Dr. Nupoor Acharya
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My mother has been diagnosed with Hepatitis B a year ago and consuming Entecavir 0.5 mg once daily. I have attached reports taken two months ago. Also, I have attached the discharge summary when she was admitted for Hepatitis B for your reference. Her BP levels are 150/100 mm Hg. So far, no medicine consumed for the same. No history of COVID-19. She has arthritis for the last 30 years. She is off medication for arthritis. Also, she was using Celestone for 25 years for asthma. Over the previous six years, she has been using an Asthalin inhaler twice a day and Foracart 400 twice a day. Do you recommend any medicine for arthritis? She feels pain in the trigger finger. We are planning to get the COVID-19 vaccine. Do you recommend the same for her?
Hi,
Welcome to icliniq.com.
You have not mentioned her arthritis in detail. I assume she has rheumatoid arthritis looking at her pictures (attachments removed to protect the patient's identity). What are her symptoms at present? How much pain and stiffness does she have? The treatment will depend on the severity of arthritis at present. Also, I will need test reports of CBC (complete blood count), ESR (erythrocyte sedimentation rate), and CRP (c-reactive protein). About your other query, she can undergo vaccination for COVID-19 (coronavirus disease 2019).
Patient's Query
Hi doctor,
Thanks for the reply.
She cannot fold her palm or cut vegetables. Her second finger in the leg is folded. There is no severe pain. However, mild pain is there in her legs when she gets hit in that area. Also, while wearing slippers, she needs to move the finger with her hands. Otherwise, it is normal. RA factor is 7.2 IU/mL. We will take the tests that you have suggested. Thanks.
Hi,
Welcome back to icliniq.com.
It seems she has rheumatoid arthritis, which is currently not very active. The pain and difficulty she has during activities might be due to deformities. In that case, she will not benefit much from treatment. She will rather need rehabilitation and physical therapy. Please get the blood tests. If her inflammatory markers are elevated, I will suggest starting the therapy.
Patient's Query
Hi doctor,
Thanks for the reply.
I will get back to you with the test reports.
Hi,
Welcome back to icliniq.com.
Sure. Do get back to me with the results. Thanks.
Patient's Query
Hi doctor,
Thanks for the reply.
I am attaching reports of CBC, CRP, and ESR for your reference. Also, please could you suggest any medication required for rheumatoid arthritis? Thanks.
Hi,
Welcome back to icliniq.com.
Your mother's reports look fine, and her inflammatory markers are normal (attachments removed to protect the patient's identity). So arthritis does not seem to be very active. Therefore, she will need few medicines and some supplements. She will benefit the most from physiotherapy and exercises. I suggest her tablet HCQS 200 mg (Hydroxychloroquine) once at night, tablet Glucosamine 750 mg once a day, and Calcium 500 mg tablets twice a day. Repeat all her tests after three months and revert for more queries. Thanks.
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