OT & Not--Funerals & MTX | Arthritis Information

So you know that person at a visitation who is crying more than anyone else, and can't get a hold of themselves--that's me. I only go to visitations/funerals of people I knew very well, because I just can't help but cry. My friend's mom struggled with cancer forever and has been in hospice since February, she was ready to go on Saturday and didn't pass until Tuesday. So they have all mourned extensively. None of them were crying--but I was! Of course they were all sympathetic (and bf's sister even said "don't get us started again!") I wasn't openly weeping or anything but the tears just stream and stream. I get control of myself, then look at one of them, and the waterworks begin again. Nothing to be done, oh well. Just call me the weepy lawyer. :)

My new job is going great, so that's good.

But...RD appt next Wed. I had a feeling from the start that RD should go with MTX with other drugs b/c Vandy specialized recommended this. RD made me go 10 MTX, then 15, then 20. No result. At all. Wondering if he will add Plaq, or 2 more drugs. Surely not biologics since I can do most ADL but I don't know. I would hate to exhaust that option so young. Sounds silly but seriously I know I have a long road ahead.

My wrist/hand are as bad as always and my elbow/shoulder are in awful flares. Thank god for Mobic. My shoulder and elbow are at the point where they are painful to the touch. If anyone even brushes either it really hurts. They are getting gummy in the morning for several hours and following the same pattern that my wrist did last year. Ugh, here we go. Hopefully it will go away. My ankle flared like this and sort of levelled out, although my knees were hurting today because my new work has stairs and I am on the 3rd floor. Want the exercise but I may start taking the elevator.

Thanks for reading...still almost a week until my RD appointment but I am already anxious, already know he'll walk in, look at my wrist with the same puzzled look, and say I am just amazed the swelling still hasn't subsided...

Katie, this may sound strange coming from me because I'm considering AP therapy to get off RA drugs, including MTX, but if you're still going that route, maybe you should try the MTX injections. They are truly more effective and may give you the relief you're not getting now. I also thought that Plaq. or a similar drug is nearly always given along with MTX because RDs like to hit it hard early on. I'm wondering why your doctor is taking such slow steps.

Also, are you taking 2 mg. of folic acid every day? Some RDs think too much folic acid negates some of the benefits of MTX. I don't know, just something I've read/heard. My RD wouldn't give me more than 1 mg. daily then switched me to leucovorin when the folic acid didn't work. I still need more, but he won't give it to me. I wish these RDs could agree on something when it comes to our therapy!

Katie I may have missed something but why no prednisone? It took me 15 mgs of MTX and 40 mgs of prednisone to get me right but once there I have continued to do well even though I have tpered down to 5 mgs prednisone.

Glad the job is going well!

Your crying is just a sign of what a deeply caring person you are!

I know what you mean about the crying. I can go to a strangers funeral and cry more than the family members in the line.....I have no control and HATE IT.

^ Folic acid SHOULD NOT be taken anytime 2 days BEFORE and 2 days AFTER your dose of MTX. Both my RD and several pharmacists have told me this. MTX is a folic acid inhibitor and by taking folic acid with MTX, 2 days either side of your dose, you are affecting the way that MTX works. You don't want to do that. Taking Folic acid in the days between is fine, though. I take 10mg two days a week.

Katie - ask for Plaquenil or Sulfasalazine or both. The combination of MTX, SSZ, and Plaquenil has a 37% chance of bringing you into remission, whether you have RA or UA. Take care.
_popupControl(); _popupControl(); paperdoll2008-07-25 03:26:56Paperdoll - I go to a teaching hospital in Boston. My Rheumie has me taking 1 mg. of folic acid 7 days a week and 50 mg. of leukovorin 8 - 10 hours after my MTX. Every patient is different. I also asked the pharmacist from the mail away drug company that I use, and he said that it's fine to do this.

I suggest that people listen to their own doctors advice as they have the whole picture of your health/diagnosis.

I wonder about the folic acid. I got onto 2 b/c I was getting mouth sores--and that was when I was only on 10 mg. I will ask about that.

I have heard about "triple therapy." Is the sulpha drug always the third one with that, with MTX and plaq? My mom has really bad reactions to those and I worry I would too.

I will ask about injectables as well.

I really don't want to go with steroids--and RD hasn't suggested it. I can get through my day alright and I think he's bothered by how stubborn this is (which wouldn't be obvious if I were on pred). Also I took a dose pack back in December and I flared HORRIBLY afterwards--I think I just way overdid it in the few days i had. But I'll ask him about this as well.

It's so bad, but only in 2-3 joints, and not feet/ankles/knees and my left arm is fine, so it's a weird situation...

Well I'm no expert on the subject but I was awfully ill until they jacked me up on 40 mgs of prednisone and then overnight I was a new woman. I think I have heard that it "re-sets" your system somehow. It was always known that it would not be a life long medicine- 7 months later I'm down to 5 mgs and still doing better than my doctor ever thought I would.

I can understand your reservations about it though- the high doses come with nuisance side effects as well as bad ones if you use it long term. At the time my pain was so severe the trade offs were worth it.

It may be worth a shot, now that this has gone on so long. I think I'll ask the doctor. I'm also going to ask for my wrist to be x-rayed to see if any damage is being done. I type that so I remember to ask and advocate for myself!

My dad is actually on maintenance pred for Addison's Disease which he developed (or was discovered) after he was 50. But he had issues when the doc had his dose out of whack that definitely scared me off. But my blood pressure is usually low, even with being on lots of rx right now.