I'm new to RA and was just diagnosed a month ago. I have constant pain in my fingers, knees and hands and sporadic pain in my shoulders, elbows and feet. I wake up several times a night in severe pain, but manage to fall back asleep. It takes me over an hour in the morning until my fingers respond. I am fatigued all the time (however, I also have cardiomyopathy/congestive heart failure). I push myself and am able to work part-time (as a mental health therapist). I am 38, married, one child. My question is.....what are my best treatment options? Rheumy suggested plaquenil, which I have not made a decision on. I tried dolubid (made me sick) and had "some" relief from mobic. Is methotrexate or enbrel indicated for me? When I hear about the serious side effects of some of these drugs, I am able to convince myself that I am not really sick enough for them at this time. I can still function (though not optimally), but I am not bed-ridden like many describe before meds. I don't want the RA to get worse and cause joint damage though. What are my best options? Thanks for any replies. Love, JuliahHi Juliah,
The fatigue, pain, and morning stiffness that you describe sounds
horrendous. Even if you can muddle through the pain, it's not a great
way to live.
I know that the drugs are scary (I'm a totaly wimp about MTX and am
holding out on it even though I know that it's likely to be in my
future, i.e., after I'm done with the baby-making, unless the biologics
get better), but think about it this way. There are potential negative side effects of the various drugs, but you need to weigh that against an almost certain outcome of joint deformity and damage (sorry, I don't mean to scare you).
BTW, the side effects of Plaquenil are minimal (at least for me) and so
maybe you could start with that drug and then ease your way into some
of the others if need be.
As a final note, there are studies showing that people fare better if
they get early, aggressive treatment for their RA. In other
words, you might reap more benefit from starting a particular drug now
than you would if you waited a year....
Good luck with the decision making.
May I suggest that you go and get some books from the library on arhtritis and read them. Most books will give you the description of the different types of treatment and their side effects. Remember that the dr will do all kinds of testing before giving you anything like mtx. Then if you are put on these meds you will go in every4 to 6 wks and have bloodwork done so they can monitor as to how your body is doing on these meds. There is an alternative to mtx that may work better for you, but I can't remember right now. I know it is scarey, but it is important that you get treatment started soon so that you can get some relief and help slowing down the progress of the athritis. Please remember we are here for you and anytime you need to let off steam, need a shoulder to lean on, or just let us know how you are doing we are here. Welcome and we are so happy to have you join us.
I've had RA for about 11 years now. I started out on Sulfersalazine then eventually added Plaquenil along with NSAIDS like Celebrex. That was early on and it seemed to help for a while. My hands were like yours...could barely move them or use them!! All these medications wear off after a while in my opinion and evenutaully you have to change treatment plans. I'm now on MTX (For several years now) and Humira which is a good combination for me; but I've worked my way out of some of the other things. I'm a big fan of MTX...but think you might could try some other things first and save that for down the road a bit. I don't know your age...but there's a long road ahead of you.
I still have problems...I won't sit here and say I'm in perfect health; but my hands; which were one of my first/worst problems starting out, rarely bother me at all now.
I wish you the best of luck with what ever options you choose. Do like Meme said and do some research and discuss them with your doctor. Research, research, research!! That's always good advice. The more you know...the better off you'll be.
Hope to see more of you here. This is an excellent place to get first hand knowledge from people who have spent years with the trial and error routine.
Lovie.
I was really hesitant to begin my medications as well. Before I was diagnosed with RA, I was even reluctent to take drugs like tylenol/advil for pain such as cramps. It's so ironic when I think about it now since now i'm totally max-ing out on drugs. LOL! I definately think you should research the meds before you consider on ditching the idea. Even though you can handle the pain now, it usually does get worse as the disease progresses as well you start to get damage to the joints. I was lucky in that I was diagnosed quite early into the disease and the RA doc started me on an intense drug plan. I was feeling completely "normal" after only a few months with the occassional flare up. I did have to continually change my meds as the body gets used to them after a while. When I was put on mtx I think I must've been feeling the best I'd ever felt. My condition did worsen when I went off all my drugs to try Homeopathy drugs, but I feel I'm finally started to get back to my old good old self since the Enbrel has started to kick in.
Good luck in your decision making Juliahh!