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Ankylosing Spondylitis

 

 

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Ankylosing Spondylitis

Hi All,
My name is nitin, I am from Gurgaon and wanted to take your advice on my wife's case. She has been diagnosed with Anklyosing spondylitis, she is HLA b27 positive but shows no structural changes in spine or neck. we are taking the treatment from a rheumatologist at Indian Spine and Injury centre Vasant Kunj.

It was 2010 when she was first observed acute pain in back (lower) and knee, on taking some test the infection was found in her knee and ESR was also high. She was advised to take remicade, which she eventually took in June 2010. Post that she did not had any kind of pain or issue until she got married in April 2012.

It was though fine till oct 2012, but in October she developed a pain in her ankle, initially we were consulting some orthopedic and took treatment for plantar fasciitis, but with continuous exercise and medication the pain was not subsidizing, moreover it started in the left ankle also. In December we met Dr. again and he recommended to take remicade again, since we did not had any insurance cover and also the ESR that time was around 45 he suggested we can take Solu Medrol through Intravenous (IV). Even after taking the treatment the ESR did not came down and in March the condition was so bad that we had to take remicade again in March 2013 that time ES reached to 120.

Just after 1 week of taking Remicade she got allergy from colours and had to be admitted again in march, this time she was given solu Medrol again but only 2 as compared to 3 dose last time, the ESR at that time was 45. Its been almost 2 months now and from last 2 weeks she is taking following medicines:
medrol 16 mg folitrax 7.5 mg with once a week
Medrol 8 mg with folvite tab daily once
Sazz DS twice a day
nucoxia P twice a day
Supracal daily once

In last 2 weeks the ESR is constantly on 65( tested twice). the latest test (on 21st May shows ESR as 80) She is on a strong medication and still there is no improvement in her condition. Please suggest if any one can help us.

Regds
Nitin
 
  nitinsharma on 2013-05-23
This is just a forum. Assume posts are not from medical professionals.
please amplify other symptoms as per the questioner available in the forum
 
anuj srivastava 7 years ago
1. Describe your main suffering?
stiffness in whole body, specifically in back, ankle, knees. Started recently in elbows and upper arms.


2. What other physical sufferings do you have in your body?
Pain and stiffness in whole body, sleeplessness, breathlessness, dizzy, sleepy, low energy level, low BP


3. What mental sufferings / feelings do you have associated with your physical sufferings?
cannot think about anything other than pain, feel will never get better.

4. What exactly do you feel when you are at your worst?
some heavy object should press whole body to get relief

5. When did it all start? Can you connect it to any past event or disease?
IT started in 2010, pain in sacroiliac joint, extreme pain in right knee, took remicade and was absolutely fine till 0ct 2012


6. Which time of the day you are worst?

Early morning, 3 - 4 am
7. What are the things which aggravate your suffering and which are those which ameliorate the same?

long sitting hours, standing, stress, better off with rest sometimes with salty foods

8. Do your think your sufferings have relation to any external stimuli (like, change of place) or any internal biological changes in the body, like, menses (in females)?

no

9. When do you feel better, during hot weather or cold weather, humid or dry weather?

cold weather


10. Describe your general mental set up? Are you Moody, Arrogant, Mild, Agreeable Changeable, Nervous, Suspicious, Easily offended, Quiet, Arguing, Irritating, Lazy etc.
Arrogant, arguing, active, energitic, aggressive,


- How do you feel before or during a thunderstorm? fearful

- Do you like being consoled during your tough times? YES
- Are you sensitive to external stimuli like smell, noise, light etc? yes

- Do you have any typical habit or gesture like nail biting, causeless
weeping, talking to one self etc? NO

- How do you feel about your friends, family, your children and especially your husband / wife? I love them all and want to see them happy, caring for my husband

11. What are your fears and do you dream of any situation repeatedly?

Yes i see a snake often, when i am not well. a lot of nightmares, see people killing, crying, blood etc
12. What do you crave for in food items and what are your aversions?
Salty food

13. How is your thirst: Less, Normal or Excessive?
Normal
14. How if your hunger: Less, Normal or Excessive?
Less these because of pain otherwise it was normal
15. Is there any kind of food which your body can’t stand?
dnt remember
16. Is your sweat normal or less or more? Where does it sweat more: Head, Trunk or Limbs? Sweat more, trunk, limbs. Also have smell in sweat

17. How is your bowel movement and stool type? normal..but since i am taking medicines its very dark and smelly

18. How well do you sleep? Do you have a particular posture of sleeping?
cannot slppe propery in last 6-7 months, gett sleep during moring hrs. about 3-4 am. usually sleeps on right side side ways.

19. Do you think you are able to satisfy your sexual desires in general?
yes
20. How do you think you are different from others, if at all?
others do not have pain

21. What medications have been taken earlier by you to treat the diseases and do you have any particular symptom surfacing after the medication?
mentioned in details given above

22. What major diseases are running in your family?
Mother has osteoarthritis, elder sister is also HLA b27 but no sogns of AS or RA. Was low on vitamin D which is now fine. She has migrane problem, infact headache is to all in family except me.

23. Describe, how do you look like? Describe your overall appearance
5.4, round face, fat, confident
24. (ONLY FOR FEMALES)

Please answer the following questions:
(Please give details of your past menstruation if you have attained menopause.)
- Are the periods early, regular or late in general? How long do they last? not late but at times its happens for only 2 days sometime in break
- Do you suffer from any kind of physical or mental discomfort before, during or after the periods? no
- Is the flow scanty, normal or excessive? normal
- Is the blood thick bright red or pale watery? red
- Do you notice any clots in the flow?no
 
nitinsharma 7 years ago
please throw some more light on the following symptoms.

1. are you seeing snakes every night during dreams.

2. aggravation is it during the same time ie 3-4 am.do you sweat when it pains, feel better by covering or uncovering.

3. did you suppress any skin disease by applications.
4 during thunderstorms or before is there any aggravation.warmth/chill does it aggravate or ameliorates.
any swelling in the joints or body specify.
5.
sweat does it stains the pillow at night.

6.the pains =since they are wondering describe the path they take.and is any part numb due to pain

7. burning in any part of the body.
 
anuj srivastava 7 years ago
1. are you seeing snakes every night during dreams. NO ONLY WHEN THE PROBLEM IS WORSE SEEN IT 3-4 TIMES IN LAST 6 MONTHS

2. aggravation is it during the same time ie 3-4 am.do you sweat when it pains, feel better by covering or uncovering. YES TIME IS ALMOST SAME, NO SWEAT, UNCOVERING FEELS BETTER

3. did you suppress any skin disease by applications. NO
4 during thunderstorms or before is there any aggravation.warmth/chill does it aggravate or ameliorates. NO NOTHING
any swelling in the joints or body specify. HEELS JOINT RIGHT LEG, KNEE RIGHT LEG
5.
sweat does it stains the pillow at night. NO

6.the pains =since they are wondering describe the path they take.and is any part numb due to pain STARTS WITH HEELS AND GOES TILL THIGHS

7. burning in any part of the body. NOT YET
 
nitinsharma 7 years ago
have the following

1. nux vom 200 15 drops in an ounce of water three times half an hr before dinner . dont repeat.

2.kali carb 30 five tabs three times a day from next day.

give a feed back every three days and in case of aggravation immediately after stopping the medicine.

stop other medicines.
 
anuj srivastava 7 years ago
Thanks a lot for your suggestions Anuj. One query is there any SOS for pain also?? she cannot sleep in night and pain killer are no more effective.
 
nitinsharma 7 years ago
also would like to add she is currently taking following homeopathic medicine from last 2 weeks, pls suggest if we should continue:
1. heckla lava 3x+ s/l 6x (twince a day)
2. ammow carb 30 (once)
3. cf 200 (m+n)
4.arnq/rutaq/symphytum/ginseorg 1x (twice a day)
5.lyco podium 10mx3 ( thrice a day)

from last week she is taking these medicines:
1. rhus tox 1m single dose in a week.
2. thuja 30c three times a day for three days.
3. natrum mur 30c three times a day.
4. ledum pal 30c three times a day
5. berberis vulgaris q 5 drops in one ounce water three times
 
nitinsharma 7 years ago
i have read but not tried about gultheria oil 20 drop dose in an ounce of water never fails to arrest the pain.
 
anuj srivastava 7 years ago
i don't think so you should continue with them. lyco 10 m thrice a day?
 
anuj srivastava 7 years ago
yes lyco 10 m thrice a day
 
nitinsharma 7 years ago
please discontinue immediately.
 
anuj srivastava 7 years ago
how often can we take gultheria?
 
nitinsharma 7 years ago
it is a SOS remedy. when it pains.
 
anuj srivastava 7 years ago
I read about Topi MP Gel from Schwabe, it works for stiffness and pain in muscles, have you heard about it, do you suggest we should try it?
 
nitinsharma 7 years ago
No , but have heard of Maldol or R 81 of Dr Reckeweg but never tried, it is a homeo concoction slightly expensive.
 
anuj srivastava 7 years ago
Dr a n malviya is best rheumatologist in delhi. Consult him along with good homeopath.
 
hporwal 6 years ago

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