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Rheumatoid Arthritis (RA) Community
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Should I get a second opinion about rheumatoid arthritis ?

I am 24 years old I get swelling, stiffness and pain in most of my joints. They also seem to lock up from time to time. I have had a high white blood cell count (usually like 11.9 ) for atleast 2 years now. When I asked my primary care doctor about it I didn’t really get a straight answer other then take some Tylenol because my Ana blood test was negative. Should I get a second opinion or anyone have any ideas of what else this could be?
2 Responses
15695260 tn?1549593113
Hello and welcome to the forum.  We appreciate your question!  The onset for Rheumatoid arthritis to happen can be at any time but usually middle age and it can be hard to diagnose at the early stages.  Your doctor looked for swelling, redness and warmth in your joints and your reflexes most likely.  They always give a physical exam with RA.  Since you have that, they then did some lab work including an ANA test.  The ANA test is a good indicator if someone has RA but they can also look at things as a whole to make the determination if that is negative.  This link goes through some symptoms and diagnosing information for RA.   https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648  There are other lab tests that they do for RA as well as imaging that is almost always done to chart the progression of the disease.  Since RA is an autoimmune disorder, a negative ANA is a good sign, but not a confirmative one.  Have you had a the RA factor test?  This is important.  You don't mention it.  https://www.webmd.com/rheumatoid-arthritis/rheumatoid-factor-test  .  Having high white blood cells can be something that happens with RA but also can happen due to stress, exercise or infection.  It's simply a measure showing inflammation in your body.  I would think that another opinion is something you can look into, however, it is not urgent.  But it is curious that your doctor recommended Tylenol.  Is there a reason for that.  DMARDS or disease modifying agents are typically more along the lines of ibuprofen and a slew of other nonsteroidal anti inflammatory medications.  Talk to your doctor about this.  Perhaps Ibuprofen would be a better fit as that is truly used along with other nsaids and at varying dosages to treat RA.  There are other treatment options as well that are in the first link I provided but Nsaids are almost always the first line.  Let us know your thoughts.
1 Comments
Thank you for answering my question. My doctor said to avoid ibuprofen because it interacts with a beta blocker I am taking for blood pressure and tachycardia. She also said to avoid it because it breaks down in the kidneys which probably want to avoid because I have some kidney damage. I have not had ra factor blood test done. What exact does that one look for ?  I havnt had any scans done other then they saw some   sacroiliac degenerative joint disease when I had a abdominal ultrasound done. I probably am going to look into getting a second opinion once this Covid mess clears up. I kinda just wanna figure out what exactly it so I can keep whatever it is from getting worse.
973741 tn?1342342773
Hi!  thought I'd chime in here.  How is this going for you?  Have you followed up with your doctor? I know the covid19 situation means a lot of things are on the back burner that we need to work on health wise.  So, hopefully you can sort that out soon. Glad your doctor is guiding you with regards to medication.  I believe NSAID wise, ibuprofen is just one of many that are available so am not sure if there are others you could possibly take with your unique health situation. Your doctor will guide you, I"m sure.  Any suggestions that they've made for what you can take? Tylenol just doesn't have the ability to reduce inflammation the way nsaids do but hopefully helps with pain relief.  This article goes over the RA factor test.  https://www.mayoclinic.org/tests-procedures/rheumatoid-factor/about/pac-20384800 Basically, Rheumatoid factors are proteins produced by your immune system that can attack healthy tissue in your body.  If the test detects a high number of these, then it's considered likely you have RA.  
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