flying visit between RA clinic and school run!
malificence don't have time to read back over thread, has your DH had ultrasound of shoulder done for diagnosis? xray's aren't much cop for such a complex joint. ultrasound picks up even mild problems, in terms of morphology. I'm mean, I've had fissures in tendons that hurt like bejaysus and can barely be seen, but ultrasound could see them. And I've had huge inflamed bursae and synovial capsules on exam that barely troubled me, but showed joint damage being done. ANd didn't show on xray. Dear god, my last ultrasound doc even advised against physio for shoulder problems. Everyone tells me to just guard it and get on with my life best as possible.
My take on Tramadol and pain, as someone who has a food/cigs addictive personality is that I take it when I need it and leave it when I don't. During my last bout of problems, I did worry about possible addictions (co-codamol and tramadol being used) as I was necking a lot, but with sustained use they really helped. If he has a problem, he won't get pain free, you have to accept that, but you do get pain managed enough. And when I had my last steroid shot, I dropped everything effortlessly, so glad to be clear headed again.
It is very hard work managing sustained pain in high levels. My heart goes out to your DH. Do make sure he is underpinning all other efforts with constant paracetemol and anti-inflammtory cover. It always suprised me when I have a big go round, how very much of a difference this makes, especially the paracetemol. Seriously, max amount of paracetemol and an anti inflamm like diclofenac.
I find the tramadol dozy making and usually save it for night. It is also slow acting, so I would have my 2 units of alcohol just before bed to relax all the tense muscles while waiting for it to kick in. Or take it a 1-2 hours before bed. If nothing works at night, get up and do quiet slow stuff arond the house. Distraction from pain related thoughts is very welcome. DVDs, internet, whatever it takes.
wgth I'm glad i've not broken unexpected idea to you then. the RF test needs your GP to add it to a normal blood form. It depends on your PCT if the GP can order an anti-CCP or not. Ask.
Pregnancy usually gives RA remission, though the bounce back into symptoms after delivery is often painful. RA has a far amount of hormonal stuff around it - women often get it at menopause, or after childbirth or at onset menstruation. Mine always flares when pre-menstrual and falls right back 3-4 days after Day 1.
If it did turn out to be RA I'd certainly be saying go go go on the TTC now, as many of the effective RA drugs can't be taken when PG or BF. In fact, with some of them you have to wash out for months before trying to TTC, so get in there while you can! If you join the forum at NRAS, you'll find actual conception and pregnancy boards directly related to RA. And we've all got loads of top tips for managin young families with limited mobility.
I've not needed RA private care, I am very lucky to live in Islington PCT area where they anti-CCP test and Rx anti-TNFs with merry abandon and high enthusiasm. Again, try the NRAS forum for better advise about your area and good private docs.
weird top tip
for shoulder pain that get unbearable and you're crying and pacing and swearing and all the muscles are spasming and you want to beat your head on a wall and there's no more drugs to take:
kneel on the floor, bum up and forehead on floor. let the affected arm relax out of socket with gravity. work on relaxing all those other shoulder/neck/arm muscles you suddenly realise are solid with tension. if no extra pain from this, stay there long as poss. seems to stop the spasming, and the rush of blood to the head always seems to help me calm down.