I've noticed several of you mention MTX. What is the name of this medicine? I'm seeing the rheumy in two days for results of blood work taken 4 weeks ago. I've haven't been officially diagnosed yet, but some of things discussed on this forum sure sound familiar, sad to say. The pain in the joints, the widespread pain, the OA in the lower back, the fatigue--it's all there, along with chronic anemia, elevated C-reactive protein and positive ANA. Hopefully on Thursday, I get an answer. It's all I really want--an answer-after years of visiting numerous doctors. Methotrexate.MTX is Methotrexate. It was created as a cancer drug, but also works for RA. I'm on it. It's one of the first drugs a doctor will use (or an insurance company will insist on) in the treatment of RA. It's a DMARD.
As for the doctors - doctors don't always have the answers. They don't always properly diagnose. It would be nice if they did. They don't treat everyone with RA. If you believe you have RA, don't let them brush you aside. The disease will destroy your joints over time, if left untreated. There are lots of treatments.
If you read through old posts, you'll find lots of information on MTX, on how effective it is, and on side-effects. I learned most of what I know from this site, not from my doctor.
Good luck on your dr. visit.
Good luck with your app't, Gracie.
Gracie~
I've been on MTX for over 4 years now; but I've had RA for a little over 12 now I guess. I started out on weaker DMARDS like Sulfersalizine.....then plaqinel and the eventually MTX as well as Humira now.
My point is; if you are just being Dx'ed and your doctor suggest MTX I'd suggest trying a weaker DMARD first.
I'm only 35 years old and MTX caused me to go into early menopause. (I believe anyway) Had they given me this medication at 22 without trying other things first and jeprodized my child baring years I would have been very upset. Fortunately for me by the time they gave it to me I had already had my children and wasn't overly concerned. BUT; they never warned me that this could happen.
Since being on MTX I've faired very well; but I have also experienced more problems from medications than ever before. Infections are much more likely on MTX as well as Biologics. Biologics have even been linked to certain cancers.
If you are at the point where you absolutely have to have these medications by all means use them. They are wonderful; but if you have not yet tried other medications you don't know if they will work or not. You owe it to yourself to see if they will.
RA is not just an illness....it's a life long illness. Plan to manage it long term. To me that means save the big guns for later if possible.
Best of luck on Thursday.
Gracie - Good Luck with your appt. Like so many others have said and I will say it again, "read the posts and you'll learn more here than from your doctor."I love MTX and am by no means knocking it.....My RA started out like many others here have. Knocked me for a loop pretty quick; but I responded well to weaker medications.
Not everyone will respond to these medications and for those there is no other choice. I've just been at this for what seems like a life time now. (Just seems that way) It's been my experience that every medication you take you eventually work your way out of. (Even the stronger ones) It takes more and more and more until you are at the max dose and you have to be changed to something new.
All I'm recommending is that IF you can take weaker medication do so early on. You've got years to spend with this stuff. I feel like some of these doctors want to treat very aggressively which is great.....but they are not going to cure you. They should at the very least TRY some of the other things first. RA needs to be treated with the long term in mind unfortunatley. Many, many people respond well to these medications and they are less taxing on your liver and kidneys which are going to have to withstand years and years of abuse.
I don't in anyway mean to offend anyone if you were in fact started on MTX right off the bat. I'm certainly no doctor; but I wanted to just suggest this option to those that might be new to RA and have what might be considered moderate RA. Obvious if your doctor considers your case to be sever then they feel like they need to do what ever it takes from the start.
I can understand that Im a little afraid that nothing going to stop my pain and swelling. If I have to start out like this what is it going to be like in twenty years. Is anything at all going to work. I guess I wont know what it will be like untill then.
Lovie is right....
If you can use a light med before getting into mtx etc. do it. Don't let doctors jump you into harsh meds if you don't need them.
I used ibuprofen for about 15 years until this last year when i got bed ridden and had to have food made for me, help to the bathroom etc. Once that happened, then the doctors are trying methotrexate etc.
But, be sure to ask your doctor, you don't want to not take these meds if you need them.
I am just 33 and have a life long ahead of me, already i am getting on harsh meds like prednisone and mtx, by the time i retire, i may have artificial implants for every part of my body due to the harsh meds like pred.
So be sure to get proper adivce and treatment, the earlier you get it the better, but i have seen people on harder meds that shouldn't be like people on biologics that should only have been on mtx etc. and were never put on mtx.
Guess I'll play a little bit of devil's advocate here. I certainly understand not wanting to rush into any meds, especially when you look at all of the side effects of what we have to take. But it is my understanding that the reason people have a better chance of living longer, better lives with RA, is because of all of the newer, faster acting treatments that are out there now. Since a lot of the damage appears to occur in the beginning of the disease, so they say, wouldn't it be beneficial to start on something a little stronger if it's a definite diagnosis of RA?I agree with TrainingGirl and I believe this is what more and more research is showing. The damage can happen really quick, especially for some people. In a matter of a few months, without aggressive treatment, some people find themselves with bone erosions and deformity. My primary care doctor was still denying anything was wrong. If I hadn't met my RA doc and he hadn't been aggressive from the beginning, I might not be here now. My eyes, heart and lungs were all involved from the beginning. We had the MTX talk the first appointment in his office after our initial meeting in the hospital.
When I started seeing him, the biologics were not available. His office believes in it so much now that they have at least two full-time nurses with four people doing infusions five days a week. They have about four or five offices in the valley. They have at least three full-time employees to keep up on the latest research. And, they always seem to be on top of the latest info.
If you don't hit this aggressively, then you really might be looking at joint replacements and not twenty years down the road. It can happen in a year or two.
I agree with your position on that. My mother was treated by an "old school" doctor her first two years. She was on prednisone alone for two years straight and wound up with giant nodules on her hands. If she had a better doctor, she would very likely have avoided that deformity. Fortunately for her, that was the only really bad thing she had from it. But others are not so lucky.HHMMM....I am going to have to agree that once RA is diagnosed the optimal treatment is first a DMARD and then if it is still uncontrolled, a jump up to the biologics is in order.
I understand both sides of the coin here, but the current research states that permenanat joint damage has been seen to occur in as little as the first four months of the disease.
There are some things that you can take your time with, others require aggressive therapy. RA is now viewed as the latter.
The reason why Methotrexate is often used first vs the other DMARDS, is the rate of success and the degree of side effects. It is the gold standard. It is the drug by which all other new RA drugs are compared.