Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group CAN I PASS A "CA, STATE MEDICAL EXAM" with AS?

Hi everyone =) I posted a little info on my condition on another post last week. Iam still very new to all of this and learning all I can. Well Iam 25 years old and just diagnosed 2 weeks ago. I am HBLA-27 positive and all my pain is in my swollen ankles, feet, and left knee is swollen. I have absolutly NO PAIN in my back what so ever and never have. My doctor sent me in for a CT scan of my lower back and pelvic area to see if I had damage and well not really sure what he was looking for but I was told by one of my Doctors nurses that it came back NEGATIVE and their is nothing wrong and everything is normal on my CT scan. Now I was curious if anyone has ever heard of this or gone through this?? I have been in a wheelchair/crutches back and forth for the last 2 months and was told I have AS. But all my research says its a desease to the lower back and spine correct? So does this mean we caught it really really early befor any damage was delt? or could I be mis-diagnosed?? Dont get me wrong somthing is causing my knee to swell up and both my ankles and feet to swell up but what? Also I have very wierd blood tests comming back and my LIVER enzymes are very high at 179 my first test and then droped to 150 my second blood test. I was thinkin about going to see a LIVER specialist because I was looking up on the LIVER and also told that it can cause alot of things in your body to go hay-wire? Maybe Iam just being ignorant and still in denial that I have AS because it just doesnt seem right to me to have the symptoms I have but none of the others??? I dunno... but more or less this post was to ask if anyone knows if I would have to tell a Doctor who is doing a medical pyshical for a job that I have AS or do I not have to tell them? The reason Iam asking is that I will be having a Medical EXAM "physical" for a Law Enforcement agency in the next couple months and not sure if having AS will Dis-qualify me from the hiring process and keep me from being hired on. I'm saying this persay that Iam totaly healthy no flare ups and blood work is all normal and Iam taking ENBREL. Is this somthing that I would have to discuss with them? and share and tell them Iam taking Enbrel and why Iam taking it? or do I hide it? but I dont want to lie? or is their some type of Patient Medical Confindential law that I do not have to share any desease I have if it does not pose a risk or contagious to anyone else such as Hepititis C or say if I had diabeties? Because I know if you have those you are DQ'ed and can not be hired? so any help would be greatly appreciated!!! I know Iam jumping back and forth and rambling on but I just have sooooooooo many questions and thoughts going through my head all day every day all the time!!! I just dont know what to do!!! I think my family has been sooo stressed out over this especially my mom and dad who pretty much lost it the other night and well I have no one else to talk to about this stuff? Iam just so lost! I have worked my whole life to become a police officer with school/explorer programs and community service and so on so on and finaly I got on and had an academy date for March 6th and have to defer because I know I wouldnt be able to pass the medical now but I should be ok in June. So I just dont know if maybe I will have to look for a new carreer or what I dont know?

well thank you in advance =) from a lost guy in cali....

Did you say you are taking Enbrel? Liver....Enbrel? Might the two go together?
The liver can get involved in inflammatory diseases. I think I've read that AS can go to the peripheral joints first, especially in women. Think maybe a scan is in order rather than a CT Scan that is....as a bone scan may show inflammation better?
Maybe it is early. How long you had problems? Did you have back complaints? One thing about it is you can run into problems having an illness and getting a job. No company wants to hire a back problem because of insurances. So you need to get this straightened out with what you are going to do about that job. If you have an autoimmune disease it can hassle you and make working more difficult. The Enbrel may be affecting the inflammation on the tests in other ways maybe.....helping out so it does not show up on the CT? Wow, two weeks and Enbrel?
Ask your Doc. about that and most especially your liver. My husband had a bigtime problem with his liver and they were going to get a donor but you know what?... it straightened out when things settled down. Maybe even a stone in biliary tree somewhere. Other autoimmune diseases like lupus can affect livers. Sclerosing Cholangitis was my husbands diagnosis. Think maybe they were wrong but a drug made for other problems helped him out of it and if I can think of it I'll come back and put it in just in case. Did they x-ray your liver or talk about a scope? Tests like SGOT or SGPT and Bilirubins ect. are a must. If your liver gets involved seriously you will know it as you will get sick. Skin may get yellow and urine tea colored. Make sure as this is one of the more important things that can be affected. Thinking it was something called Actigall?
Oh yes. PS. We're talking Nucleor Bone Scan not just Bone scan for Osteoporosis. The Nuc. one shows inflammation ect. sometimes. They are discussing this right now on the other good board. ahem. Anklylosing Spondylosis of America ....or some such.

I think in your previous post you mentioned that you drank alcohol frequently and taking voltarin... but my memory could be wrong. If this is the fact, this is probably what led to elevated liver enzymes. Once you discontinue they will slowly drop....

I was taken off meds 4 separate times due to liver enzymes.... first time was due to drinking and voltarin back in 1998ish (soon after I moved to Neenah, WI). I gave up the alcohol and was switched to naproxen from voltarin and they dropped back down.

As for foot... maybe it was caught early, I believe at times the body will attack the "weakest" link. My AS first showed in right SI for good... same place that I had a basketball injury... later back involvement came along. So "traumas" to the body may be a triggering factor for AS for some.

So my question... have you suffered injuries to your feet in the past?

Tim

yeah I spanged my ankle lots and lots of times over the years... I have week ankles as it is. The MRI of my ankle came back showing small tears in some of my ligaments and that it healed larger then usual so maybe that triggered it I dunno.. Yeah I was drinking alot befor this and was taking like 30+ vicodine pills for pain in like the first 2-3 weeks starting last dec 1st, but I havnt takin any more pain pills since then so thats prob what made my liver go way up. It droped 29 points in 1-1/2 weeks so Im sure it is going to still drop I will get another blood test in a few weeks to make sure! Also I think the Prednisone Iam on might have somthing to do with it. The doc said celebrex is safe to take for the liver so I take that also. I hopefully start the Enbrel next week I dunno insurance sucks these days...

I dont know that I have alot of advice for you....

I just wanted you to know that I will keep you in my prayers, that things start going weel for you and that it works out for you with what you want career wise.

Welcome to Kick AS,

Try and keep your chin up!

Lisa

Nah I havnt started the ENBREL yet I hope next week... Insurance sucks and is going to cost me 300 co-pay every month so I have to gear up for that. But as far as my back NO PAIN OR PROBLEMS AT ALL. I have had a perfect back my whole like never anything wrong with it. The doc did a CT scan to my pelvic lower back and it came back NORMAL. I go to UCLA next thurs for my 2nd opinion so I will know more then Im sure with tests. The only meds Iam taking now are Prednisone 20mg and Celebrez 200mg a day for swelling and pain.. My liver Enzyme was at 179, then I took another test and it was 150 2 weeks after and it droped 29 points, So the Doc said that my Liver seems to be getting healthy and healing its self. It was prob all the drinking I was doing and i was taking 30+ Vicodine when this first happen. These syptoms all started on 11-29-05 and for the first 3 weeks I took the pain pills, I dont take any now. and I have not drank since 11-24-05 and will never drink again. But yeah my syptoms are in both my ankles and feet and left knee are swollen and cant walk, I go from wheelchair to crutches... I was just curious it their were any LAWS in CALI that say I dont have to tell them what I have or Diagnosed with. I mean you cant Diagnose AS 100% soo maybe I can just say its an immune system desease and take the Enbrel to control it so I dunno....

Hi
I am sorry i dont know the answer to ur questions either. I live in the Uk and things are dealt with a little differently here.
In my opinion i wouldnt rule out AS until u have had the second opinion. I wish u all the best of luck with ur second opinion, and good luck with ur CA state medical, i have my fingers crossed (well my hands arent doin this at the mo they r too painful but u know what i mean) that it all works out how u want it to.
take care
heather

Chris,
I really have no idea about the medical exam you have to take and whether or not you have to tell them. I would talk that over with your doctor and see what information he has, or can get for you.
I did want to let you know, that just because AS is primarily listed in most information sources as mainly (or someplaces listed as only) dealing with the spine and lower back. A lot of people start having problems with feet or knees first. My brother started with swollen feet so bad he couldn't walk on them. My son Noah, started with swollen knees. It is different for each person I believe.
I hope you are gaining much information from this site. I know it has helped me tremendously. Sometimes I feel I have gotten better help and info from here than some of the doctors I have seen. 5 years after being diagnosed I actually had a doctor tell me that there is no way I have AS, as it is a "man's disease" And that because my spine was not fused, I couldn't have it since that is the first and only place it starts.
I asked him if the medical book he read that out of was printed on stone tablets. I got rid of that one and now have a great doctor.

Hope you are feeling better today.

Take care,
Pam

If you can keep your illness a secret and it will not show off unexpectedly, perhaps it is better to keep it to yourself. I have never disclosed my health issues with any clients. Becuase they make you look unreliable. I am unreliable at times, but I cant let that screw up my career. Many times, I have worked under severe pains without telling with colleagues or clients. There is a price to pay...

Of course, certain jobs are demanding for which chronic sufferers cannot manage or even dangerous. A police or military job is not exactly the ideal job for this type of disease. These professions show no mercy towards the human body and only the best can do well.

Ram

Hi, Chris:

Chances are that you do not yet have AS, but "pre-AS." Even some doctors wait for the damage before giving the proper designation.

Something to consider is a reactive arthritis that is in the process of turning into AS because of your genetic susceptibility.

I don't know what is required in the CA medical exam, but I am almost certain that, unless you begin the dietary regimen, you are at very great risk of developing AS and then may not be so suitable for any physically demanding occupation at some time in the future. Invest in yourself.

Good luck to You,
John