New Diagnosis, Questions, Humira | Arthritis Information

I am new to this forum. My husband (27 years old) was recently diagnosed with Psoriatic Arthritis. This all started a year ago when he began to notice pain and swelling in his foot. We brushed it off at the time thinking it was plantar fasciitis, however the pain persisted, worsened, and eventually began to spread to his hands. Shortly after he noticed the hallmark skin manifestations. Since then he has progressively become worse, with the arthritis spreading now to his back and knees.

My husband was always very active and enjoys playing golf. It has reached a point that there are some mornings when he is unable to get out of bed without being in excruciating pain. His rheumatologist wanted to try Methotrexate, however with a recent concommitant diagnosis of Crohn's, he thinks Humira is a better option. We are still awaiting approval from our insurance company.

I guess my questions regard prognosis, time line, medication side effects (especially regarding infections), and if anyone out there has experience with this at such a young age. Although his doctor was very nice, he really didn't divulge much information. I must embarrassingly admit that I am a fourth year medical student who has done copious amounts of research, however having no hands on experience with this disease (my husband's is the first case I've ever seen), I would really like to hear others' experiences and expertise.

I apologize for the wordiness, but it really does feel good to get all of this out!

Thank you,

Rose

Rappel2010-08-24 13:53:07Your worry is understandable I'm a 37 yr old male back surgery 2 yrs ago now psa in knees back fingers feet and neck doc said Ive had since i was a teenager after explaining some of the problems i have had off and on through my life. My wife hates the fact I'm on mtx. Ive had several small infection in my knee with psoriasis on it mainly due to it splits open and hard to keep clean. any how I'm only on 4 pills a week and most likely going up to 5 or 6 tomorrow when i see doc. My wife and i have worried about this more then my microdiskectomy l5-s1. where they take a portion of your disk out of back do to rupture. Just stay on top of you doctor visits and follow his or her advice and things should be fine. My doc doesn't like humira and so on just because they don't have research into the long term side effects yet and mtx has been around for many yrs even on humira some docs like to add in mtx for a 20 percent increase in successful treatment from what i heard. Good luck positive thinking and stubbornness have gotten me through. My wifes biggest complaint right now is docs wont give me much for pain I'm on tramidol right now and Advil witch for the most part helps but when i first went my pain level was at an 8-9 most night and when slept i moaned and groaned and wife hates to hear me or see me in that kinda pain. magnumtagem2010-08-24 18:09:45I had a good run with MTX for 17 years. Then it started "failing" me. What I did to "get me through" was to get Kenalog injection in the inflamed joints. I still swear by the stuff.

I didn't want Prednisone pills and DepMedrol sub-Q had little impact on me. But the Kenalog injections in my case really help a lot.

What I've found is that if you can eliminate the pain in the worst couple joints, it's amazing how tolerable the rest of the pain can be.

Word of caution: I wouldn't let anyone do these injections except an orthopedic surgeon who does these day in and day out. Lots of MD's like to think they know what they're doing, but in my book only an orth surgeon really has the experience.

Sam12342010-08-25 22:47:37so i went to doc and am now on 5 MYX a week 3 Friday night 2 Saturday morning. Most joints are better swelling is better but knees still bother me allot. I only hope that some of the pain left in knees isn't from my back surgery and compressed spinal Cord and left leg nerve damage. They all say it cannot be so i hope they are right. I hope you and you hubby get some answers and he gets relief from some or all pain.What is 5 MYX???? Are you saying 5 MTX pills of 2.5 mg each for a total of 12.5 mg weekly?yes MTX sorry lol For a minute there I thought maybe you were taking some new space age drug I hadn't heard of.

It is hard to see a loved one in pain. But talk about it. Get it out in the open. But I do think you need to see a pain management specialist to get the pain under control. And the spouse must be part of the initial visits......best for them to understand the disease and have an opportunity to ask questions of the doctor.

And speaking of doctors.....it's YOUR responsibility to be pro-active and make a list of questions before the visit and make sure they're answered before you leave the office. If you sit and wait for the doctor to divulge information, the doctor will probably think you really don't want the information.

Thank you all for your responses! Regarding pain management...I do not think any alternative to NSAIDs is warranted as the source of rheumatic pain is inflammation. Just as a side note. Not to mention we live in Florida where pain management is extraordinarly controlled and frightening (haha)!

I had a piece of paper for doc and asked him alot of question he kinda looked at me weird and i said well i don't like taking meds and if I'm gonna take them I'm gonna know why and what they do. He said he understood just didn't see allot of people with them all written down lolThen it's about time the doctors get used to being asked.

Magnumtagum: NSAIDS are not the only kind of drug that reduce inflammation and therefore pain. Kenalog injections is one alternative.

I will keep that in mind ive had one knee drained and injected once cant recall what with at moment but if my right knee (now ) keeps bother me i might look into it.The left knee was worse for a long time now its the right that is around a level5-6 most days which is better than 8-9.Tramodol helps me alot with my painas long as i take it before pain getts t a level of 8-9.My head aches are back to right now i only do the manditory visits every six months im broke as a joke. In the last three yrs ive had back surgery my wife an emt just had an overy and filopion tube replaced after a yr of now work due to pain with 4 different diognoses and 1 doc finally found it was filopion tube full of sistes and ready to burst. She is getting better and acually start sckool for EMT BASIC on tuesday. She took care of me for the 4 months I could stand or sit for1 hr had to be reclined most of the day. Regarding a doctor not liking Humira because they don't know what the long-term side effects are.....Humira's not the only anti-TNF drug. Check into Enbrel. Frankly, if things were that bad I wouldn't worry about a drug that's already shown to help so many and its long-term effects. There is no guarantee about any drug.

And about the MTX - it's absolutely silly to be worried about MTX when used for arthritis. If you were talking about cancer, where the dose is so much, much higher, that would be another story.

You are right all drugs do have side affects Mtx At dose im taking now has less side affects then the max dose of advil plus tylenal i was taking every day before I went to doc. As for the MTX ive talked to a few nurses that have seen bad side affects on MTX but that could have been they where taking it every day instead of once a week like they are supposed to.

Generally the reason for "bad side effects" while on MTX is because people are not taking folic acid [1-2 mg daily].

Also, there have been known cases where a few doctors screwed up and prescribed DAILY doses of MTX......or patients who assumed this was a daily dose.

Taking the drug in the appropriate manner may cause you to feel fatigued one day out of the week or have some nausea [easily relieved with folic acid]. But these are hardly bad side effects.

If you're getting this info from the "nurses" in the doctor's office, be reminded that very, very few of these "nurses" really are RN's.

HI,
I am 55yrs old , worked since i was 15 yrs old -- last year my left ankle swollen up in bad pain went to see a bone and joint doctor- after taking a steroid dosepak from the doctor the left ankle went back to normal with no feeling of pain or swelling -- following week - left ankle swollen again one day and then the right ankle swollen the next day - i was close to being unable to walk -- and the pain was almost unbearable for the next month or so ---
Went to RA Doctor, she put me on Methotrsate, Sulfasalizine, Predisone, and now she wants me to take HUmira injections because nothing seems to be making it go away -- I have good days and bad days, and about a month ago my knees began starting to hurt bad also along with my left shoulder joint ...
My biggest wonder is why nothing is showing up in my blood test or x-rays -- they all give no indication that i even have anything wrong with me...
Just wanted to tell my story ---

there is no definate test for psoriatic arthritis. My blood work was all clean too and my knees where swollen and hurt hoibly. Ive been moving up on my dose of methotrexate for six months now, Im feeling better but still have my realy bad days. I hope you get some pain relief soonMoving this up...........
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