I was diagnosed with PA about a month ago | Arthritis Information

Share
 

About 3 months ago the knuckle on my index finger of my right hand swelled up. It was all of a sudden, in about three days I could hardly move my finger. I went to my family doctor. They x-rayed it and found nothing in it. He thought it was Gout. He gave me a steroid shot and a dose pack of MethylPrednisolone. He also gave me prescriptions for Methocarbamol - 750 MG and Hydrocodone-APAP 15 MG. After taking the medicine it went down to the point that I could just touch the palm of my hand after about noon. I went back to see him a month later and he made an appointment with an Arthritis doctor.

By the end of that doctor visit with a bunch of tests I was told that I have Psoriatic Arthritis. The doctor prescribed 2 packs of MethylPrednisolone to be taken during the month before my nest visit. He told me that there are several levels of treatment. First is Meloxicam 15 MG ( Anti-inflammatory), which I have been on for a year or two. Second is the steroids. Third is methotrexate with folic acid. There also are more levels. I went for my second visit last week and after more blood tests he prescribed methotrexate with folic acid. They discussed the side effects, depressed immune system and possible damage to my liver.

My thinking was until I started reading this forum that I would try to get my family doctor to prescribe enough Hydrocodone-APAP 15 MG to get me thru the remodeling of our house, Maybe three months. However, after reading some of your stories I think that I may have to start taking methotrexate with folic acid. I must say that I am not happy trading a sour knuckle for a sore throat and liver damage.After reading some more posts, I see that many of you are young. I guess that I am one of the fortunate ones, I am old, 68. lol After the doctor started asking me questions about my medical history I see that I have had many of the symptoms for years. I have had soriaous (skin problems) for years and iriutis (eye problems) since I was about 20 years old. I had a sever sculious (curved back) and surgery for it when I was 28. Sorry I can not spell all of these words, I will have to start looking them up.welcome rolacoy,  have a swollen ondex finger as well. I was diagnosed a couple years ago, still trying meds. If i can give you one bit of advice, please be careful being on the prednisone, it is a nasty drug! Only use it if you have too. I am on mtx enbril and prednisone. anyway its noice to meet you, i seldom meet and talk to people with PA. I went to my family doctor yesterday to discuss the use of methotrexate with folic acid. After talking with him I decided to start taking methotrexate with folic acid. I have an appointment with the Arthritis doctor in about three weeks to do blood work to check my Liver. We will see how it goes.Hi Rolacoy!  Here's my question you asked me to post on your post. :)  Hope we get some answers. :)

 
After about 3 months of shoulders and hip pain..we went to the Rheumatoid MD.  My DH has psoriasis. In January, the Dermatologist gave him a spray that kicked the lesions perfectly within a few weeks. Then..all of a sudden my DH started getting the shoulder and hip pain. This went on for 3 months.  Yesterday the Rheumatoid. MD prescribed him Humira.
My question is...in researching the Humira..it says should consult MD if have past history of hepatitis.  My DH had Hepatitis B 35 years ago.  (the infectious type..not the needle type)
Is he still eligible to take the Humira?  Thanks for any help.
Roacoy..Do you have Psoriasis too?  Also..how long after the onset of P did you discover you have PA?  My husband's PA just came on real quick.. just after he was spraying his skin with the steroid spray.  It's almost like the skin problem went inside him and destroyed his hip joints!!!  Weird and very surprising.  He's always been pretty athletic. :(I guess I have had the symptoms most of my life. I had a curvature of my back that started when I was about 14 years old. Around 20 till 40 I had a lot of trouble with iritius in my eyes. Psoriasis came along by 30. I have always had a lot of back problems. Most of my upper has been fused and some rods put in it. My toes on my right foot hurt and feel real stiff, that started a year or so ago. About 3 months the knuckle on my index finger of my right hand swelled up.

I went to an Arthritis Dr and he says that I have PA. I am a 68 year old man. I have probably had PA for years. I would not have went to the arthritis except for the knuckle.The Psoriasis is on both sides of my nose and chin, behind my ears and scalp.Hi and welcome Rolacoy and Marcy.  I'm in clinical remission for rheumatoid arthritis but PsA is flaring and very painful.  Unfortunately, mine is in my knees, feet, ankles, elbows, and hands.  Don't think for a moment that it will remain isolated to just your finger.  PsA started in my finger 23 years ago.  I wasn't diagnosed until 1998 with a severe onset of RA and then diagnosed in 2005 with PsA.  I went to Stanford Arthritis Clinic and was told that I didn't have RA because my RA factor was negative!  It has since reverted to positive. 
 
Whatever you do don't take this diagnosis lightly.  Even though your joint doesn't appear to be inflammed or hurt, damage is still being done.  I found that out when I had my second set of xrays done and they were compared to the first set that was taken several years earlier. 
 
Be more afraid of the disease process than the meds.  Most of us on the forum have been on MXT for years and I've read of few problems other than brain fog, a little nausea, some intestional issues, and every once in awhile someone will have elevated liver enzymes.  Mine were elevated slightly one time and I quit MXT for a month, labs were normal and I restarted MXT.  There is the occassional person who posts their horror stories of MXT but those are few and far between.  Your priority when taking these meds is to have routine follow-up with your RD, lab testing done every few months, and to take some precautions regarding infections.  Your RD will order a TB test and lab tests prior to you starting MXT. 
 
If you have a cold, upper respiratory infection, skin rash or infection, or other medical issue you should call your internist or RD.  Because you'll develope a compromised immune system it's important that you stay well.  Some people have more of a problem than others.  I've been on MXT 17.5 mg. for 4 years and in that time I've had 1 sinus infection and 1 upper respiratory infection, so I guess I'm not too compromised.   Like you Rolacoy I'm in my 60's and I'm pretty careful about my body. 
 
Marcy, your husband needs to call the RD ASAP and talk with him/her about his medical history of Hepititis.  Only his RD can answer that question.
 
Take care and keep us posted.  Lindy
Something else that I forgot is that I have a problem with a dry mouth mostly when I sleep. This wakes me up at night and also small sores form inside my mouth. Are these also part of PA or some other problem ?Sorry, but being new to PA questions keep coming to mind. I have worked with teenagers in church for 45 years. I am youth leader in our church and teach on Sunday and Wednesday. On Wednesday I some times have 25 kids in a 12 x 24 classroom. How much will my risk go up for getting colds from the kids since I am taking MXT ?Probably very little risk.  I'd still take some precautions.  Sick children should stay home, even though it's church.  Use bacterial soap and wash your hands often.  Don't touch your face or around your nose.  If a child comes in who's obviously ill, I'd talk to the parents about removing the child from the group.  Not only will you possibly get ill but the other children will.  If it's teenagers I'd ask that they return will they're well.  After all these years you've probably had exposure to most of it.  Lindy Dry mouth could be the start of another auto immune disease -Sjorgens (Sp?)  Call your RD and talk to them about this.  I've found that rinsing my mouth with a diluted 3:1 Hydrogen Peroxide keeps the mouth sores at bay.  I've had one in 4 years.  Rinse for 5 minutes and spit out, rinse mouth.  LindyI took 4 MXT pills on Wednesday as prescribed. Yesterday I had some intestinal problems. I sometimes have flair ups of Diverticulis. It was not bad by discomfortable. Today I had no energy till this afternoon. Are these symptoms of taking MXT ?It may or may not be related to MXT.  You're on a low dose of MXT and I doubt that symptoms are related other than the fatigue.  With time the side effects will disappear.  Usually the fatigue if the day after taking MXT.  Very unusual that it would occur 48 hours later.  You'll be fine.  I know it's scary but hang in there.  Right now I'm on 17.5 mg. injectible with no symptoms.  Others are on 25 mg. with no symptoms.  Others have persistent side effects and have to discontinue MXT.  Think positive about the results of taking the med.  LindyI realized that I for got to take the Folic Acid yesterday and today. I forgot what it does.Also did they tell me not to drink any alcohol ? I do not drink, but if so I will have to be careful with anything that contains alcohol like mouth wash, etc.Folic acid is supposed to help with the side effects of MTX.

MTX makes me ill for about 48 hours after taking it every time.  I have been taking MTX once a week for 3-4 months now.
shouamabane, what medicines do they have you on besides the MTX and Folic Acid ? I take the following:

St. Joseph 81 MG - each day

Dairy Digestive Supplement - at least one a day

Glucosamine Chondroitin - one per day

Omepraxole 20 MG - 1 per day ( anti-acid)

Meloxicam 15 MG - 1 each day (anti-inflammatory)

Hydrocodone-APAP 7.5-500 Tamck, 1/2 tablet every 6 hours ( for pain )

Methocarbamol 750 MG Tabletwsw 1/2 tablet every 6 hours ( muscle relaxer )

MethylRREDNISSolone 4 MG - Not taking on a reg basis ( steroid )

Methotrexate 2.5 MG - 4 Pills each Wednesday - ( immune suppressant )

Folic Acid 1 MG - 2 pills each day - ( counters the MXT )

I won't forget the Folic Acid again. I felt really bad yesterday. Today I feel better, still tired and have a touch of diarrhea.. I don't know how I am supposed to feel.

I choose Wednesday to take the MXT, I think that was a good choice of days because of two factors. We are in a remodeling project. My help works Monday thru Wednesday and I teach teenagers at church on Wednesday night and Sunday. If I am going to have a down day or days Thursday and Friday will be the best days for me.
I have felt pretty good today. Just my lower back seems to be real tired and crampy.Mouthwash, cough medicines, etc. are ok.  LindyMany of the medical problems that I have I have had for many years, I am 68, are these. Do they all fall under PA. ( now, I can not spell all of these medical terms, but will try. ) I have had Scoliosis of my spine since I was in my early teens. I had surgery when I was 28, a Herrington Rod instrumentation that fused most of my upper back (two steel rods). I had my first case of Irisitus at about 20. It was really a problem for several years. I learned to recognize when it was coming on and treated it early.

Is Psoriasis and a scaly scalp the same thing? The scaly scalp came on in my mid 20's. The Psoriasis started probably in my 40's. I have treated them with a save that the pharmacist sells me, not sure what it is, but it has a steroid in it and works pretty well.

Dry mouth and mouth sores started about two years ago. Also coughing as I try to go to sleep. I keep a cough drop by my bed and bite off a little bit before I go to sleep. When I wake up during the night my mouth is dry, but usually don't have a problem with coughing.

I read on someone's blog that alcohol, coffee, tomatoes and other spicy foods are not good for people who have PA. I do not drink any kind of alcoholic beverages, I do not like coffee, tea or spicy foods. I do not use much dairy products because of being lactose intolerant. I do sometimes eat tomatoes and I like tomato soup. My diet is pretty broad, However I do try to keep my weight under 195 pounds. Breakfast is usually a Boost and biscuit, I eat a good lunch, I try to keep supper light. Before bed I eat 4 chocolate chip cookies and some water. Well, maybe 5 ? lol Are there some foods to stay away from ?

Below are the medicines that I take, what a pile of pills.

St. Joseph 81 MG - each day
Dairy Digestive Supplement - at least one a day
Glucosamine Chondroitin - one per day ( Supposed to improve joints )
Omepraxole 20 MG - 1 per day ( anti-acid)
Meloxicam 15 MG - 1 each day (anti-inflammatory)
Hydrocodone-APAP 7.5-500 Tamck, 1/2 tablet every 6 hours ( for pain )
Methocarbamol 750 MG Tabletwsw 1/2 tablet every 6 hours ( muscle relaxer )
Methotrexate 2.5 MG - 4 Pills each Wednesday - ( immune suppressant )
Folic Acid 1 MG - 2 pills each day - ( counters the MXT )
MethylRREDNISSolone 4 MG - Not taking on a reg basis ( steroid )

I know I am repeating some of this, but I am trying to learn about PA so I can learn to deal with it. I think that I must have had PA for a long time. Seems that my doctors just never connected the dots. At first I thought, PA, so, no big deal. After reading some of the forums I see that it is a big problem. I am fortunate to have a light case and am old so I won't have to deal with it for all of my life. There are "JUST" a few things good about getting old. A pretty girl opening a door for you, Social Security, not having to go to work every day, is there something else. lol

Rolacoy, your questions for the most part oare moot.  Much of this happened in the past and it's your present symptoms that need to be addressed.  You have to be patient.  It can take MXT 3-4 months to start working.  If it hasn't started by that time your doctor will raise the dose to 4 or 5 pills.  If after a couple of months and you're not responding they'll up the dose and may add Enbrel or Humira to the mix.  Finding a combination of meds that work is a long, slow process.  It's the very fortunate few who have immediate relief. 

You need to call your RD about the dry mouth and eye issues.  Like I said you may have another auto immune disease - Sojgrens (sp) and you will need to be treated for it.

Concerning your spine, no one on the forum can tell you if it's related to PsA.  Could be, but likely not since it's been such a long time between your surgery and diagnosis.

Have you had xrays of your hands, feet, or knees? 

Also, I'd go to a dermatologist about any skin or scalp problems.  There are prescription meds that will completely clear up your scalp and yes, it most likely is psoriasis, but once again it might not be. 

Please Google Psoriatic Arthritis and look at and read the sites that pop up.  There's a lot of information there.  I'll look for my saved sites and post them for you.  Lindy
Thanks for all of the information. From all that I have been reading I must have a very light case at this point. Yes they did all of the x-rays and blood work. I go back to the doctor the 18th of June for more blood work, to check my liver I think. With the help of people on the forums and other reading online I will have a long list of questions. I think that I will also take my wife so she can get some understanding of PA.Always try and take your spouse, it gives them a much better understanding.  PsA is a hard disease to wrap your brain around.  It's hard for us, how do you think it is for others?  Also, there's another set of ears listening to what the doctor has to say and that's invaluable.  LindyThursday will be very interesting. I will not forget to take the Folic Acid this time. Last week I forgot to take Folic Acid on Thursday, I remembered about 2:00 PM on Friday. Thursday I felt bad, I didn't hurt, just no energy.

And my next step is to make a list of questions to take to my next Dr visit. The 18th of June will be my third visit. The first visit procedure was to visit with the Dr.'s Asst. Then blood tests/x-rays and a visit with the Dr and his Asst. The second visit I saw the Asst and then blood tests. I had one more question after the tests, I went back to the nurse and ask to see the Asst again. She acted like that would be unheard of, said that the Asst was seeing other people and asked what the question was. I asked her and she gave me kind of an answer.

Do you all always see the Dr or an Asst ? I want to see the Dr, but in Shreveport there are only a few of these Dr.'s

If you have any suggestions as to the questions I am listing below please let me know. I will take my wife this time. The questions will help her understand what is going on. My list of questions for the Dr. follows:

• Can we take Penicillin while taking MXT ?
• What is that Folic Acid does ?
• Could the PsA go into remission so I can quit taking the medicine ?
• Is dry mouth one of the symptoms or another problem ?
• From the Liver test that you took does MXT seem to be doing any damage ?
• Steroids seem to help the way that I feel, what is the down side to daily steroids ?

I will add to and revise this list over the next two weeks.hi Relacoy and welcome I have pa and psoriasis for awhile(6-7 yrs) now I went for 4 yrs or more before the dr would send me to the rd.  I was diagonose with ra before pa,and the dr just kept thinking it was ra or oa.  I finally got another dr to listen to me and she sent me to the rd and that is when I foung out I had pa. Lin was right in saying it will take sometime for the mtx to kick and it is sad to say but your body will get use to the mtx.  If the mtx is hard to take ask for the shots, some people say they found it was easier to take.  The scaley scalp is moe then likely psoriasis.  I have come out of remission and am having alot of problems right now.  the psoriasis is going havoc on my body, and my hands,  and joints are swelling but they are not as bad as they  usually get.  I know it is fustrating and daunting, but LIN is right in saying to take your spouse with you to the rd and have the rd talk to them as to exactly what is going on.  Another thing too go to the library and check some books out on arthritis, they do have definitions of pa in them and it will help you get an idea of what is going on. If you are working with young children what I use to do during flu and cold season was have them  wash their hand before class and after class.  I was helpng with computer lab so the school would have all the keyboards,desks, and monitors wiped down nightly to help cut down on students being sick.    Usually if you are taking penicillin, I would assume it is for an infection, the rd normally will want you to stop the mx, ebrel, etc. till you are over the infection.  I cut myself with a piece of metal one time didn't even think about it till my leg started turning red and there was a red ring going around my leg.  I had an infection and blood poisoning.  I was off my feet for 3 -4 weeks.  you just learn to watch what you are doing try and take better care of yourself and learn to take a deep breath when it gets fustrating.  Again welcome to the board, we are glad you found us!!!! meme1.  Usually the RD will tell you to stop MXT if while you're taking Penicillin
 
2.  Folic Acid helps with building a certain element in blood cells.  Been a long time since I've read about Folic Acid.  Please Google and read about it.
 
3. Yes, you could go into remission and it's between you and the RD about stopping or weaning off meds.  Some people stop, others continue.
 
4. Talk to your RD about this, could be a symptom of another disease process.
 
5. In 4 years I've only had one elevated liver enzyme lab.
 
6. Once again Google Prednisone and look at the longterm side effects and damage that can occur.  Loss of bone density, cataracts, diabetes to name just a few.  Not everyone develops side effects but then many do.  Many times it depends on the dose and how long you've been taking the meds. 
 
Am glad your wife is going with you.  Lindy
 
 
I took the MXT and Folic Acid Wednesday morning about 7:00 AM. I felt a little bit of upset stomach about 4:00 PM, but an hour later I felt ok. It is now Thursday at 3:00 PM and I have not felt sick all day. This morning I started laying a brick retaining wall for a flower bed that will be 60 feet long. It will be three bricks high, I laid two rows of brick, about 170 bricks. Now I did have a helper.

I was wore out by noon, Two or three years ago I would have still been laying bricks this afternoon. I took a nap today instead.

So you had help that is good, it is better you have help then to wear yourself out and make your immune system worse.  I am glad to hear it wasn't too bad this time for you, keep hanging in there, it sounds silly but it will get better.  meme
Copyright ArthritisInsight.com