instruction: hello doctor I have seronegative inflammatory arthritis with ana positive joint pain especially at right knee shoulder joints map ip joints unbearable in the night for the last three months relieved with said non steroidal anti inflammatory drugs patient cannot walk chairbound with in situ catheters for more than four years I am taking ultracet if pain unbearable few days back I have taken injection kenacort 60 my im on the advice of rheumatologist with some relief but again pain resurfaced apart from that patient is on apixaben 5 daily mirabeg 50 soliton 20 and donezepil vitamin go daily no be and do issue I am taking inhaler lab with corticosteroids for long
output: hello I have gone through your reports and history there seems to be some inflammation going on in the blood reports and with a diagnosis of previous arthritis it looks like it is coming back again does rheumatologist did not want to start on methotrexate or any other dmard are you not on any medications for the ca prostate any other symptoms of oral ulcers dry eyes or dry mouth do let me know these queries and I would advise you further