RA

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Hi, I went to a general doctor about a month ago because of pain in my hands and wrists, and occasionally one of my toes. He did bloodwork and the results came back with high RF, and inflammation. He then set me up with a Rheumotologist. I went there yesterday and right off the bat he prescribes me methotrexate, he did his own blood work, and X-rays of my hands and feet. I'm to take 5 of the Methotrexate pills a week, plus meloxicam. Does this sound right? I don't have anything completely unbearable at the moment, and I hope it doesn't get that way. I have no swelling...just painful fingers when I bend them, and also..right now my left knee is swollen. Seems to me that he should have prescribed prednisolone to get the swelling out of my knee. Any info is appreciated. What should I do from here? I want to be really pro-active so that I can get a hold on this before it affects my entire life. 

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  • Posted

    Hi Erin: you dont give your age but I got RA at 16. I'm now 61, and after trying everything on the drug list since 1971, methotrexate did work last year, 20mg a week, with folic acid tabs to keep my liver in a good state..The side effects were not good, so I went onto injections that helped. Am now on Cimzia as well, that shuts down my immune system, and pow, overnight, no more pain and the inflammation has died off. Over the years, nothing worked. one Doctor put me on 32 soluble aspirin a DAY...

    Good luck..I have found, what works for one person, may not work for another..

    Regards

    Dave

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    • Posted

      By now you can see you have a good resource in this site and in those who have had their own experiences. Also use Google to research your concerns and observations. There are several arthritis research sites online, such as "Arthritis Today" for one.

      One more thing....a positive outlook really does help!

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    • Posted

      Oh yes!! I have what my Consultant called "total destruction" of joints. The joints inflame, break, then turn to "dust" and disappear! I have no sacroiliate in the base of my back, it's gone!

      Timothy11402 commented to me above, "a positive outlook helps".

      After 44 years, I have only got through this with that!

      There are millions worse off than me.

      The Cimzia injections have worked. For the last 4 weeks I have been 99% pain free!

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    • Posted

      No, no, don't be sorry!

      I'm fine compared to a lot of people.

      I get worried for the younger ones on here! It's not easy to come to terms with.

      But then me, being archaic, I was a tester for every conceivable drug going in the 1970's!! Now, all banned!!

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  • Posted

    Hi Erin

    RA is an auto immune desease (your body is rejecting it's own

    joints)

    MTX is an immuno suppressant this is used routinely in early

    diagnosis it is not a pain killer so usually alongside you will most likely be given an anti Inflamitory NSAIDS (meloxicam) is a

    NSAIDS

    Along with paracetamol or Cocodomol or tramodol

    Everyone is different.and pain tolerance is different.

    MTX takes a few weeks to get into your system and they will

    need to find the correct dose for you if you take MTX read the

    side effects and don't suffer in silence as some people have

    little or none of the side effects others have extreme side effects.

    If you fall into the second category you can always ask for MTX

    in injection form which is easy to do yourself and relatively

    painless you should have also been given folic acid to take 3

    days after you take the MTX. To lessen the effects on your body.

    Painful joints do not necessarily need to very swollen usually

    There is an excess of fluid.around the joints some or all of them.

    Steroids can be used to supplement the Meds you are taking if it does worsen quickly ask for steroids to get you through the 1st

    Few months until MTX kicks in this can be as you suggested

    prednisolone or injection in your bottom of Depomedrone

    But as I said earlier you can take painkillers along with what you have.

    But if your joints are swollen try to take it easy on them, ice packs are a big help on the knees

    I buy the plastic bags that you can make ice cubes in as they

    bend nicely over the joints.

    You only need about 10 minutes every few hours.

    Hope this helps don't forget knowledge is power so read all you

    can before your next Rhummy appointment, it's always handy to get the direct number for the specialist nurses too as you can

    always ring them for advice.

    Hope this helps and good luck

    A LITTLE ABOUT ME

    I have had RA for 15 years now and I am 57

    I have just gone through an acute flare up which has lasted 10

    Weeks or so, I also take amytriptaline 75 mg (which is a high

    dose) at night as a muscle relaxant it is actually an anti

    depressant but not a very good one but the starting dose is

    usually about 30 mg.

    This medication helps with the sharp shooting pains I experience at night.

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    • Posted

      Thanks so much for all of the info. I am 33 years old, and this has been going on for a year or so. Rheumy didnt prescribe anything except Methotrexate and Miloxicam...now Im worried about the Folic acid, as he didn't say a word about that. Not satisfied at all with the Dr that I saw...Im working on finding a new one. 

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    • Posted

      Hi Erin

      when first diagnosed I had a steroid jab in backside, mxt and folic acid ( to offset the anti folate action of mxt) I think it's worth googling whether can have mxt without folic acid on a different day as I thought it was always prescribed.

      i was in a lot of pain - hence steroid jab. The meloxicam is an anti inflammatory so should reduce inflammation so may not need pred.

      But latest research shows early diagnosis followed by aggressive treatment of 2 DMARDS is best to hold back disease. Like you I ve been keen to be proactive and positive. I found the following web sites useful. Arthritis research and NRAS. There are lots of tips too on fatigue, dealing with pain, sparing joints. I am 65 and diagnosed nearly 3 years ago. I am now on a biologic as other meds were not enough - it took a year to find what would work for me, but we got there and I m now in remission. Hope you get a consultant who you can trust.

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  • Posted

    Hi Erin:

    Your experience is a lot like mine. I had pain in my feet and in the large knuckles of my hands. And then my ankles and wrists were involved. My GP sent me to a rheumatologist the very day I complained to him of my pains. I am a negative RF person, but I do have RA, the "palindromic" type which means the RA travels around my body in unpredictable locations and severity of pain.

    At the start, I was put on plaquenil and meloxicam. After two years I was put on methotrexate (mtx) with 12, 2.5mg tablet per week. I soon found that taking meloxicam every day produced blood in my urine (invisible, but there, and which is not natural for a guy). Now I take it but only if I need it and you will learn when that is by listening to your body. The blood stopped when I was more sparing of the drug.

    As time went on, my 12 pill per week mtx intake has decreased to only 3 pills per week (due to me taking a proactive role just as you would like to do) by using turmeric capsules (1g to 1.5g per day) which has made it possible to decrease my mtx intake. Gooood stuff and your liver actually likes it. Now I supplement that with pineapple juice and black cherry juice. Google this stuff and you will find reputable sources that advocate the juices.

    As for your knee, it is possible the swelling is due to inflammation from the RA. That should be toned down as time goes on. 

    I just had an abnormal CBC (blood test) which showed an increase in the diameter/volume of my red blood cells due to an inability to metabolize folic acid in the presence of mtx. So now I take leucovorin which is the metabolized form of folic acid and will soon learn if this has been effective. Otherwise I feel pretty good.

    So one has to notice what is going on and bring ANY questions/concerns you may have to the rheumatologist. I found that things that are seemingly innocuous perks up the doctor who then makes needed adjustments.

    Your proactive attitude is an absolutely beneficial thing for you!

    Good luck and be positive.

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  • Posted

    Somehow I was misinformed on how to take the MTX... I thought I was suppose to take 1 pill a day for 5 days... But I called today, and the nurse said no I was suppose to take 5 pills at once. I told her I took one last night, and she said to take the other 4 tonight. But I'm scared to take them because of the the folic acid issue. He didn't mention anything about it. I did blood work yesterday and I'm scheduled to go back Dec 1st so I guess he will know more at that time. What do u guys think? Should I take the remaining MTX tonight? Or wait to call them about the folic acid?

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    • Posted

      By all means take the 4 mtx tonight. My problem with folic acid took 12 years to develop! Each of us responds differently. 

      I know you may have seen others on this site anticipating that the mtx intake would be a horrible, sickening event. Only a minority of patients experience this. You may or may not be one of them. See what your body does with this. 

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  • Posted

    If it was me..I would ask re the folic acid. What size are the mth pills? 25mg per week is ample.
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