newly diagnosed RA please help | Arthritis Information

Hi there; I am new to this site. I was diagnosed with RA 3 weeks ago. Rheumatologist says x rays show no damage yet to my joints but I have extreme pain. Hands, wrists, elbows, knees feet. I have all sorts of other things too swelling, numb fingers sometimes and shooting pain on both arms from elbow to wrist. I sometimes have had shooting pains from my hips too. I feel like I hurt everywhere all the time and no one seems to understand what I am going through. I am a full time nursing student at a big university and it is really hard to keep up like this. I also am a mom of a 6 year old little girl and a wife to a hard working husband. I just feel like my life needs to be on hold until I get better but I cant stop the things that still have to get done everyday. I am trying to cope with the pain but I am not doing very well. Doc put me on methylprednisolone 6 day pack the first week then just very weak non narcotic pain killers that are doing me no good. He wanted me to do methotrexate but I am worried about the side effects and the birth defects risk (I am not on birth control) So now he wants to try plaquenil starting tomorrow. I also am having uscle spasms and am having difficulty sleeping but am always exausted. I really am frustrated because I feel like he should be helping me out with the pain with something stronger. I feel like when I tell him about my pain that he is very reluctant to give me anything. Is this normal? should he give me anything else or is this what all the rheumatologists are like?

starting plaquenel

naproxen

tramadol

Hi and welcome.

Hang in there. There happen to be a lot of posters who really know their stuff. They will help you out I am sure.

I am not sure about the rheumatologist as I don't have one as of right now. Right now I am only on an anti-inflamitory along with a few other meds for my stomach.

Hey there - I'm newly diagnosed as well. I was diagnosed in January. I know the methotrexate (MTX) is scary, but it is one of your best shots at relieving the pain. After a couple of weeks on it I was pain free. It gets at the source of the pain instead of just masking it, and I agree Tramadol is a joke!

I have had no side effects after 2 months.

You would have to be diligent about birth control. Good luck.

I find it difficult to understand why a doc would not be trying to make the patient as comfortable as possible.
You are going through a very stressful time at the moment, try to stay as calm as possible as stress will only help to hurt more..

Welcome to the board.
The pro's will be along shortly with more detailed replies.
Welcome to the board. Sorry you have RA.

If you have pain, that just means you are not on meds that are controlling the RA from attacking and causing inflammation. Pain meds do not really help with controlling RA, it is to help you cope with the pain while you are working your way toward meds to help control your RA. MTX is probably the best defense you have right now to help get it under control. There are reports that if treated aggressively during the first so many months that you have a chance to control it easier and a chance at drug induced remission.

I know you fears of birth defects and all, but maybe you need to go get some type of birth control in place, so you can start on the course to find the right med combo for you.

Good Luck on the plaquinel! Hope you can stay at the med and be pain free.

Keep us posted!

Welcome to the board. I'm so sorry you're dealing with RA along with your busy life. I can just imagine how hard it is to deal with everything at once.

The MTX is the gold standard for treating RA and the one (along with Plaquenil) that they usually try first. I know the side effects are really scary but as long as you don't get pregnant (a HUGE no-no) and get your blood work done regularly, you should be fine. Be patient with the drugs. It takes time for them to kick in. I wonder why your doctor isn't putting you on both MTX and Plaquenil. That has been proven to be the best way to really fight the RA....aggressive treatment immediately. As a nursing student you are in a good position to really discuss your case in a way some of us cannot and that will be to your benefit. Ask him about using both drugs and of course, folic acid for the MTX.

Please let us know how you make out. It's not true that no one understands what you're going through. WE DO and we want to help. Call on us, please.

I can give my guess as to why he's hesitant to start the pain meds.

If you take those, before starting RA meds, how would you ever know how effective the RA med is? He may be hoping that getting you on a good med that controls the disease will take the pain away.

But that's my speculation. Hang in there, and be persistant. Let him know how you feel. And know that the sooner you get on meds, the sooner you'll get this under control. *hugs*

We're ALWAYS here to answer questions too, so don't ever feel like you're lost or confused, just pop on and ask! :)

Welcome. A friend of mine chose another DMARD med other than MTX so she could have another child too. She did very well on the other drug (sulpfasalazine?). It is important to make decisions about your meds with consideration of where you are in your family life, as you have. Don't take MTX if you are going to try to have a child soon, there are other choices as your RD has presented to you. If you do decide to do MTX, you'll need to take birth control and stop taking it well in advance of trying to have another child.

It can take weeks or months for the DMARDS to take effect, with adjustments along the way by your RD in response to your letting the doc know how you are doing. It's very hard to have patience, especially when your life is as busy as your is, but you will have to find it until you get the right mix figured out with your RD.

As for having pain that is acute and not managed while the inflammation being brought under control by the DMARD, as others have already said, you need to address this with your doc.

Best wishes and I hope your pain is better managed soon,
Joy
I do too, Bodak, find it difficult to understand why a doctor would not a patient as comfortable as possible either but it happens. I was left 10 years without any pain relief.

All you are describing is RA. What your RD is doing is hoping that the DMARDs (Disease Modifying Anti Rheumatic Drugs) ie Plaquenil will get you out of pain and they won't have to resort to pain killers. Plaq takes three months to kick in so that plan is not really helpful.

I have a single parent to a six year old girl too and went for 10 years without pain relief attempting to cope because the DMARDs were supposed to cut it, however three years past dx they still haven't found a medication that stabilizes me so 6 months ago I demanded pain relief. I hurt all the way from my nose to my toes, everyday, all day without relief ever.

Okay, so let me give you a couple of first steps you can take as being dxed with this is scary and overwhelming. You will experience grief and loss, as will your family and you will have to make adjustments, all of you, life will not be the same.

1. If you have a PCP or GP, as it's called here in AU, go to them about pain relief. Here is some information I wrote recently for another post about the two types of pain relief that is used for chronic diseases:

There are two types...sustained release and fast acting that they use for us.

Things like Endone, Methadone, Panadeine Forte...sorry, the names are probably different over there...they are the fast acting and used for breakthrough pain. So you take one of them and it will last say, 4 hours. Short, acute, fast acting.

Then there is the sustained release...which for chronic pain sufferers like us is what they use to control the pain in general. These are slow acting, and may last anything from 12 hours to 24hours to 72 hours.

MS Contin - 12 Morphine, Kapanol - 24 hour morphine, Fentynal Patch which lasts three days or 72 hours. Sorry, again the names are probably different over there.

In my experience, as a chronic pain sufferer, the doctors prefer to have you on a sustained release medication and then bring in a fast acting for any breakthorough pain.

So me, I am on a Fentynal patch...that's my sustained release and then I take Endone for breakthrough pain. So some days I take no Endone at all and others, like today, thank you for all your replies. I am reconsidering the methotrexate because I know it is the strongest and may work the best. We do want more children but there is no way I am trying in the near future with what has been going on and how much pain I am in. I guess I should go ahead with the birth control. I have an appointment with the rheumy tomorrow and will talk about the whole thing. Thanks so much for all the support. I will let everyone know and keep in touch.

elise
Well, Elise. I sure can't add to what all these people have said. But I do want to welcome you to the board. As you can see their are many fine people who are here to help, please feel free to ask anything.

My kids were older when I was diagnosed, I can only imagine the hard time you have trying to do all the things you have to with a little one. Do you have friends/family nearby who are willing to help out? I know it's hard to ask other people to do your stuff, I think we all feel that way. But until your disease is managed, and I'm sure it will be, take whatever help comes your way. It feels good to help so their's something in it for them too!!

Anyway, try not to be discouraged. RA isn't as bad as you are probably thinking it will be.Welcome to the boards.
I don't have a whole lot to add, I'm fairly new here and have no DX yet, but I come here for information and I ask questions when I have one. Everyone here are so helpful, so ask away.

Welcome. First I think you should use birth control. It take a year or two to get the RA under control and your number one priority is to get it under control. The most recent tactic is to hit it hard and use the important strong meds first. The most damage happens in the first year or two so really you must look at this situation including the future. MTX is the first line med for a reason-it works for more people for a longer time than any other medication. After you have it under control you can think about having another child but if you don't get it under control you won't be able to care for the child you have and lets face it, you don't want to be on most of the meds (except pred seems a common drug even while pregnant) without birth control.

http://www.hopkins-arthritis.org/
http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020
http://www.hss.edu/rheumatology.asp
http://arthritis.about.com/

Robin

Here are some sights to look at for more information.Welcome to this board as well Eliseo- we've met on another. This one gets a lot more posts but both have equally as nice and helpful people!Hi E and welcome to the board. Keep us posted on what your dr says. We all are interested and care what happens to our "fellow ra'ers". I would be firm with the doc and tell him/her that the meds you are on isn't helping and you need something else for pain. Also, tell the doc you have a family to raise and a life to live.
Keep your chin up!
take care
Hi Elise, you have been given some really good advice, my little bit I feel is very important, KEEP A JOURNAL, meds that you are taking and doses, side effects if any, pain levels, joints that are affected, ie; any new ones. A record of your physical activities, for example, housework might bring on a flare, and having a journal is so handy when the Drs ask how you have been going. Trust me it is vital. Hugs and welcome, Janie.

Copyright ArthritisInsight.com