Arthritis - looking for a rheumatologist

[TimBKK]

I am dealing with a rather sudden onset of joint pain and stiffness that has set in over the past month - an ankle, both hips, a shoulder and some fingers.  Blood/urine work at Dr. Olivier’s clinic in Pattaya is negative for uric acid (gout) and rheumatoid factors BUT c-reactive protein and ESR 1 hour (sed rate) are both elevated and well outside of normal ranges.  

 

Any recommendations for a rheumatologist in Pattaya (where I live) or Bangkok?  In looking back over posts the following have been mentioned, think by @Sheryl:

 

Dr. Virat Pinyopornpanit (now at the new hospital in BKK):

https://www.medparkhospital.com/en/doctor/dr-virat-pinyopornpanit

 

Dr. Hiroshi Chantaphakul:

https://www.bumrungrad.com/en/doctors/Hiroshi-Chantaphakul

 

Would welcome any thoughts on the above or others.

 

Also any advice about how you deal with arthritis?  A daily 400mg of celebrex (celecoxib) really helps but I am concerned about using it for an extended period of time so will try turmeric/curcumin with peperine and am researching CBD as well.

 

Much thanks in advance.

[gearbox]

Naproxen is relatively inexpensive here, they sell 500mg pretty much everywhere, no prescription needed.

Do you know already that you have arthritis (confirmed by a doctor before), or you only suspect it?

[Sheryl]

Don't try to treat until it has been diagnosed.

 

NSAIDs are fine for osteoarthritis but what you describe - sudden onset of pain in multiple joints - is unlikely to be that.

 

The 2 doctors you mention are good, so is this one

 

https://www.bumrungrad.com/en/doctors/Porawat-Makornwattana

[Sheryl]

5 minutes ago, gearbox said:

Naproxen is relatively inexpensive here, they sell 500mg pretty much everywhere, no prescription needed.

Do you know already that you have arthritis (confirmed by a doctor before), or you only suspect it?

He does not know and from description it is very unlikely to be osteoarthritis.

 

Possible rheumatoid arthritis or other autoimmune condition.

 

No treatment should be attempted until it has been diagnosed.

[TimBKK]

4 minutes ago, gearbox said:

Naproxen is relatively inexpensive here, they sell 500mg pretty much everywhere, no prescription needed.

Do you know already that you have arthritis (confirmed by a doctor before), or you only suspect it?

thanks @gearbox - will check out naproxen, as celebrex/celecoxib is not cheap - 560b per 10 from Boots.

 

Right now, only suspect arthritis, never been confirmed by a doc.

[gearbox]

2 minutes ago, Sheryl said:

He does not know and from description it is very unlikely to be osteoarthritis.

 

Possible rheumatoid arthritis or other autoimmune condition.

 

No treatment should be attempted until it has been diagnosed.

Absolutely, hence my question. There are quite a few arthritis types, and also different people respond to different medications.

[TimBKK]

3 minutes ago, Sheryl said:

Don't try to treat until it has been diagnosed.

 

NSAIDs are fine for osteoarthritis but what you describe - sudden onset of pain in multiple joints - is unlikely to be that.

 

The 2 doctors you mention are good, so is this one

 

https://www.bumrungrad.com/en/doctors/Porawat-Makornwattana

Thanks @Sheryl

 

Its weird, I kinda hope its maybe a bacterial infection (I had an appendectomy at Bangkok Pattaya in early March) as the root cause of the inflammation, which would potentially be a lot easier to address.  
 

In any event, definitely will see one of these docs soon.

[BritManToo]

Sudden onset of joint pain ........ Dengue fever?

[gearbox]

8 minutes ago, Sheryl said:

Don't try to treat until it has been diagnosed.

 

NSAIDs are fine for osteoarthritis but what you describe - sudden onset of pain in multiple joints - is unlikely to be that.

 

The 2 doctors you mention are good, so is this one

 

https://www.bumrungrad.com/en/doctors/Porawat-Makornwattana

 

I have auto-immune arthritis and have used NSAIDs on and off for more than 20 years, so they do work for that too. But they were prescribed me by my rheumatologist back in Sydney, not taken as a result of Internet searches.

[gearbox]

3 minutes ago, BritManToo said:

Sudden onset of joint pain ........ Dengue fever?

I think the Dengue hits the backbone the most.

[Sheryl]

He would have fever & chills with dengue.

 

From the description and lab results this is most likely an autoimmune condition. Hence seeing a rheumatologist.

 

OP - one other possibility would be a drug reaction. Are you on any meds?

[TimBKK]

5 minutes ago, BritManToo said:

Sudden onset of joint pain ........ Dengue fever?

hmm, hadn’t considered that @BritManToo.  I haven’t experienced fever or other typical dengue symptoms but it appears easy enough to test for, so why not?

[Sheryl]

It's not dengue. You would have significantly high fever and chills, you would nto miss it.

 

Are you on statins or other medication?

[TimBKK]

2 minutes ago, Sheryl said:

He would have fever & chills with dengue.

 

From the description and lab results this is most likely an autoimmune condition. Hence seeing a rheumatologist.

 

OP - one other possibility would be a drug reaction. Are you on any meds?

No meds.  That is my big fear, that it is early RA despite negative blood work - seronegative rheumatoid arthritis.  Fingers crossed it isn’t but better to know sooner rather than later if it is.

[Sheryl]

Not drug-induced arthralgia then.

 

Seronegative RA  or PMR seem most likely

 

https://www.mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/diagnosis-treatment/drc-20376545

 

https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653

[banglay]

I suggest you research/google  "cinnamon as a anti inflammatory"   .I personally stopped using all my prescribed medications several years ago  in favour of taking Cinnamon every day (2 table spoons) ... it has little to no/zero side effects and for me has worked wonders .....

You may ask why is this not endorsed by the medical fraternity, the simple answer is there is no profit in it  for  the large multi national drug companies . 

[gearbox]

33 minutes ago, banglay said:

I suggest you research/google  "cinnamon as a anti inflammatory"   .I personally stopped using all my prescribed medications several years ago  in favour of taking Cinnamon every day (2 table spoons) ... it has little to no/zero side effects and for me has worked wonders .....

You may ask why is this not endorsed by the medical fraternity, the simple answer is there is no profit in it  for  the large multi national drug companies . 

If the cinnamon works for you it certainly contains some chemical which impacts the disease. Whether it is in the cinnamon or in the NSAID wouldn't make much difference. It is not in the normal human diet to take 2 table spoons cinnamon every day. And there is no study that 2 x table spoons of cinnamon for 10 years doesn't have any side effects.

Edited May 31, 2021 by gearbox