03:36 PM
So I had my quarterly blood work done on Saturday, which I'm required to do being on Humira, and had an interesting result.

I've been fighting off a wicked infection for weeks now (I think it was viral because when I started an anti viral medication I was better 5 days later) so I'd not been taking my Humira while waiting for the infection to clear. So the blood work I did on Saturday was a full FIVE WEEKS after my last Humira injection.

My SED (WSR) rate was a 2 (0-15 standard range).
And my C-Reactive Protein rate was <0.1 (<0.9 standard range).

In other words, my inflammation markers were about as rock bottom as is possible, five week after my last injection. Moreover, I'd had no pain or inflammation that i can feel. So I now have a couple of questions that, yes, I intend to talk over with my rheumatologist.

Is it possible the Humira kicked me into remission? (Five weeks, I'm sure, is probably not nearly a long enough time frame to tell). Could I be spacing out my injections even further than I already am (every three weeks prior to the infection)? How far apart can a person safely space the injections without the risk of building up antibodies to the drug rendering it less effective? And if I just stopped taking Humira (which I would not do without my rheumy telling me it was okay) do I risk the drug not being effective if I had to take it again at a future date? (I know there's some disagreement in the medical community about whether or not that really happens.)

I guess I'm just wondering, with those results, if stopping my biologic is in any way a realistic option? Or if I could monitor my inflammation markers a little more frequently and take it again if they begin to creep back up?

I'm just kind of thinking out loud here but I didn't know if anyone else here had an experience with their biologic putting them into remission and then being able to stop the drug.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 02:55 PM
Originally Posted by person42
The simplest way to check if one has AS is to check the following factors:
1. HLA-B27 gene is present (99% correlation for white people)
2. Pains are more severe on the morning than at the night (immune system is most active at the night so if it acts against its own body then pain would be worse early morning after it finishes its job)
3. Family has a history of AS because it runs in generations. (It is very important to check as for example my family has no history of AS or any other type of arthritis)
4. RM factor is negative (just to rule out rheumatoid arthritis)
5. Lyme test is negative (rule out lyme disease)

If nothing of the above applies to you then look for reactive arthritis.
1. Pains are more severe at the night (Immune system punishes you for going trough the daily activities but not attacking your body when it rests)
2. There was a case of urinary/digestive tract infection weeks/(1-2 months) before the first flare


I think your entire post is interesting but somewhat confusing in my case. I was diagnosed with reactive arthritis 25 years ago but it is possible that I was misdiagnosed. I agree that reactive arthritis presents itself as you described --- after an infection of the GI tract or urinary tract. My understanding is that the initial episode should resolve and new flares are triggered by new infections unlike AS which is chronic. Some have suggested reactive arthritis can somehow become chronic - just like AS.

I will apply the test that you suggest:

To check if one has AS:
#1 --- true, HLA-B27+ however a high percentage of reactive arthritis patients are positive just like AS
#2 --- true? - the pain wakes me up at night but tends to be more severe in the morning
#3 --- false? - no history that I know about
#4 --- true, RF negative
#5 --- true, negative for Lyme

To check for reactive arthritis:
#1 --- true? - the pain wakes me up at night and persists until morning but is better when I move around or after taking prednisone
??? Pains are more severe at the night (Immune system punishes you for going trough the daily activities but not attacking your body when it rests) --- doesn't make sense so please clarify

#2 --- false? - no infection 1-2 months prior to initial event that I can remember.

I generally believe it is hard to differentiate reactive arthritis and AS once it starts however reactive arthritis seems to have an acute onset. Both AS and reactive arthritis are strongly associated with uveitis also.

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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 11:26 AM
Alex, my symptoms are matching to the case of reactive arthritis (RA) triggered by ureaplasma/mycoplasma bacterial infection (Reiter's syndrome) the way it is described in some Russian medical sites. As bad as my symptoms are - there is nothing new. Symptoms of Reactive Arthritis are specific for every ethnic group and for what had caused it (urinary or digestive tract infection).

As I am HLA-B27 negative it is unlikely to be autoimmune disease like AS. And technically speaking AS is not an auto-immune disease like rheumatoid arthritis is. In the case of AS body is not attacking its own cells deliberately but attacking what it thinks is an infection. Problem is that molecular structure of gene HLA-B27 looks similar to many infections and makes body to attack it by anti-bodies. It does attack HLA-B27 cells slowly because it sees no real harm from them. Body is reacting to HLA-B27 purely based on some historical memories saying it that something of this nature should be addressed. And this process could be slowed down by modern medicines.

The simplest way to check if one has AS is to check the following factors:
1. HLA-B27 gene is present (99% correlation for white people)
2. Pains are more severe on the morning than at the night (immune system is most active at the night so if it acts against its own body then pain would be worse early morning after it finishes its job)
3. Family has a history of AS because it runs in generations. (It is very important to check as for example my family has no history of AS or any other type of arthritis)
4. RM factor is negative (just to rule out rheumatoid arthritis)
5. Lyme test is negative (rule out lyme disease)

If nothing of the above applies to you then look for reactive arthritis.
1. Pains are more severe at the night (Immune system punishes you for going trough the daily activities but not attacking your body when it rests)
2. There was a case of urinary/digestive tract infection weeks/(1-2 months) before the first flare

In the case of RA your body always should had had an infection and in most cases had successfully defeated it but it is still staying alert and trying to prevent it from happening again by reducing physical activities to the minimum. It is producing pains in the joints just to tell you to reduce amount of physical work you do.

In my case it was a urinary tract infection, but most often RA is triggered by a digestive tract infection (that why it was first recognized during the WWI where soldiers where very often food-poisoned).

It is important to notice that during the time when body was straggling with the infection the host (me, you, anyone else) did some hard physical activities that compromised chance of defeating infection. So body took it as a signal that physical activities is something person should avoid to be able to resist the infection in the long run. Even infection is gone at the moment your immune system is preparing itself for another round of it and creating a defensive barrier by eliminating all negative factors that affect its ability to resist. It considers moving joints as a negative factor and it punishes you or me for using them. It is just telling - lie down, rest, we are at the risk of getting infected. Body is not trying to harm you. It is trying to save you by making you ready to defend yourself against a new infection.

From what I read when a digestive tract infection is triggered by food it can make your body super-paranoid about food intake. So it can for a long time consider risk of reinfecting be very high and force you to remain passive (not moving joints) as it makes you more resistant to potential infection.

So reactive arthritis can run for a very long time (years) as long as your body gets irritated by food.

There is a book called Conquering Arthritis available on Amazon written by a lady who had RA for many years described how she completely got rid of it by preventing itself from eating food that suggests to the body that risk of digestive tract infection is real.

If your reactive arthritis was triggered by digestive tract infection then it can only go away when your body stop thinking that food you eat can cause reinfection.

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General Message Board for Ankylosing Spondylitis and Related Diseases
10/23/18 08:39 AM
Originally Posted by person42
Alex140. My symptoms are very much like your. I have knee pain and pains in toes. Unlike you I also have pain in a middle of my back (come a go), elbows, wrist, fingers, and in a place where my right leg connects to sacroiliac Joint. It started around a month ago and progresses every day. Every day I feel new joints gets involved. I am HLA-B27 negative (white male). From what I heard AS is 99% HLA-B27 linked when it comes to white people, especially of nordic origin (I am Russian living in the USA).

ESR is low,CRP is low, ANA negative, RM factor negative. Nothing was found on my knees and back x-rays but doctors want to make more that involve sacroiliac joints . I was tested negative for chlamydia however all my symptoms started after a contact of sexual nature (oral sex). The same like you I have no any visual symptoms, swelling on visual inflammation. I look healthy and my blood work is completely fine. Well, they found Herpes 1 and 2. Not sure it might be related.

Strangely enough I also was a video gaming enthusiast.

I was tested negative for Lyme however some homeopathic doctor found it using a strange Electrodermal activity sensors. From what I read it is a quackery and could be trusted. People just take advantage of situation and offer you a useless treatment to get money as nothing else helps. This doctor gave me some lyme medicine that does not work. However everything my RM gave to me does not work either. She gave me steroids and they for sure did not help but made me feel worse. I feel better on the morning, but as day progresses it is getting worse. At the night I even have muscle pain in my legs, it feels like burning waves or like blood has difficulties passing (mini explosions of some nature - may be Fibromyalgia). Another thing is I have headaches that started bothering me even before onset of joint pains and they come on the scull under the hairs not from inside the head. It was as bad as I could not sleep but now it is more mild.

I guess we are in the same boat for now. I have no idea how to survive this as I could not work (even sitting causing pain in the back and achilles tendonitis joints. There is no disability for this condition. Government does not recognize it as a valid reason for disability. I have mortgage and many other expenses. End of road to me looks like. I have no idea what to do as it is getting worse literally every day or even every hour.



Good lord, that's horrible. Wish there was anything I could say or do for you, but that sounds even more baffling and horrible than what I've had these past couple years. Raynaud Syndrome is the only thing I've heard of that even comes close to what you're describing, regarding blood having difficulty passing through your legs. I really hope you can get that figured out soon.

Originally Posted by Winston
The treatments are the same -- some combination of NSAIDs, DMARDs, and biologics. Hard to say about long-term prognosis. You can have a severe case of psoriatic arthritis that is worse than a mild case of AS and vice versa. But I think that, in general, people with AS (and, specifically, people who are HLA-B27+ and have AS) have a higher risk of extra-articular complications such as heart valve disease. Just curious -- how are your fingernails and toenails? People with psoriatic arthritis usually have problems with their nails, e.g., pitting, thickening, nails that peel away from the nail bed, etc.


To my knowledge, there's nothing wrong with my nails. At some point, a rheumatologist thought they may have seen pitting in them, but I don't see it.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 01:07 PM
Originally Posted by Alex140


So hypothetically, if I were to have PA, what would that change about my situation, if the method for diagnosis and treatment are so similar? Would I be worse off in the long run?


The treatments are the same -- some combination of NSAIDs, DMARDs, and biologics. Hard to say about long-term prognosis. You can have a severe case of psoriatic arthritis that is worse than a mild case of AS and vice versa. But I think that, in general, people with AS (and, specifically, people who are HLA-B27+ and have AS) have a higher risk of extra-articular complications such as heart valve disease. Just curious -- how are your fingernails and toenails? People with psoriatic arthritis usually have problems with their nails, e.g., pitting, thickening, nails that peel away from the nail bed, etc.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 12:50 PM
Originally Posted by Sean O


Do physiotherapists help with your neck?



Well, I'm 51 ... 52 in December ... and in the same boat as you. I have PsA and AS and my neck is my chief pain area. I was an avid weightlifter since age 19 and had NO idea I had PsA until age 48. So in that time I likely did a whole lot of damage to my neck lifting very heavy weights over my head. In addition to neck pain, I've had head pressure, occasional vertigo and tinnitus in my left ear. TWO things have made a difference.

One, Humira. It probably made the biggest difference in tamping down the inflammation in my neck. And two, finding a GOOD physical therapist. I stress good because I've been to some crap ones. One group did acupuncture, cupping and put my head and neck into traction for 10 minutes each time I visited. This did ZERO to help me and they seemed more interested in keeping me visiting than in helping me fix my issue.

Fortunately, I went to a head and neck specialist at Cleveland Clinic who recommended a great physical therapist in Toledo where I live. This guy has a doctorate in physiology. He zeroed in on exactly what my problem was and gave me some daily exercises to do (which take less than 10 minutes a day) which have made a world of difference. Once he taught me what I needed to know, and saw I was making progress, he said I no longer needed to keep visiting him.

The Humira managed the inflammation, as I said. But it was the physical therapy that tamped down the head pressure and tinnitus to reasonable levels.

I can tell you the four exercises I do each day if you're interested but they may not help you. My exercises are designed for my specific neck issue. That's why finding a really good physical therapist - one who will examine you and look at your MRIs and x-rays - is so key.

Oh ... and someone above mentioned swimming. BEFORE I'd started Humira, and before I found my good physical therapist, my wife and I took a vacation to Cancun. I firmly believe there are healing properties in warm saltwater because, for the week I was in Cancun, MUCH of it spent in the ocean, I forgot I even had PsA and AS. it was glorious. Unfortunately, while I make a nice income, it's not house on a tropical beach levels of nice.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 10:36 AM
for me swimming does the difference, though I must be careful every time die to my uveitis issues.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 10:13 AM
Alex140. My symptoms are very much like your. I have knee pain and pains in toes. Unlike you I also have pain in a middle of my back (come a go), elbows, wrist, fingers, and in a place where my right leg connects to sacroiliac Joint. It started around a month ago and progresses every day. Every day I feel new joints gets involved. I am HLA-B27 negative (white male). From what I heard AS is 99% HLA-B27 linked when it comes to white people, especially of nordic origin (I am Russian living in the USA).

ESR is low,CRP is low, ANA negative, RM factor negative. Nothing was found on my knees and back x-rays but doctors want to make more that involve sacroiliac joints . I was tested negative for chlamydia however all my symptoms started after a contact of sexual nature (oral sex). The same like you I have no any visual symptoms, swelling on visual inflammation. I look healthy and my blood work is completely fine. Well, they found Herpes 1 and 2. Not sure it might be related.

Strangely enough I also was a video gaming enthusiast.

I was tested negative for Lyme however some homeopathic doctor found it using a strange Electrodermal activity sensors. From what I read it is a quackery and could be trusted. People just take advantage of situation and offer you a useless treatment to get money as nothing else helps. This doctor gave me some lyme medicine that does not work. However everything my RM gave to me does not work either. She gave me steroids and they for sure did not help but made me feel worse. I feel better on the morning, but as day progresses it is getting worse. At the night I even have muscle pain in my legs, it feels like burning waves or like blood has difficulties passing (mini explosions of some nature - may be Fibromyalgia). Another thing is I have headaches that started bothering me even before onset of joint pains and they come on the scull under the hairs not from inside the head. It was as bad as I could not sleep but now it is more mild.

I guess we are in the same boat for now. I have no idea how to survive this as I could not work (even sitting causing pain in the back and achilles tendonitis joints. There is no disability for this condition. Government does not recognize it as a valid reason for disability. I have mortgage and many other expenses. End of road to me looks like. I have no idea what to do as it is getting worse literally every day or even every hour.

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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 10:05 AM
yes I am afraid...
I take NSAID 2 max 3 times per week only trying to manage the rest with swimming/yoga, even though many constraints in flexibility on my side and pain. Someone mentioned on this forum and somehow i am keen on this NSAIDs contribute somehow in destroying microbiome and further aggravating intestinal permeability.

I am also afraid of the Sulfasalazine I am currently on 3g per day including: kidney stones, hair loss, nausea, dry eye syndrome, but most of all infertility in males and foetus malformation, especially me and y wife are just married and most of all would like to have family.

I would gladly got of this crap drug, even for the price of pain, but cannot due to acute uveitis for which NSAIDS did not work.
For which brings me to the ultimate choice: for which I am also very afraid but you can see we have to take the stance of trying to forget and hope for the best because there are no other options or at least not very well managed/explained due to disease complexity.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/22/18 02:03 AM
I'm just confused aren't people afraid of side effects of nsaid and tnf?

It's like people take nsaid 3 times a day where I take it once and feel ill get a heart attack or something .
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/21/18 03:47 PM
Originally Posted by SouthernMoss
Psoriatic arthritis is seronegative. AS and psoriatic arthritis both come under the spondyloarthritis umbrella.

The increase in your general pain level does not necessarily mean you have permanent damage. There is not a direct correlation between pain and damage. The only way to know for sure whether you have damage is through imaging (x-rays and/or MRI).


Huh, didn't know that about PA. I guess I should be relieved about what you said about pain and damage, since I had an MRI of my left elbow about a year ago, and the only thing of note on the report was "mild" tendinosis. That concerned me for a while, until the doctor informed me that that actually just meant normal tendon wear and tear with age and use. That scan may be a bit old now, but even then my pain had already gotten pretty debilitating. I also had an ultrasound of both arms, and they didn't find anything of note then either.

Originally Posted by Winston
Alex140, have you been given the HLA-B27 genetic test? The genetic test is not 100% conclusive, but AS is strongly correlated with HLA-B27. Over 90% of people who have AS are HLA-B27+. AS and psoriatic arthritis are in the same family of immune-mediated diseases, but the link between peripheral psoriatic arthritis and HLA-B27 is very weak. So the results of the genetic test can help your doctor(s) narrow the list of possible diagnoses.


I somehow remember being told that I'm HLA-B27 negative, but I'll have to double check that.

So hypothetically, if I were to have PA, what would that change about my situation, if the method for diagnosis and treatment are so similar? Would I be worse off in the long run?
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/21/18 03:41 PM
Concerning small joints involvement, I had dactylitis in two or three toes and in two fingers and I'm pretty sure I had a psoriasis patch, a single one, behind my right ear that has cleared when I started Enbrel. My diagnosis was still AS based on SI erosion.

Sometimes my rheumy asks me if I have some psoriasis anywhere so maybe she's given me the AS diagnosis but she's still monitoring my evolution to see if it could be psoriatic arthritis instead. I'm also HLA negative.

Does PA cause SI erosion too?
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/21/18 02:29 PM
Alex140, have you been given the HLA-B27 genetic test? The genetic test is not 100% conclusive, but AS is strongly correlated with HLA-B27. Over 90% of people who have AS are HLA-B27+. AS and psoriatic arthritis are in the same family of immune-mediated diseases, but the link between peripheral psoriatic arthritis and HLA-B27 is very weak. So the results of the genetic test can help your doctor(s) narrow the list of possible diagnoses.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/21/18 03:46 AM
Psoriatic arthritis is seronegative. AS and psoriatic arthritis both come under the spondyloarthritis umbrella.

The increase in your general pain level does not necessarily mean you have permanent damage. There is not a direct correlation between pain and damage. The only way to know for sure whether you have damage is through imaging (x-rays and/or MRI).
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/21/18 03:37 AM
Sounds like a productive appointment. It normally takes multiple appointments for an AS'er to get diagnosed, so don't be disappointed that you didn't get an immediate diagnosis. The rheumy is taking you seriously, and hopefully the MRI will give you a definitive answer one way or the other.

Keep us posted.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/20/18 06:42 PM
I've already had a blood test for other autoimmune diseases. Supposedly, I don't have psoriatic arthritis, unless it's seronegative like AS, which I haven't been told.

So one other thing I've been wondering is, since AS seems to be a progressive disease, would treatment do less for me depending on how much worse my pain has gotten over time? Is the increase in my general pain level permanent damage being done to me that can't be reversed, or do I still have the same chance at feeling better that I would have two years ago? I know everyone is different and nobody can answer this definitively, I'm just throwing this out there in case anybody has some insight.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/20/18 06:29 PM

Just an interim update for anyone interested. Appointment was very good, doctor very interested and knowledgable, was dismayed with previous assessment of my condition and ordered blood test and x-ray. Blood test came back NEGATIVE for HLA-B27, which I understand might suggest it's not AS but is not conclusive (10% of AS patients don't have it is what I understand, right?). Anyway, there was enough on the x-ray for him to want an MRI so I'm now waiting to schedule that. Not sure how to feel about it- good news in some ways and bad news in that it feels like I'm not closer to a diagnosis of any kind. But at least I'm on the road to hopefully figure it out....thanks again for everyone's support and suggestions!
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/20/18 01:04 PM
All of those are considered small joints. Sausage toes and fingers are caused by a condition called dactylitis, and I think dactylitis is more commonly associated with psoriatic arthritis and rheumatoid arthritis than with AS.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/20/18 10:43 AM
Originally Posted by Sean O
For me October and November are typically the worst months of the year.

My pain control is not helped by the fact that I get nothing stronger than Tylenol No. 3s

Canada seems to be much more restrictive than the US on pain medication.

Also, I have some prednisone at home. Do you know the dose you take for a flare?


Yes, I agree, Oct-Nov are high on my list also.

I don't think Tylenol #3 will help much but may make you constipated.

Many years ago, the US gov't decided that it was everyone's right to be essentially pain free. Satisfaction surveys for health care providers were weighted heavily toward pain control. In order to get a good score, providers would freely give out pain medications. After all, it was taught, a person can't get addicted to pain medications if they were given for pain control. As a nurse, it seemed liked everyone rated ANY pain as a "10" and you were taught not to question anyone's perception of pain. Therefore pain pills were handed out like candy. This has created a huge market for pain medications and a huge problem as well.

Prednisone --- don't go there but anything greater than 5 mg is probably too much if taken longer than a few weeks but your system will probably recover. This medication is very risky.
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General Message Board for Ankylosing Spondylitis and Related Diseases
10/20/18 10:34 AM
What are considered small joint? Toes & fingers? Would ankles, wrists orcelbows be included? Would sausage toes and fingers also be an indicator? Thx!
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