It's a little victory, of sorts. Finally got to see a ophthalmologist today, and my Schirmer's Test showed 5mm for both eyes. So at least I have clinical proof of dry eyes now. It will be interesting to see what my rheumy has to say at our next visit, as since the last visit I had a negative lip biopsy, and was already seronegative.
If your rheumy is still dragging his heels I would get a second opinion. The doctors who don't believe in seronegative autoimmune disease are truly mistreating their patient by not treating them. Many doctors are finally starting to understand that seronegative is real and needs to be treated. I lost all my teeth and had arthritis, trigonitis (inflammation) of the bladder, surgery for carpal tunnel, GERD and other issues to numerous to mention before I even had an elevated ANA.
That is just the way the cookies crumbles and it would bode well for you to get further advice.Many times the eye doc is the only one who is guessing Sjogrens. Unfortunately I didn't have dry eyes until after the sjogrens diagnosis. Good luck. Irish
I second Irish's suggestion. Even though approximately a quarter of clinically diagnosed SS patients will have a negative lip biopsy and another quarter will have negative SS-A/SS-B tests, many doctors still refused to acknowledge the pervasiveness of seronegative Sjogren's Syndrome. My first rheumatologist basically told me it was all in my head and to get lost, despite objective signs of dryness and other symptoms that had appeared fairly suddenly. Unfortunately, all you can do is continue to search for a doctor who will take your needs seriously and treat your symptoms.
My rheumatologist (who had been practicing for nearly 40 years) mentioned to me that, in the past, doctors relied heavily on symptoms to diagnose patients. While there were undoubtably misdiagnoses that happened due to the lack of specific tests, it seems like many doctors have swung in completely the opposite direction, to the point where they almost ignore symptoms in their diagnoses. Honestly, it feels lazy to me, and could be a symptom of our assembly-line style of medicine that forces doctors to see too many patients for too short a period of time.
Hopefully your rheumatologist will be more accommodating with the new data, but don't be afraid to fire your doctor. You are paying them a lot of money to help you improve your quality of life; if they aren't doing their job, you need to find someone who will.
Oh, I have no issue as far as the rheumy dragging her feet. During my first visit, she told me that she's pretty confident I have Sjogren's, even though I was seronegative. The only concern I had was that she was trying to tie every ailment I had into Sjogren's (kidney stones, a shoulder surgery performed 23 years ago), and that she seemed too eager to get me on rituximab. I've only had two appointments with her so far, so it's hard to make any assumptions about her right now, other than she's been a wonderful doctor who takes plenty of time with me during our appointments.
It's just a small personal victory, even though I have had the symptoms for almost a year now.
Pete. Ask rheumatologist to run the early sjogrens syndrome profile blood panel.