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Methotrexate/operation

Posted , 8 users are following.

DebbieHurts
DebbieHurts

Hi, I can't seem to figure out how to search this particular forum for the posts that might be about this subject, so if anyone can explain that to me, thanks!  About this: My history is 3 years of PMR, trying to reduce pred. getting a flare, and going all the way up to 20 mg for a year, and now reducing to 15 due to an upcoming knee replacement operation.  I'm in so much pain on 15 and my SED rate went from 41 at 20mg to 52 at 15mg.  I'm just bearing it for the help it gives to not get infections at lower doses during operations.  So, anyway, today the rheumatologist decided to give me a low dose of methotrexate to take with the 15 pred.  We are going to see if that lowers my SED marker.  Has anybody else done this?  Thanks for any info.

1 like, 11 replies

11 Replies

  • ptolemy
    ptolemy DebbieHurts

    Posted

    Hi Debbie, I do hope your knee operation goes well. Out of interest is your surgeon happy to operate while you are on 15mg of pred? Also have you been told to stop taking methotrexate before the operation? I was just interested to see how your surgeon thought. 
  • iellen32
    iellen32 DebbieHurts

    Posted

    I am sorry for all you are going through and ask if you would consider to hear a second opinion.

    I would try as soon as I could I would look for means to bring the relief I need.

    I have GCA there are 4 years now and when something comes to break my well being in my case my vision I go to look for another opinion.

    Be safe, take care.

    My heart is wishing you the very best in 2017 and always.

    iellen

  • FlipDover_Aust
    FlipDover_Aust DebbieHurts

    Posted

    I had some (minor) surgery at 10mg - no drama. I also take methotrexate and can attest unequivicably that it has assisted me in reducing pred significantly.

    However, I don't understand the concept of reducing your pred dose to increase your chances of fighting an infection, if one occures, if at the same time you are being put on MTX as it reduces your immune fighting capacity even more!

     

  • DebbieHurts
    DebbieHurts

    Posted

    Thanks for your replies.  That is great that you told me about methotrexate also causing trouble; I will ask the doctors about that right away before taking it.  Maybe I should wait to take it til after the operation.
  • amkoffee
    amkoffee DebbieHurts

    Posted

    I can't believe you're doctor allowed you to stay on 20 milligrams for as long as you have. You are very fortunate to have a doctor like that. I have been battling my Dr and I've only had PMR for 4 months and she's already pushing me to get off the prednisone. And I keep having trouble getting past 10 milligram. Good luck on your endeavors. I hope that your surgery goes well.

    • Anniecurd
      Anniecurd amkoffee

      Posted

      My rheum is the same. She says I want you off the pred by this date. Well excuse me, my body has other ideas. It's not ready. Do they think we want to be on steroids? Of course not, we're not stupid, we understand the risks, but if it's the only thing that works for the pain, then we're stuck on it for however long it takes, no matter what the doc says. My doc is concerned for my bones on the pred. Well, if I'm inactive because of pain, isn't that also bad for the bones?

    • FlipDover_Aust
      FlipDover_Aust Anniecurd

      Posted

      ...of more concern is what the untreated inflammation will do to your organs!
    • EileenH
      EileenH Anniecurd

      Posted

      It is - being unable to move with PMR can lead to weight gain, osteoporosis, potentially diabetes and raised cholesterol (immobility is a major risk factor for them all), depression due to being ill and in constant pain. I once compared the side effects of pred and unmanaged PMR - pred may have potetntially 80+ but there are a lot they get uptight about that happen with PMR too. I know - I had 5 years of unmanaged PMR. It was not a nice experience and it informs my own attitude to pred.
  • EileenH
    EileenH DebbieHurts

    Posted

    If you go to the "front page" all the previous posts are listed. Takes a bit of time but scrolling down them is as good a way as any of finding such posts. (Click on Polymyalgia rheumatica in red at the top of the page, above Follow this discussion).

    If you are trying to reduce 5mg at a time that in itself could cause pain. But if you are struggling to reduce it is possible that you have something besides PMR, such as late onset RA for example.

    Methotrexate won't help the PMR directly but if there is any RA present it may help that and in some people it also means some patients get more effect from a given dose of pred because it changes the way the body processes the pred. It is mentioned in guidelines for managing PMR as something to try but the evidence is very mixed.

  • Anhaga
    Anhaga DebbieHurts

    Posted

    I actually discovered this forum when I googled something about whether it was okay to increase pred dose if pain returning.  It was the middle of a sleepless night and I felt I had fallen amongst friends.
  • amkoffee
    amkoffee DebbieHurts

    Posted

    Actually it's funny you mention RA because just today my rheumatologist called me after examining all the blood work and everything and she thinks I have RA. Although even she had to note that there's no markers to indicate that I have it. And of course none of my joints are swollen the only reason she thinks I have it is because even though my PMR has settled down since I went up to the 15 mg of dose after I flared I still have joints that are hurting me. And I truly have to say I don't believe what's hurting me now is PMR related. I don't know what's causing it but I'd sure like it to stop. So she gave me some ibuprofen lotion to rub on the joints that hurt and actually lowered my methotrexate. So I'm kind of at a stalemate right now. We'll just have to see what happens.

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