X-Rays Showed Erosions | Arthritis Information
RD said my right ulnar-styloid has small erosions, it looks moth bitten. He has xrays from last November that were fine. So it's happened in less than a year. He says erosions are a four letter word to him and we may want to consider biologics again. I am scheduled back in 3 months but he said I can schedule for 4-6 weeks if I like. Will probably give plaq. that long to work and will have x-rays and eval by oral surgeon on my jaw during that time. I am still hesitant but glad I have time to think/research. He was open to sending me up to Vandy for a second consult there and also is wondering whether I have a secondary source of some of my joint pain, as there isn't swelling in my shoulder or foot despite pain (although elbow and jaw are visibly swollen).
Still digesting all of this...the joints in my hand and fingers and left hand were fine though and joint spaces were unchanged.
Wow!! Sorry. Glad he is on top of this. Can you imagine if he had not done the exrays. Hope you get some relief from the Plaquinil. Best of luck to you.I don't really have swelling and erosions are seen on xrays and mri's. I don't think swelling is a good indicator in that.
I've done real well on Humira. It's a lot scarier than it sounds.
Even if I am convinced he will take some convincing. He told me he had a patient get TB on a biologic recently. He said he thought he was more open to biologics than some, but maybe that's just here in a smaller city. Plus I am not on disability or anything so I think he's doing risk/benefit. Such a pain b/c my dad is freaked about the possibility of biologics which is rubbing off. At this point more than anything I don't want to give myself a shot. Also I may wait until March and flu/cold season is over with my kids. But I will prob go to Vandy in the meantime and if that guy pushes for them I will go.My shoulder was hurting like heck when my elbow was really bad...it was referred pain
What is right ulnar-styloid? Sorry to hear that you have some damage happening. 2nd opinion sounds like a good idea. As scary as biologics can be, I'd be worried about the damage.This is one of the top dogs at Vandy. They're doing some incredible things if your interested in an AP doc -
Pip
[QUOTE=buckeye]My shoulder was hurting like heck when my elbow was really bad...it was referred pain
[/QUOTE]
I had terrible shoulder pain from a pinched nerve in my neck once. I can always tell the difference when it's referred pain. For me, the level of pain doesn't change when moving the joint if its referred pain. When its my RA, even though the joint hurts all the time, the pain increases on movement.
Katie, you have damage in less than a year while being on a good strong DMARD, MTX. When doing your risk/risk take into account additional damage in the next year at that pace. The best part of TNFs, which very few other DMARDs offer is rapid response. Within a month most people see good improvement. It is an important advantage with the aggressive nature of YOUR disease. All peoples RA is different and since your dr seems really on the ball, you should trust his judgement.
I recommend getting hypnotized to conquer the fear of needles, since needles will probably be a part of your life at some point. You can always do the Remicade which is an IV, but I rather have needles than sit around with an IV for 4 hours.
TB and other infections are still a rare side effect. When I hear someone sneeze or cough I turn my head a way and even cover my nose/mouth brief. Those germs are done flying in a couple seconds. I've been on all the TNFs and they have kept me mobile with minimal damage. I consider them a miracle for me. Of course, I would go nuts sitting around, not working or being a useful member of society.
Good luck, sounds like you have a great doctor.
Katie,
I understand your reluctance to go on biologics. I had the same worries, but for me enbrel has helped. I have been on some type of biologic since 2002 and have not been sicker because of them or had any side effects.
Re the TB case your doctor mentioned, did he say how the person may have contracted it? People travel alot to countries (Russian, India, Asia) where there is higher incidence of TB and are exposed there. My doctor has me do an annual TB test, and I get a flu shot every year.
I noticed you inject mtx, but you still have anxiety over injections? I get weary of the 3 shots (mtx and 2 enbrel-25mg) that I take weekly, but y'know, its over pretty quick and its really not painful. I try to focus on the positives, it helps, its covered by my insurance, and its convenient to have shots at home rather than going in to a docs ofc or an infusion center.
You might also consider omega 3s, fish oil or flaxseed oil, they are suppose to help reduce inflammation, many doctors agree.
You seem to have a good doc, together, you'll decide what's the best approach in controlling the RA. Good luck, take care, be well.
Hi Katie,
I am on Ebrel, since Feb '08 and have found it the most helpful as far as regaining movement of all other drugs (plaquenil and MTX).
I had a HUGE fear of the shot that took me about 2 months to get over, but I did eventually and now it's really not a big deal. I would have panic attacks about the shot, thinking about having to do it for at least 3 hours b4 I got up the courage. Now I don't at all.
I use the syringe (sp?) instead of the pen for Enbrel, which I prefer.
I just want to say in deciding on a bilological, please take the issue of giving yourself a shot off the table. B/c you will eventually get over that fear, even though it is very scary in the begininning.
Nori
Sorry to hear this. Good luck to you.Thanks everyone! Yeah, I inject MTX and I am okay with it now. Once a doctor looks at me in the eye and says "biologics are a must" then I won't refuse b/c of needles. But since he is so on the fence it's just one of those things that makes me that much more reluctant to try. And I am going to have to find some websites for my mom and dad to allay their fears b/c at first they were like "it's just carpal tunnel!' and then less than a year later they all of a sudden start to pay attention and are getting freaked out about the biologics etc. So I wanted them to be involved and care but now I'll have their opinions in the background...just another hassle factor that makes me not push for them. I think that's where I'll end up though, just a matter of months. I'm also afraid that they won't work b/c the mtx has failed so miserably. And maybe, just maybe, plaq will give mtx the boost it needs!
Haven't discussed with RD whether he would keep me on mtx too. If not then being able to drink would be plus! I could on biologics, right? Although I have 1-2 drinks a week as it is, I inject on Sat nights so I miss having a drink at weekend events.
Convincing your family that you are sick is not an easy task. They prefer to live in denile. They think we are so strong. It is just i have found my family to be unable to really fully except that i am as sick as i am. So I love them but i do not take any of there suggestions to heart. Your family seems to be trying to understand. If it makes you well then they will be happy. I am going to be changing things up medicine wise in November myself. I think you will have a good idea of how the Plaqunil is working for you in four to six weeks they say four to twelve as i recall. If it works then great. I just wish you the best. Did you flare badly after giving birth?
Dealing with family can be a tricky thing. I hope the plaquenil works wonders for you! when the time comes to move on to something else, the rheumy's office will help you along. I took ativan an hour before my shots a while back, but it didn't take long at all to get used to them. Hang in there sweetie, I'm sorry to hear about the erosions.
deb
I put it off for 6 months after my doctor first suggested it. It is scary. Something about taking these shots made it seem so much more serious for me in a way. To be honest though by the time I started taking Humira it had become much more serious. At 33 I could hardly climb the stairs anymore. I was walking with a constant limp and was misrable. Tired all the time!
I decided on Humira because it was one shot every two weeks. I've rarely been sick with any sort of illness besides RA related stuff. For me it's been a decision worth making; but I spent many, many years without needed the stronger medications like I need now. Joint damage was visable in the early years; but sulfersalizine, plaqunel and MTX has slown it down over the years.
You've got plenty of time to make this choice. You're on some DMARDS so don't force yourself to make this choice if you aren't ready to me it. Your probelms aren't going away....and frankly; if you choice to go with a biologic....They won't go away then either. They mearly make life more managable for folks that find managing without them too uncomfortable.
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