Fatigue/exhaustion

I need some ideas please. I have just been diagnosed with seronegative(no RF shows in the blood tests) auto-immune something with arthritis/lupus symptoms. I just got the phone call from the rheumatologist this past Tuesday. I have mailed out the RX for Plaquenil she wants me to start on. Well. Friday(2 days ago) the pain in my fingers was intolerable, and lasted that way for 24 hours. It is down to an 8 on the pain scale today, but the fatigue is awful.I feel like I did right after my hysterectomy. My Gyne said that I had fibromyalgia at that time, and I’ve been dealing with that for 2 years. I don’t know what to do for this exhaustion now. Of course it started on a weekend. I go to a pain clinic for the fibromyalgia, and have only seen this rheumatologist twice, once a year and a half ago, and then again last month. She ordered a bone scan that showed inflamation in most of my joints and gave me the diagnosis by phone last week. Is this typical for RA? I know that I sometimes overdo it when I feel good, but this is the worst this fatigue has been in ages. Thanks in advance for any advice you may have.

I am so sorry for your diagnoses.  I was diagnosed with RA when I was 24 in 1984.  Pain is a tough one.  What I would do is soak my hands in warm water  or have your hands dipped in wax - this can usually be done at an arthritis clinic or you can purchase a wax machine yourself.  Which if you can afford it, it would probably be more beneficial to save you the energy of making regular trips out. (Cold treatments don't work for me but may for you.) Pain at that level may benefit from morphine.  Make sure you take a gravol to prevent nausea.  I also take tramacet for pain. Pain in most joints and fatigue are two key symptoms of RA.

As for the fatigue, your body is telling you to rest and you must.  It needs the time to deal with your pain and inflamation.  My rheumatologist told me to rest at least 30 minutes twice a day.  Sleeping pills may help to make sure you get a deep, full sleep - as you know our pain usually prevents that. You may also have to think about some kind of antidepressant - with all that pain you can't but help feeling depressed and they do help with energy.

 There are naturopathic medicines to try.  Unfortunately none worked for me, my health actually got severely worse as my naturopath insisted I stop regular meds.  Everyone is different and responds to medications differently.

When you feel good I know it's hard not to over do it.  Remember you want the good days to last as long as possible and they won't if you over do it.

Sorry this is so long.

Thanks for your response Fin. I spoke to my rheumatologist yesterday and she wanted me to go to the ER since it was such a drastic change in my symptoms since she saw me in March. Well I did go and they did many tests, CT, chest X-ray, bloodwork… everything was Ok except for a slightly low level of potassium in my blood. So it must have been the fatigue from the arthritis, and maybe also from the uncontrolled pain. I must figure out how to pace myself.
Also, I just remembered that I had celebrex at home that I had never taken, and when she told me about the inflamation that showed on the bone scan I started to take that. I just looked up the possible side effects while I was writing this, and I wonder if that may have had something to do with it. I’ll call my Dr. tomorrow and ask what they think.
Thank you so much for your advice, it will help alot. I do have a parafin wax heater that my daughters gave me a few years ago, I’ll have to get that out and give it a try. I hope you are doing well and thank you again, I really appreciated reading your thoughts.

Hello, I RA Dr said that the blood test for RA only shows on 75% of the people with RA. So the other 25 has a hard time getting DX. So keep going to the RA Dr. It took about 8 vists before he DX me with RA. But the xrays and MRI shows it in a lot of my joints. One sure give away is it attacks the same joints on both sides of the body. So if its in your elbow then it will be in both. It can be in more joints than 1 but you get the idea. Good luck and try and have a great day. P.S A good RA Dr takes several vists to get a proper DX.

Jesse