Need opinions | Arthritis Information

I am having a small flare I think It may be because I was off methotrexate for 3 weeks. Not in a row, off one week, on two, then off two two. I'm having soreness and a bit of pain in both hands and and toes. The toes concern me, I haven't really had foot involvement.

I did have foot swelling whrn I was diagnosed. I called my RD and she said prednisone for 5 weeks. I have mixed feelings about this. In fact, it's been a week and I haven't done it.

The soreness is certainly fairly mild. What would you do? Would you just wait until the MTX kicks back in or take the pred to help it along?

Another question, do you always do what your RD tells you to?

And my last question, does the MTX always kick back in? My hands aren't swollen or barely useable as they were initially.

Okay, I'm through. Hope for some opinions. Thanks a lot!

I'm a a little scared of prednisone. I took it for months originally and thought it was a wonder drug. I took 5 milligrams . This time she wants me to do 7.5 for the 1st week. 5 is kind of my limit I think.

I wasn't quite through after all!

no I don't always do what the dr tells me but I do listen and tell him if I'm not following things. I would think a short 5 week course of pred would cause you minimal problems and probably provide great relief. And if you can now take your mtx consistantly it should kick back in about 4-6 weeksDottie-

I was off MTX for 3 weeks on for one off for one and I had a flare that lasted 7 weeks. I ignored it at first then I called my doctor who increased my pred from 2 to 6 mgs. That did nothing so I went up to 10. That took me out of the flare but I was still not back to feeling good. We increased my MTX to the max dose and I still don't feel good. It's been about a month. I haven't been able to taper the prednisone. I don't feel ready but I don't want to be on it so I'm going to do my 1 mg drop today.
Going off the MTX sure did me in. Unless it's just a coincidence and my RA got worse.
I'll never figure it out.

Good luck.
Thanks for your replies. Unfortunately, I'm an agonizer.

So one more question. My issue is the 7.5 milligrams for the first week. Does anyone think it would be okay to start with 5 miligrams of pred for the 1st week and then perhas move up tp 7.5 if it isn't effective.

Again, thanks so much. I know I should be more straightword about this. I have some concerns that make me a bit leery about the higher dosage.

Dottie- I would say if you didn't feel relief in 2 days you would know you need more. 7.5 is not really too high of a dose. I wouldn't worry about it - it's just for short term right?

I am a pred-a-phobe.

I hate the stuff.

I was off my MTX for one week and felt horrible (of course I was off enbrel for 5 as well) but I would try to stick it out.. since you say it's not too bad.... and hang on til MTX starts working again..

but as I said, I'm a pred-a-phobe

Not everyone that uses predisone has a problem with it. I've used it on a taper basis numerous times during the course of my treatment but never used it long term. I think it's a myth that everyone that uses it has a problem coming off of it.

It's been a life saver for me in situations where I had to be off my meds. It helps pull me up while my medications have a chance to start working again. Then once my medications have started working again I've tapered down and off easily.

Then again I've always responded very positive to every medication I've taken. (DMARD/Biologic wise)

I on the other hand loved the relief I got when I was on Pred. and had no adverse effects for the year that I was on it. It was what pulled me out of a terrible flare. Started at 15 for a week, then went to 10 to get me through the summer then weaned off for a couple months. It can take a couple of weeks for the MTX to wear off and then a couple more to start up again after you quit. You have to decide how miserable you are. I wish I could be on a maintenance amount of Pred, I think it would really help the daily grind pain that I have. I have been on different doses at different stages of my life since RA. Ive never been trhough the tapering process yet, just fluctuated between 10mg and 7.5mg. Right now I am at 7.5. I have a love/hate relationship with the pred. Love how it works on the inflamation and helps control the flares but I hate the other things it does like weight gain, constant hunger, etc. These have been major issues for me with the pred.
I would agree with others who say try the lower dose and if you don't feel relief than go the high dose., after all if it is ony going to be fo ra little while it shouldn't be a problem.
Thanks again, I know my problems are small compared to most in here, but I certainly appreciate your replies!

I'm getting a little bit annoying I think, but I just want to say I just have a bit of pain in my fingers and toes. I have had no problems with MTX except a few rashes which I'm not sure sure were caused by the medication. I was absolutely horrified at the thought of taking methotexate but it's really worked for me, so I am brave in some ways, lol.

I also hate prednisone and have stayed away from it for many years now.

I had to stay off mtx for a few weeks and (for the first time) have been very sore now because of it. Just waiting for some relief now that I'm back on mtx.

I don't see a problem with waiting to see if the mtx helps before trying the pred. If you find it doesn't help and you need some relief from the pain, you can always try the pred at that time.

Good Luck, Dotty!

[QUOTE=dotty]Another question, do you always do what your RD tells you to?[/quote]
No. However I always discuss my reasoning, feelings, and intuition about not following her advise and/or prescriptive.

I think (although my many critics would deny that I can think in a logical way) that honesty between patient and physician is an essential component in being proactive in my treatment and progress, or lack of same.
[quote]I'm a a little scared of prednisone. ... I took 5 milligrams . This time she wants me to do 7.5 for the 1st week. ...[/QUOTE]
I avoid prednisone IF I can, but sometimes all the other possibilities have been exhausted. I am currently on a burst-and-taper 40 mg for three day, 30 mg for three days, 20 mg X3 day, 10 mg X 3 days, and 5 mg X 3 days.

Best wishes, Shug
[QUOTE=Spelunker] [QUOTE=dotty]
I think (although my many critics would deny that I can think in a logical way) that honesty between patient and physician is an essential component in being proactive in my treatment and progress, or lack of same.
[
Best wishes, Shug
[/QUOTE]

I think you are right! If you can't be open and honest with your physician, in my opinion you need to find another doctor..........

Actually I have expressed my feeling with my physician. She has a rule dismisses them.

I took prenisone for many months at 5 milligrams, it worked very well for me but I knew it wasn't the long term medication that would help disease progression. She prescribed methotexate for me and that has worked very well.

There are a couple of health issues that I don't feel comfortable sharing that affect the way I feel about prednisone. She is aware of them.

She's formidable in some ways, but she's a very good doctor. It is slim pickings for RD'S where I live.

Our conversation was on the phone, she belongs to an HMO and there are schedulers that supposedly arrange appointments.

The conversation should have been in person but I was never called and I was scheduled 2 months later than she originally intended This drives me nuts as I like to get an appointment while I'm there.

She's my 2nd, my phone calls are always answered and by her personally on more than one occasion.

I wish our relationship was different, but I do feel I am in good hands.

She is a no nonsense person, but I have to do what's I feel is right for me also. I wouldn't mess around with the MTX but I feel I have a little more leeway with the pred.

When I see her I will tell how I've handled it and hope she's not too angry.

I know I've made a mountain out of a mole hill. I did start 5 milligrams of pred today.

I don't dislike prednisone, it helped me a lot but I am leery of some specific side effects that might apply to me.

Thanks again for some many good opinions.