Hello you experienced ra'ers -- I am in a cycle that I need advice on handling. My Dr's tell me I have to make a decision about what drugs to take, and I just can't figure out what to do. I am confident in my Drs and understand what they mean, but wish there was more info. Maybe someone on list might have insight?
I am seroneg ra x 3yrs, on remicade, plaquenil, feldene, mtx, folic acid, leucovoran, etc. etc. etc.
I developed a bad cold in October, skipped a MTX shot or two, seemed to get better, started MTX, got slammed with wicked sinus and ear infections, a yeast infections, and mouth sores. Skipped MTX and took atbs for two weeks. Got better. Stayed off mtx for another week. Arthritis creeping up again. RA doc suggested trying half a dose (7.5) last week, and bang - got another cold a few days later. My options are to quilt the MTX (but how do I know there is a relationship, there?) and continue Remicade w/o it, or continue the mtx and *hope* I can stay uninfected with something. I work with the public and see kids with colds all the time. My PCP told me to consider whether the meds are helping the arthritis enough to make it worth being sick all the time.
has anyone else had MTX cause this kind of stuff? The Dr tested my IG levels but I haven't heard back yet. If they come back normal, does that mean the MTX isn't the culprit?
ARGHHHHHHH! Prednisone isn't an option -- I was on it in October when I first came off the MTX....oi.
THANKS!
boosie, I wish I had good advice, but I can only relate. I am doing the tip toe with meds and infection. I have been taken off meds (Enbrel and MTX) twice in the last two months for open sores. My RA symptoms come back immediately when taken off. Open sores are suspicious for MSRA which is very serious. These are tough choices. I make them with my rd, luckily, I have an rd that will brainstorm with me, but admittedly, neither one of us know what will happen. It is a gamble. In the meantime, my RA is very aggressive and doing significant damage. It is enough to deal with the symptoms, pain and damage of RA, I totally sympathize with the pressure you feel making these decisions. I hope you find someone with better expertise that can help you. Stay in touch.
Seems to me that before you make a decision with respect to drugs that you identify the exact type of infection[s] you have and get appropriate antibiotics.
I seem to be susceptible to strep infections, which triggers arthritis flares for me. I have since learned to get the infection cultured and identified, use the correct type of antibiotics [don't settle for a broad spectrum antibiotic and hope for the best, as many physicians often do]. Treat any superinfections as they arise.
It's easy to assume the mouth ulcers are due to MTX but one wonders if it's not an oral infection going on that's causing ulcerations.
I'd get to the root of the infections first. Just maybe they are not caused by the MTX. But still. to be clear, mouth ulcerations are a common symptom of toxicity.
I've never stopped taking MTX during any of these situations. But we all know that what works for one doesn't necessarily work for another.
Good luck.