Dr. Robert Roschmann

Internal Medicine - Rheumatology 48 years experience

Paraproteinemia: The Sed Rate often goes up if there is inflammation somewhere in the body but it can also go up if lymphocytes are producing excessive protein (calle... Read More

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A 29-year-old female asked:

Child has jra on 25mg enbrel (etanercept) for 4months had some improvement but not in remission should i talk to dr about changing meds?

Internal Medicine - Rheumatology 48 years experience

A Personal opinion: I was involved in phase 3 studies RE: efficacy IN ADULTS of "biological" TNF agents of which Enbrel (etanercept) was the first. Impression = that TNF ... Read More

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4k viewsAnswered >2 years ago

A female asked:

What are the autoimmune disease that causes baldness spots at the age of 29?what are the other symptoms needed to rule out the causes?

Internal Medicine - Rheumatology 48 years experience

Lumpy or flat?: If you have areas of hair loss with lumpy areas (or scar like tissue) in the region of hair loss, you may have an autoimmune skin condition called "di... Read More

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4k viewsAnswered >2 years ago

A 21-year-old male asked:

Can cts and ulnar nerve damage cause all five fingers to twitch while resting on computer mouse?

Internal Medicine - Rheumatology 48 years experience

Possibly: The median nerve primarily controls the first 3 fingers whereas the ulnar controls the 4th ( ring finger) and the 5th ( pinkie ) digit. Depending on t... Read More

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4.1k viewsReviewed >2 years ago

Dr. Paul Harper and another doctor agree2 doctors agree

A 25-year-old female asked:

Dehydrated disc, bulge at c5-c6 will fasting in the month of ramadan make the dehydration worse? can i hydrate the disc?

Internal Medicine - Rheumatology 48 years experience

No and No: "Dehydration" of the disc material refers more to changes in the collagen content of the disc. Fasting will not aggravate this type of "dehydration" ... Read More

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Dr. Holly Maes and another doctor agree2 doctors agree

A 25-year-old male asked:

Can you still have inflammation with normal crp and sed rate titers ? and what are the best markers for inflammation ?

Internal Medicine - Rheumatology 48 years experience

It depends on....: It depends on the severity of inflammation that is present. If you're talking about the type of inflammation that you might see from an insect bite or... Read More

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A 37-year-old male asked:

Please share an interesting fact about dealing with a spinal fracture.

Internal Medicine - Rheumatology 48 years experience

Ignore: It takes about 8 - 12 weeks for a spine fracture to heal. Rx can decrease further fracture risk.

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4k viewsAnswered >2 years ago

A 25-year-old female asked:

How to stop hair loss when am on methotrexate for my ra?

Internal Medicine - Rheumatology 48 years experience

Some thoughts: I have seen hundreds of people on Methotrexate for their rheumatoid arthritis and then I agree that hair loss is a bothersome side effects. Nonetheles... Read More

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4.1k viewsAnswered >2 years ago

A 33-year-old female asked:

Can autoimmune illnesses i have; sarcoidosis, sjogren's, raynauds & m.e. worsen chronic pelvic neuropathic pain? if so, how?

Internal Medicine - Rheumatology 48 years experience

Possibly: Sjogren's can be associated with a peripheral neuropathy whereas Sarcoidosis could actually involve the nerve roots at the spinal cord level (some of ... Read More

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3.8k viewsAnswered >2 years ago

A 58-year-old female asked:

Could uctd with elements of lupus and sjogrens cause sporadic sweating resulting in hair plastered to my head (not hot flashes)?

Internal Medicine - Rheumatology 48 years experience

Doubtful unless...: Undifferentiated Connective Tissue Disorders (UCTD) should not affect the propensity to sweat. If, however, you are using steroid therapy (such as pre... Read More

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3.8k viewsAnswered >2 years ago

A 37-year-old male asked:

Please share an interesting fact about living with rheumatoid arthritis.

Internal Medicine - Rheumatology 48 years experience

Ignore: If a knee joint flares, rest the joint/do daily stretching; when better, restart low impact aerobics.

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3.9k viewsAnswered >2 years ago

A 33-year-old member asked:

What is the ayurvedic treatment for autonomic neuropathy ?

Internal Medicine - Rheumatology 48 years experience

Alternative Therapy: Ayurvedic therapy (sometimes called alternative Rx) can be traced back to its origins in India with foundations in Hinduism and Buddhism. There are di... Read More

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4k viewsAnswered >2 years ago

A 32-year-old female asked:

Primary dr.did chest x-ray told me that he saw rheumatoligic inflammation. isn't something like that only show on ct scans. i am a patient with ra.

Internal Medicine - Rheumatology 48 years experience

Yes, can see....: In Rheumatoid arthritis even on a conventional chest x-ray you can see changes that have reported with rheumatoid arthritis. These changes include... Read More

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A 64-year-old female asked:

Thyroid removal side effects and does calcium have side effects?

Internal Medicine - Rheumatology 48 years experience

Levothyroxine: If only a part of the thyroid gland was removed then unlikely to see side effects. If entire gland removed you will need to be on thyroid replacement ... Read More

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Dr. Colin Sanner agrees1 doctor agrees

A 38-year-old member asked:

Ethosuximide (zorontin) and muscle pain, how are these related?

Internal Medicine - Rheumatology 48 years experience

May cause: Muscle cramps can occur with Ethosuximide but it's not very common. Occasionally it can result in an auto immune type disorder so if you have muscle p... Read More

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4k viewsAnswered >2 years ago

A 18-year-old female asked:

I hv a pain in like my whole body esp my back also weakness, fatigue, mood swings,deprieved sleep. is it fibromyalgia?

Internal Medicine - Rheumatology 48 years experience

Many mimicks: The symptoms you describe may be a reflection of fibromyalgia (FM) but there are many conditions that mimick FM and are treated very differently. Fo... Read More

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4.1k viewsAnswered >2 years ago

A 62-year-old male asked:

I am suffering from idiopathic myosotis with interstitial lung disease and rhematoid arthritis !iwas wondering what the outlook will be tks?

Internal Medicine - Rheumatology 48 years experience

Depends on lungs: It sounds like you have an overlap syndrome with an inflammatory arthritis as well as inflammation of your muscles and lungs. In this situation my exp... Read More

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4k viewsAnswered >2 years ago

A 53-year-old female asked:

I was diagnosed with bells palsy 18 months ago. i am 80% improved. i still have flutters and slight ear pain is that a good sign?

Internal Medicine - Rheumatology 48 years experience

Overall good: The overall picture you're describing is one of progressive albeit slow improvement. The flutters and slight ear pain is not a good news or bad news; ... Read More

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Dr. Saul Hymes agrees1 doctor agrees

A 27-year-old female asked:

Deep ache, sharp pains in arm from hand to all sides of shoulder for 2 months (started in hand, moved up) stabbing pains in shoulder blade. cause?

Internal Medicine - Rheumatology 48 years experience

Referred Pain : The sensation of "sharp/stabbing " pain may be a PARASTHESIA symptom often associated with nerve irritation/ inflammation/compression. However, I not... Read More

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4k viewsAnswered >2 years ago

A 37-year-old male asked:

Please provide a tip on how to ask your doctor about living with degenerative arthritis.

Internal Medicine - Rheumatology 48 years experience

Ignore: Artificial joint fluid injections may help delay the need for knee joint replacement. Ask your MD...

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3.9k viewsAnswered >2 years ago

A 26-year-old female asked:

If a person has ra. is it possible that his ra suddenly goes away and the person is back to normal?

Internal Medicine - Rheumatology 48 years experience

Possible but....: What you are referring to is called a "remission" which can be drug induced (I see you are on Enbrel (etanercept) Rx which can result in a medication ... Read More

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4k viewsReviewed >2 years ago

Dr. Heidi Fowler and 2 doctors agree3 doctors agree

A 26-year-old female asked:

Can rheumatoid arthritis take time to show in blood work?

Internal Medicine - Rheumatology 48 years experience

Yes: In ~ 40% of people with bona fide Rheumatoid Arthritis (RA) the RHEUMATOID FACOR (RF) test will never be positive. Non specific tests that measure inf... Read More

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Dr. Walter Husar agrees1 doctor agrees

A 49-year-old female asked:

I know that medrol (methylprednisolone) dosepak is a steroid, will it have side affect retaining water or bloating?

Internal Medicine - Rheumatology 48 years experience

Short term: Yes, the Medrol (methylprednisolone) Dosepak contains the steroid prednisone. There could be some retention of salt and water by your body that might... Read More

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Dr. Inaam Schneider agrees1 doctor agrees

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A 58-year-old female asked:

I had a total knee replacement three years ago i have done two marathons and walk and swim every day. i'm having significant pain. is this normal?

Internal Medicine - Rheumatology 48 years experience

Not normal : There are people with new knee replacements who do complete triathlons successfully. Although a person may have knee pain (even without a joint rep... Read More

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Dr. Gurmukh Singh and another doctor agree2 doctors agree

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A 54-year-old female asked:

Thank you! could you give me your opinion of which works best and is safer with the least chance of negative side effects: mobic, (meloxicam) relafen or voltaren?

Internal Medicine - Rheumatology 48 years experience

Even odds: These are all members of the NSAID family. They all have about the same potential for side effects such as stomach irritation or possibly some salt an... Read More

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Dr. Marisa Johnson and another doctor agree2 doctors agree

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A 37-year-old male asked:

Please provide a tip on how to ask your doctor about raynaud's disease.

Internal Medicine - Rheumatology 48 years experience

Ignore: Emotional stress can increase Raynaud's. Learning the technique of mediation breathing can help!

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3.9k viewsAnswered >2 years ago

A 52-year-old female asked:

I have herniated disc st l4 l5 pain down right leg waiting to have fusion done . i have delobped swelling of right leg is this relatef to my back?

Internal Medicine - Rheumatology 48 years experience

Unlikely: It would be rather unusual to see swelling in your leg because of compression of a nerve in your back. Is their swelling your calf? If so, that would ... Read More

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4.1k viewsAnswered >2 years ago

A 39-year-old female asked:

Can lupus cause gastroparesis or vagal nerve damage?

Internal Medicine - Rheumatology 48 years experience

Unusual: Gastroparesis is more typically seen when there is a autonomic neuropathy condition as can be seen in diabetes. Connective tissue disorders on occasio... Read More

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4.1k viewsAnswered >2 years ago

A 63-year-old female asked:

I had a l4-l5 left hemilaminectomy. 6 mo post-op mri "residual or recurrent moderate focal l subarticular protrusion-extrusion". have l-radiculopathy.

Internal Medicine - Rheumatology 48 years experience

Correlation needed: It is not clear from your description if the radiculopathy is brand-new or if it's associated with old symptomatology. The MRI suggests that there may... Read More

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4k viewsAnswered >2 years ago

A 24-year-old female asked:

Abdominal pain for a few months nothing is helping gagging nausea vomiting stabbing pain right and middle upper abdomen elevated bilirubin no appetitefor 6 going on 7 days can't hold food down at all?

Internal Medicine - Rheumatology 48 years experience

Consider gallbladder: Recurrent episodes of inflammation of the gallbladder can be associated with gallbladder stones that block the normal passage of bile, which in turn, ... Read More

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4.1k viewsReviewed >2 years ago

Dr. Sewa Legha agrees1 doctor agrees

A 53-year-old female asked:

How is polymyositis treated? and can it be cured?

Internal Medicine - Rheumatology 48 years experience

MTX & ROIDS: Typically a combination therapy with steroids in the form of Prednisone and a drug call Methotrexate is usually started at the same time. A decrease i... Read More

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4.1k viewsReviewed >2 years ago

Dr. Colin Sanner agrees1 doctor agrees

A 40-year-old member asked:

What to do if i have arnold chiari malformation 1 and now i also have lupus. i am very active , but will that end?

Internal Medicine - Rheumatology 48 years experience

Close follow up!: Arnold Chiari 1 occurs when part of the brain (cerebellum) presses into the opening at the base of the skull. The future depends more on what what you... Read More

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4k viewsAnswered >2 years ago

A 37-year-old female asked:

12 year old daughter has small, white, flat round patches on her forhead. what can it be?

Internal Medicine - Rheumatology 48 years experience

Tinea: A picture truly is worth 1000 words. In this situation without actually seeing the patches it can be hard to make a diagnosis but if your daughter ha... Read More

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4.1k viewsAnswered >2 years ago

A 57-year-old female asked:

The muscle relaxer prescribed is not helping with the pain, can i take advil or tylenol (acetaminophen) with the muscle relaxer?

Internal Medicine - Rheumatology 48 years experience

Probably : Commonly used "muscle relaxants" include cyclobenzaprine (flexaril) or benzodiazepams (Valium - Xanax (alprazolam) drugs). None of these should resul... Read More

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Dr. Tracy Brenner agrees1 doctor agrees

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A 35-year-old female asked:

Painful muscular type pain in my mid back for 3 days. hurts to the touch and very painful to sneeze. active but no new exercise. likely muscle strain?

Internal Medicine - Rheumatology 48 years experience

Probably: Given your age, about 70% of all cases of acute back pain are self limited and due to "myofascial" irritation/strain. Sometimes sneezing can aggravate... Read More

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Dr. Kaveh Karandish agrees1 doctor agrees

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A 17-year-old female asked:

I'm 17 yr f with horrible iliopsoas tendonitis in r hp. treating since 2 yrs including modalities and steroid but no help. any suggestions?

Internal Medicine - Rheumatology 48 years experience

US giuded Rx: The iliopsoas tendon/bursa can be difficult areas to treat. Although you say you had "steroid" therapy did you ever have an ultrasound guided injectio... Read More

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Dr. Adam Lewis agrees1 doctor agrees

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A 31-year-old female asked:

What is borderline lupus? rheumatologist stated i have this but what does this mean? i have a follow up scheduled but i'm so confused

Internal Medicine - Rheumatology 48 years experience

"Borderline"????: I am not quite sure what the term "borderline" means. Some people with symptoms may have incomplete criteria for lupus and are therefore Lupus "suspec... Read More

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Dr. Diane Minich agrees1 doctor agrees

A 30-year-old female asked:

Why does knee hurt to straighten it out hurts when bent it hurts also when i get up and walk putting pressure on it and if i stand too long it swells?

Internal Medicine - Rheumatology 48 years experience

Effusion: It sounds like you have a knee effusion. An effusion is a collection of fluid within the knee joint. It increased the pressure within the joint. As y... Read More

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3.8k viewsAnswered >2 years ago

A 24-year-old female asked:

Elevated igg,crp,ccp and normal rf .. what does that indicate.?. i feel tired everyday and had staph infection in my face and had an abortion 33 weeks

Internal Medicine - Rheumatology 48 years experience

Possibly RA: This CRP measures inflammation and can be elevated if there has been a recent infection or even surgery. You didn't mention when the abortion was. ... Read More

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3.9k viewsReviewed >2 years ago

Dr. Heidi Fowler and 2 doctors agree3 doctors agree

A 45-year-old female asked:

I am going through a second bout of reactive arthritis in a year. is there anything i can do to speed the recovery time of this second bout.

Internal Medicine - Rheumatology 48 years experience

Need more info : You mention you have a "reactive arthritis". That term is often used if there is an arthritis reaction to an infection. Other than cellulitis have you... Read More

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4k viewsAnswered >2 years ago

A 36-year-old female asked:

Was on bed rest for almost 3 months. and in the mornings my legs are stiff and wobbly and walking helps but next morning same way all over again. why?

Internal Medicine - Rheumatology 48 years experience

Muscle atrophy: The astronauts had the same issue. You haven't been using your muscles for ~ three months and you probably have some loss of muscle mass (called atro... Read More

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A 30-year-old female asked:

I'm on infliximab infusions for cd i had my 3rd dose today. in spet i will be study medical forensic science. can i have the infusion go college after?

Internal Medicine - Rheumatology 48 years experience

Do not interrupt Rx: Imfliximab can markedly reduce the symptoms of CD in many people. If you begin noticing improvements of CD then Imfliximab should be continued on a re... Read More

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4k viewsReviewed >2 years ago

Dr. Albert Pizzo and 2 doctors agree3 doctors agree

A 56-year-old male asked:

Md,gi:when in vertical position no acid or discomfort. any time laying flat/sleep,i feel stomach ache/burning &upper left chest tightness. any clue?

Internal Medicine - Rheumatology 48 years experience

Esophagitis : You did mention in your history that you have acid reflux. There is a muscular valve in between the bottom of your esophagus and your stomach. If the ... Read More

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Dr. Diane Minich agrees1 doctor agrees

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A 35-year-old female asked:

Neuro couldn't explain this to me. can someone explain this ana? norm la1&2, positive hex.pho, prolonged appt and saline. approx 15%of lupus anti.

Internal Medicine - Rheumatology 48 years experience

Anti phospholipid : The neurologist may be screening you for condition called anti-phospholipid syndrome. In this condition the most common manifestation would be a prop... Read More

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3.8k viewsAnswered >2 years ago

A 47-year-old male asked:

I have a severe pain in my left middle finger on the top joint ?

Internal Medicine - Rheumatology 48 years experience

Possible Heberden's: Women are more likely to get a certain type of osteoarthritis of their hands when compared to men. Typically this involves the set of joints that the ... Read More

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Dr. John Munshower and another doctor agree2 doctors agree

A 48-year-old member asked:

Help can cracking your knuckles cause damage to your joints?

Internal Medicine - Rheumatology 48 years experience

No: There is a study that followed people who cracked their knuckles daily for 20 years vs people who didn't crack their knuckles. Serial x-rays of their ... Read More

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Dr. Robert Killian agrees1 doctor agrees

A 23-year-old male asked:

Liver alt elevated -mrcp and fibroscan nrml.no hep,drugs,alcohol,not fat, wilsons autoimmune etc what could it be? ~2xuln all common things checked.

Internal Medicine - Rheumatology 48 years experience

May represent ....: A statistical anomaly. ~ 1 out of every 20 lab tests may be above/below the famous "Bell Curve" that describes statistical variability. In addition, y... Read More

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3.8k viewsReviewed >2 years ago

Dr. Laura Martin agrees1 doctor agrees

A 27-year-old female asked:

Hip bursitis affects my sleep, travel, exercise, standing, & sitting how can i improve it? i've had 2 shots, therapy, nsaids, & ice/heat treatment.

Internal Medicine - Rheumatology 48 years experience

Some thoughts : Is it really hip bursitis? Although you are young, occasionally there can be a hip joint issue that's really the source of the problem. Has a hip join... Read More

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Dr. Diane Minich agrees1 doctor agrees

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A 17-year-old female asked:

Okay, so i just changed my soap from dove to a natural honey and oat soap. i noticed i have some random bumps (possibly irriataed pores?) on my leg.

Internal Medicine - Rheumatology 48 years experience

Folliculitis : Well, the idea of putting honey the soap is interesting but I'm wondering if that would result in the soap having some degree of sugar in it. If so, I... Read More

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4.1k viewsAnswered >2 years ago

A 41-year-old female asked:

Is aleve (naproxen) or ibuprofen safer to take if you have high blood pressure and you are on blood pressure medication?

Internal Medicine - Rheumatology 48 years experience

Both affect BP: All NSAID's, including ibuprofen and naproxen, have the potential to increase blood pressure (BP). In most people the change is small but, on occasion... Read More

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