I really need some help so would be grateful for any advice! I'm having a really bad flare up and it's probably the worst it's ever been!! My knee is actually swollen to look at and I have only ever had one swollen joint before and that was my thumb. I'm 22 years old and have been diagnosed with arthritis almost two years ago, I think. I have been on methotrexate around 8 months, which I am really struggling with as it makes me really really ill, even just the thought of it makes me want to throw up! Methotrexate is my second medication I have tried as the first option didn't help, but I fear methotrexate isn't working now too!! I've struggled to do anything this week and I'm desperately trying to get an emergency appointment at the hospital for a steriod injection but I am unable to speak with anyone over the phone.
Does anyone know if I just went to hospital like to A and E, would they be able to give me a steriod injection? Or is this not acceptable and would I be wasting their time as 'not an emergency'? I'm really desperate and in so much pain please does anyone have any advice?
i don't know if it's the same for you, but I have a number to call for advice, the rheumatology nurse. I have done this several times and they can ask the consultant for advice/ then medication via GP. I have had this once for steroid jab, another time for increase in meds, another time she was able to book me into the flare clinic the next day at the hospital. I doubt A and E could help as this was all run by my consultant , even though I didn't actually see him. Hope you have a number to be able to do this.
I'd be so tempted to go to A&E too. But I think it would be best to try other options first.
Try calling your doctor and telling them it's an emergency (I would say it is as swelling for any length of time in RA is a sign that joint damage is actively happening, which needs addressing to avoid future joint deformaties). Doctors surgeries often have slots reservered for emergency patients. If the doctor deems it to be necessary, he/she then may be able to call ahead to a hospital and get you seen to relatively quickly.
The only other thing I would suggest is an NHS walk-in centre. I'm not sure if they'd be able to administer an injection then and there, but again they may be able to arrange some help for you.
I had a similar situation a while ago. My feet were crippling me so I hobbled to the doctor and asked to be seen. They said they there were no appointments that day. But I was so desparate that I started crying and told them that I was happy to sit and wait all day just in case they had a cancellation. I felt pathetic, but they were very understanding and managed to fit me in pretty quick. Not something I would recommend though
I assume you are in the UK so try calling 111 and ask them for advice. They will advise you - they aren't all bad if you've heard bad things about their service. They are more likely to tell you to go to A&E than dismiss you though.
A GP should also be able to send you to hospital - and this would be an emergency as far as they are concerned.
But as Rowbirdie says - you should have access to a rheumatology specialist nurse. My experience of one was I was told she'd call me back and nothing happened in the next month so it wasn't much use!
Frankly though - if you are in so much pain I doubt A&E would accuse you of time wasting - so I wouldn't rule out going there.
Hi Laura; as an ex ED staffer, it really is only for Accidents and Emergency (meaning has this only started today/last few hours after normal GP's working hours)? However, if it were me answering your call as the Triage, I would suggest you firstly, ring an After hours clinic,explain your Pain Level (they should ask "out of a score of 10"....you reply 11 + ), hopefully they can give you a shot of Pethidine/morphine or something similar, to get you through the night; and advise you to ring your Rhuematologist first thing in the morning, as they are really the only ones who can administer Cortisone into your joint? (in Australia anyway). If you try this, and get no results, then ring the ED, explain that you have tried other avenues (eg the after hours clinics)...and explain to the person answering, exactly the above....tell them you are hoping that they can give you something for the pain (don't mention what, as you will be classed as an abuser of Narcotics)....hopefully they will adminsiter a stong analgesia, to get you through the night, and they too will advise you to ring your Rhuematoligist first thing in am....hoping this gives you something to work on? Will be waiting to hear how you get on......Bron
I assume Laura is in the UK. Here the A&E department functions as an after-hours clinic for anything much more than needing a prescription for abx. There are no walk-in ones outside very large cities - the 111 number I mentioned is the equivalent.
Nor is it possible to "ring your rheumatologist in the morning" - all NHS specialists provide their services from a hospital department with clinics for out-patient access unless they offer private consultation for megbucks which is NEVER covered by the state system. Laura says she has tried calling the hospital for an emergency appointment but can't speak to anyone. Hence her problem.
i think your gp can do a steroid injection in the backside. I am not sure about In the joint as I had mine done in rheumatology clinic. But pester your gp or rheumy nurse. As someone said, you could at least get a strong painkiller to tide you over. But it sounds like they need to look again at your meds to try and control this flare in general. Hope you manage to get some help.
Rheumy Nurse would be good because they can advise on meds but for quick fix while you wait for appointment would be gp. I have been advised that it is classed an an emergency at the gp's so can get appointment same day. I have a steroid injection in my bum and that does me until appointment with rheumy. Good luck x
Hi Laura, I am so sorry you are so young dealing with such problems. Have you ever been tested for Lyme Disease? Have you ever gone camping, done gardening, golfed, hiked, walked through the woods, tall grass or across a grassy lawn? You may have been bitten by a tick.
" typically wayyy too young to be afflicted with arthritis"
There are more cases of juvenile arthritis (ages up to 16) in the UK than cases of Lyme disease (all ages). Lyme is increasing in the UK but there are relatively few areas where is is endemic.
Juvenile arthritis can affect children as young as 2. This isn't osteoarthritis we're talking about which is caused by wearing away of the cartilage by use - this is one of the autoimmune diseases where the body attacks and destroys the tissues, in this case joints, and destroys them. Too many people think it is only "old" people who have arthritis.
Yes, this can certainly be a need to go to the emergency room. They can access you and give you steroid injections to help you relieve this horrible pain. Methotrexate is toxic to many, including myself, and is not tolerated, and a sign that my body was rejecting this toxin. It felt as though I was taking arsonic each time I took this, and induced terrible flares that seemed unbearable. I went off after 2 months, as this was not effective and was toxic to me. From my research, Methotrexate only helps 30% of those taking it. It is one of the first medications doctors try, to see if this helps or hurts. If you read the literature that goes with this drug, you will read that if you experience these toxic side effects, this should be STOPPED. This medication caused tremendous pain and flares, lowering my immune system, and causing systemic body infections, making my RA intolerable. When I stopped this toxic medication, my nausia, all over joint and muscle pain, and continuous flares in my knee and hands, wrists and feet. Like I said, I tolerated this noneffective toxic medication for only 2 months. I hope you go to the emergency room and find relief very soon.
Thanks for your reply. Unfortunately I don't have a number for my hospital. At the moment they don't have a arthritis helpline for me to ring. I have rang the secretary for my doctor and I am waiting a call back so hopefully my doctor can advise.
What often happens is that methotrexate, and even biologics can induce temporary lupus, which goes away when these medications are withdrawn. I take plaquinil for my RA, mobic for the much needed inflammatory, and a low dose of 5 mg prednisone to help me effectively manage my RA. No methotrexate or biologics at all.
I am in the UK yes. I have tried to call my GP who said they cannot give me an emergency appointment for a steroid injection because the doctor that is doing the emergency appointments cannot do the injection (how helpful). I have spoken with my rheumatology doctors secretary who has advised my doctor has been passed my message but the doctor is really busy. I have asked if I went to A and E what would they do and the secretary said she's not 100% sure. The Secretary has advised that I wait to see if my doctor calls from rheumatology and if my pain is really bad then to go to A and E.
The only problem I have is I don't want to be sat there for hours waiting for something I might not even get. The hospital unfortunately do not have a helpline. I am really worried about my knee as I already have a deformed joint being my thumb and at my age it is really embarrassing and I struggle to talk to people about how bad it really is hense me joining this group. My partner who I live with is really good and helps me like to get in and out of the bath etc but people at work and things don't see how I really am with it because I try and hide it and I won't be able to hide deformity very well.
I have looked into Lyme disease a while back but I have only ever been camping once around 3 and half years ago and I've never done any of the things listed above but I did strongly think Lyme could be what is wrong and I haven't ruled it out. Saying that however, I do have two male friends same age as me that have arthritis but luckily for them the treatment works where as for me, unfortunately I don't feel it is.
I think the best thing for me to do is ring the nhs helpline and see if theu can advise what to do as I am really worried here.
Thanks for the reply. So do you think if I go to A and E they will be able to give me a steroid injection? I'm absolutely desperate here! Really need help
Thanks for the reply. So do you think if I go to A and E they will be able to give me a steroid injection? I'm absolutely desperate here! Really need help
Yes, I do believe very strongly that going to the A & E will give you the relief you are needing. Be sure to tell them your pain is very high, when they ask, and if asked to rate this on a scale from 1 to 10 that it is in the very high numbers. The emergency care is there for relief of high pain, and its extremely inefficient and wrong to have a doctor on call that does not do what is needed as an on call physician. Look for another RA doctor.
I have deleted several comments that are taking this discussion off topic. Please do not use these forums to "campaign" about topics like Lyme etc. There is a separate group for Lyme Disease. It is fine to post in other discussions to say "Have you ruled out Lyme disease" but we do not allow repeated posting in other topics trying to tell or convince users that they may have Lyme or other conditions despite their history, symptoms location etc.
I think I am going to have to go to A and E and hope they provide me with thr help I need. My RA doctor has not contacted me back as yet so still waiting but it is my actual GP who advised they cannot gove me a steroid injection this afternoon.
If the A&E is at the same hospital as your specialist they will be able to get one of his team to see you - don't worry, A&E staff don't mind dealing with someone who really has got a problem and you do. They are less enthusiastic about the person who turns up with a cold or a broken nail - and that does happen believe me!
Good luck - hope they can sort you out. Do tell them how ill the methotrexate is making you feel too and you will probably get an emergency rheumy clinic appointment as well at the same time.
