How do you know when it's time? | Arthritis Information

How do you know when it's time to discuss a med change with your doc? I'm currently on Orencia which I think might be helping a little but lately my stiffness level and pain is getting worse. It pretty much lasts the whole day and despite being on provigil for fatigue I still feel run down most of the time. I'm also still on about 25 mg prednisone daily so inflammation and swelling is so minimal that the doc may not believe that I feel pretty bad. The thing is that I'm afraid to throw in the towel with Orencia only to find out it was helping me more than I thought it was.

So how about it...what do you all think? Should I talk to my doc when I see her this week or let it slide? By the way, I've been on Orencia since June '09 so you'd think the full "kick" would be apparent by now.

Bob

I can't help you with your situation Bob as I have not come to that hurdle yet.
What did trigger was that you are still on 25 mg of pred which I find is a high dose.
I don't know what others think but I'd be wanting to get that dose down if at all possible.

With regard to the fatigue, it has taken just over three years for my system to get back to somewhere approaching normal.
Perhaps I should say along way from where I started when I first got RA.
For the first two years it was a shocker, fall asleep at the drop of a hat.

I still get those days but they are less frequent..
You talk to your doctor when the issue surfaces in your brain is what I've always found works. He/she may not agree with you, but at least the issue is aired and then the doc can properly evaluate if the issue persists. I was in the same tough situation. Talked to doctor and he gave me a systemic cortisone shot to see if that would jump start my system. It didn't do anything although I had had success in the past. I waited 3 more months and by that point I was so much worse that the decision was obvious . I couldn't live the way I was so I really felt that there was no decision to be made.

All the best.

just the fact you are thinking about it indicates it is time to have a discussion

Hey Bob- wow-I didn't realize you have been on the Orencia since 6/09! It seems like only yesterday. When you went on was it a toss up between Simponi and Orencia? Do you feel like you are back in the place when you were not on it or is it just petering out? It's definitely worth discussion with the doctor. You've come a long way down on your prednisone dose but I'd be hoping you could get on a safer dose of that by now too. Yet with how you say you are feeling I can see why you don't want to taper... Although I'll have to say in my experience I got to a point with prednisone that it didn't seem to be doing what I expected of it and when I continued to taper I found I felt no different without it pain/stiffness wise but so much better without it's added side effects.

Keep us posted- I wish you all the best.

Bob, I had a similar result with Orencia...helped a little, but not nearly enough. I would go ahead and talk with your doctor now, and ask if you can come back to the Orencia if you don't find something else working better. My doctor said this would be an option for me.You took the time to ask the question......so, yes, it's time. Remember, YOU'RE in the driver's seat, not the doctor. You have to have a collaborative relationship with your healthcare providers.

My experience has been that if you say nothing, the doctor assumes all is well.