DEBATE: Does more meds = worse off? | Arthritis Information

Does someone on a lot meds for their RA mean it is worse than someone who has a shorter list of RA meds?

Does someone getting infusions mean their RA is worse than someone still taking just all pills?

No reason for it, just wanted to see what everyones view and take on the above was.

I thought about this because of how diabetics are... like injectable insulin means they are worse than someone who takes pills for theirs. At least I think that is how it goes.

joonie2009-07-11 19:30:49Interesting debate, I look forward to others thoughts. I haven't really given it any thought but I wonder if someone being on an infusion means they have had the disease longer and have tried everything else? There could be some people who are really bad off, but are only on one med or so for other reasons (money, allergies, etc). I know for me, my RD is extremely conservative and absolutely wants to start low and go slow and only do one thing at a time. I'm interested to hear what others think??

Phats

Also don't forget that many RA patients are women of childbearing age, which can definitely affect treatment options.

Oh, I had forgotten about that. Great point!

Phats

[QUOTE=JasmineRain]Also don't forget that many RA patients are women of childbearing age, which can definitely affect treatment options. [/QUOTE]

Hi Phats!

Just wanted to ask a question, I see you are on 10mg of Arava, I was on 20mg but went off about a month ago. Needless to say I am beginning to feel it. Is 10mg enough for you because I am thinking of going back on but I want to try a lower dose?

Not sure what the answer really is to this, however, here's my take....

My doc wanted minimum drugs to find what would work to give me back

some sort of my previous life. Started with Prednisone, then that and

MTX (and the usual folic acid, leucovorin, etc) and then when that wasn't

working well enough, took the above and Humira....then when that wasn't

working well enough, switched to Enbrel and the above.....then when that

wasn't working well enough, the above and Orencia.

For me the drugs work for a little bit of time then stop working...so it's

off to the more powerful drugs. I wish my RA was controlled with just

MTX but it isn't. Everyone's body works differently with meds....I think

anyway, lol

I don't nessesarilly think because you are receiving infusions that you're worse off than other's. I know before I started Humira I was given a choice of many different options. I could have started infusions at that time....but wanted to try an injectable first. As luck would have it I responded well to Humira so we've stuck with that. Everyone responds differently to different medications. Some people that start off with infusions find that they don't respond as well to that as they do some sort of injectable. I do think the infusions sound much more "serious" though. Sure sounds like you're worse off....but when you look at what the medications are their pretty simular; their just administered differently.

Just because someone take a ton of pills everyday doesn't mean they are worse off either. It just means that they are taking a bunch of pills that aren't really working and their doctor has not just found a combination of medications to control their symptoms. Some doctors would prefer to through more pills at people verses changing things up and actively seeking the right treatment to control things. Numerous pain pills is the perfect example. If those folks had a treatment plan that worked for them they could reduce the need for some of those.

Diabetic treatments I agree with you on. RA~Not so much.

Dalmantinka,

Hey! I am actually on 10 one day and 20 the next because the pills are so small, they are impossible to cut in half. (the dr. wanted me on 15 mg). I suspect he will increase me to 20 mg daily. When I first started Arava, it made a huge and almost immediate difference. I have been on it since Apr and it seems like it is no longer working. I'm not sure what is going on. I haven't had a single side effect from it though.

Phats

[QUOTE=Dalmatinka]Hi Phats!

[/QUOTE] "Worse" is such a subjective term. Bad, worse, worst...the negativity of each of those seems destined to set up a negative comparison. Who is qualified to say that the treatment one individual responds to is better or worse than the treatment another may respond to?

Why I see the benefit of a discussion related to relative response to any number of therapies I am less sure of the benefits of a debate regarding who is worse off with this devastating disease.

Simply my personal and considered opinion.

I meant that their RA is "severe" or uncontrolled.

I go through spells of not being able to find the right words to use for what I mean. Most times the words I want to use are on the tip of my tounge, and I just cannot for the life of me get the word I want. I even use the online thesaurus and go through the list of words similar to what I am meaning, most times I find the word, other times, I don't. I mean it can be a simple word like "severe" and only thing I can come up with is "worse off".

I do that everytime my fibro is acting up, which is has been for a couple of weeks now because of all this rain we are getting. It messes with my thinking abilities, and everyone knows I already have a hard time in that department.

As for "debate"... I should have used "opinions".

I am not wanting anyone to compare or anything. I just want their view on it. I have no view on it, myself. I just could not find anything via Google in that respect.

I am kinda wondering why my Cardiologist and my neurologist both say I am on a lot of meds. My cardiologist was just shaking his head at my list of 18 meds I take, I listed both meds I take daily and meds I take before infusion. Minus Tylenol Arthritis, solumedrol, and benedryl. I listed ampicillian and aggranox.

And then for my cardiologist to say I have a "severe" case of RA. It just makes me wonder why he would say that. Because of the meds I am on?

I am just not sure what to make of it all. All these meds. They seem to be working. I am functional to a point. I am not as funtional when the remicade needs to be upped.

I just have a lot to think about and a lot of things that are bothering me. My meds are one. I do not like taking 15-18 pills a day, and if my pain is bad then I take more pills in a day, and even more meds go in me on infusion day.

I do not see myself as "worse off", or anything like that. I just see it as uncontrolled. But you would think with all the meds I take... I would be under control RA & Fibro wise.
My opinion is those who have trouble responding to RA medications are "worse off" than those who do regardless of how many or what they take. The key is getting the disease controlled- not only with a comfort level but for your blood work to show remission or near remission levels. My wish is that everyone here achieves this. [QUOTE=joonie]
Phats
[QUOTE=Spelunker] [QUOTE=joonie]

And then for my cardiologist to say I have a "severe" case of RA. It just makes me wonder why he would say that. Because of the meds I am on?[/quote]
Only your cardiologist can answer that question. However, there are some pretty well-defined lists that determine mild, moderate, and severe RA. to the best of my understanding the number of medications a patient takes is not part of the determination or classification of the disease.

>>HERE<< is a very good article that speaks to the determination of mild, moderate, and severe as the descriptor applies to RA.

Right now my disease is classified as severe aggressive, but with time and Enbrel I am aiming for that tight control and remission so often spoken of in this forum.

Cheers.
[/QUOTE]

Yeah... I think he might have gotten it from my RD, as they are keeping touch and sharing information and all.

I cannot ask him, I do not get to see him for a whole year! And he is not one to talk to you on the phone about something that really is not related to his testing and all. I know... because they have an answering thingy, and it goes up to 9 on departments to be forwarded to, and even then you do not talk to anyone unless you are making an appt. It is either leave a message or punch in #'s.

So... I will just not worry about it anymore.

Was just trying to make converstation. [QUOTE=joonie]Was just trying to make converstation. [/QUOTE]

Joonie, you can blame your Lyrica for that.
[QUOTE=kweenb][QUOTE=joonie]I go through spells of not being able to find the right words to use for what I mean. Most times the words I want to use are on the tip of my tounge, and I just cannot for the life of me get the word I want.[/QUOTE]

Joonie, you can blame your Lyrica for that.
[/QUOTE]

I have the same problem but I'm not on Lyrica. For me maybe the MTX?

It drives me crazy and sometimes is scary. I have to think up a different word to use if I'm writing. If I'm speaking I stammer and feel like a complete idiot.
[QUOTE=kweenb][QUOTE=joonie]I go through spells of not being able to find the right words to use for what I mean. Most times the words I want to use are on the tip of my tounge, and I just cannot for the life of me get the word I want.[/QUOTE] [/QUOTE]

No, I do not find any of your replies in the way you stated. They give me more to think about. I like you! I was just pointing it out that was all. I did not mean for it to sound like I was talking to just you. I was not. I just know I had not posted much, and have had nothing to offer... so... I posted one of my thoughts.

No worries. Reply away on my posts. [/QUOTE]

Joonie, you can blame your Lyrica for that.
[/QUOTE]

I wouldn't be so quick to do that if I were you, J. You've had neurological problems (suspected TIA's, if I recall?) in the past; you've recently complained that your heart was still racing. Definitely bring this up with your medical team. Hopefully it's nothing... but given your history, better safe than sorry.[/QUOTE]

I did, with cardiologist... and he said if the testing I get done today comes back good, he is going to say it is physical stress or distress one of them words. *shrugs shoulders*

Me, I am thinking it is the Remicade. I will be asking for a switch after this last infusion on the 28th. I also get to see my RD on the 28th as well, for a follow-up appt. So... it is time to make a change.

Wannabe - I wonder if the MTX is playing a small part as well.
I don't know joonie- could be wannabe is perimenopausal which also gets blamed for things like this too. Whatever it is I wish it would go away. I hate being on the phone with someone important saying... ahommana hommana hommana....?????I have the same problem and also take MTX!!

As far as the "debate", I don't know. I don't even know how bad my RA is except my CRP and Sed rates will NOT drop. Had my appt today, and my RD said if it did not improve this time, then we need to think about trying Remicade or Humira.
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