Questions about rheumy visit | Arthritis Information

I went to the rheumatologist yesterday. Ironically I forgot to take the methotexate the night before which was Wednesday night.

She is upping the methotrexate to 15 mg and told me to change the day to Friday morning.

I don't feel comfortable with this as I would rather take it Friday night when my husband is home. Actually I really liked Wednesdays.

I've decided on Friday night and hope it's okay to make this change with out consulting her. I had mentioned being worried about breathing problems at a higher dosage although I have had no problems so far. That was probably a mistake as I had just read about other people's concerns.

She also told me to wait one month and and taper the prednisone down to 2.5 mg's fron 5 mg's. This seems a bit drastic to me.

I have some one milligram pills my pcp prescribed so I am thinking if I have problems I may just go down to 4.

Do you think I am taking too many liberties in terms of not closely following her instructions?

I don't want to appear non compliant but I probablly should have expressed more of my concerns.

Any input would be appreciated.

Hi Dotty,

I don't see a problem with what you want to do. Over the last 15 years, I've changed my mtx days many times.

Good luck!

Do whatever makes you feel better. You can always call the office and tell them what you are doing. My rheumatologist has tried to get me off of prednisone, everytime I get below 5 mg the pain comes roaring back. I told him this at my last visit and he was OK with it.If it is better for you to take mtx at night then take it at night. The predisone i can't tell you what to do about that because I have never been on that one. memeYeah, I think that sounds ok too. I bet your doc just thought that it would be easier for you on Friday night. Guess you can always call just to make sure if you'd feel better.Dotty. Was your doctor thinking that by taking it on Friday, it would be the
weekend and you would be able to take it easy? Does she realize that
maybe Wednesday works better for you? It does not matter what day you
take it. What matter is that it works best for your schedule. I wouuld have
told her that Wednesday worked best for me. Also, make sure you let her
know that you don't feel comfortable going down that much on the pred. If
you do it on your own, and then she finds out, it may change the
relationship you and her have. You want her on your side. Good luck.My rheumy has never told me when to take my MTX. I decided on a day and I can change it when I want to for any reason. It makes little difference to me because I have no ill effects from it as many of you do. If it makes you tired or off colour, I can understand you wanting to take it at a time that fits around that reaction better.

Dotti, with RA the most important thing we get to realise as you gain experience after dx is that you listening to your own body and it's limits and needs is one of the most important things in managing this disease well.

As for the Pred, well, give the reduction to 2.5mg a go and if you have problems do what you suggest and use the 1mg tablets to go to four. I would simply tell your RD on the next visit or call the rheumy's office and tell them what you are doing.

Listen to yourself and what you feel your body needs and can cope with. This is important.

We need to take ownership of our disease and most RD's appreciate us doing that as it shows a level of acceptance about where we are at and what we can handle. This makes their job easier in the long run and we become much better at communicating the reality of where we may be at.

Do what makes you feel okay. When we first begin to see an RD we can feel like they are the 'authority' over our RA but actually we are.

[QUOTE=dotty]Actually I really liked Wednesdays.[/quote] Me too, but like others I have changed my MTX days (whether on oral or injection) to suit myself.

At least on occasion I have switched by taking half doses: half the dose on the "old" day and half on the "new" day. Perhaps a call to your physician's office to explain that Wednesdays currently -work- best for you and inquiring about half today and half on Wed. ...

[quote]...but I probablly should have expressed more of my concerns.[/quote]

It can be difficult to remember everything we want to discuss with our physicians. I write everything down, and like it or not, I go through my list one item at a time and ask questions over and over until I understand. After all, physicians work for us, not vice-versa.

However, having said all that I second Lorster's suggestion re: not wanting to create a chasm between you and your doctor: call the office.

FWIW, Happ

edited for formatting...
Happ39430.4562037037I can't advise you on the Pred. but I switched my day from Friday to Sunday gradually by taking it on Sat. instead of Friday on one week and then the next week took it on Sunday. The RD said that was fine. Really, I don't know what difference it makes which day you take it as long as you are consistent overall.

Thanks so much for your responses. Actually I have had no bad effects from methotrexate. I just anticipate that I might!

I took fifteen miligrams Friday evening and I felt fine.. I mention to the rheumy what I think might happen and I think she reacts from from my unsubstantiated concerns. My mother-in-law takes mtx and has had some breathing problems. She has severe arthritis so I mentioned her side effects as a concern without without mentioning her.

Again, thanks for your replies.