I'm very upset tonight. Every month when I see my RD, he drains my left knee & gives a cortisone shot. March, April, & May. This month when I went to see him I told him I was having problems with my right knee. He drained it & put a cortisone shot in it. I know that you should only have a cortisone shot once every 3 months. Today I saw my Orthopedic Dr. & he flipped out. He said I have had too many shots. He is sending me for MRI on Monday to see what is going on in my knees. He also said that 15/Mg's. of MTX is a pretty strong dose. I think that Monday I will be looking for another RD. He is scaring me now. Is 15 /Mg's of MTX a high dose?
What would I do without this board?
Trisha
It is a high dose, but I'm at 25 mg. They usually don't go above that. I agree with what your Ortho said. My doc has been a little too quick with the cortisone shots. The last time, I turned it down. It weakens your tendons.
Your RD should have sent you for a MRI a long time ago. I'm really pushy with getting those. Xrays just don't always tell the story. I sure hope your ortho can get things straightened out. You might ask him if he knows of another Rheumy, after you hear all that he has to say.
I was really wondering why your doc just giving you shots. I guess I should have spoke up more, but I already have such a big mouth (yes, like big mouth frogs).
It just seems if he is draining fluid that there is some kind of infection going on. Although I have fluid in my right hip and there's nothing they do about that. I will be real interested in what your ortho says. At least maybe something else is going to be done now. I hope so, you have been suffering so much.I have had several shots in various joints. My understanding is you don't want more than 3 in any one joint as it can weaken the joint and cause it to degenerate later. Some of the nurses will have better input.More to the point, Trisha - your RA isn't under control if they're having to do this - is he addressing that? I'm with everyone else; you need a new RD. Hi I was told by my DR. that I can not have more than 3 or 4 a year in the same joint...Hi
I asked my rheumatologist recently about the safe level of shots into the same joint each year and he said the 'once every 3 months' rule had been revised. He said he did them as a problematic joint required. (And he is the rheumatologist who teaches all trainee rheumies at Med School here and he has just published a book on arthritis.) It probably comes back to that old balancing act of risks vs benefits, that we all face with our medications and quality of life.
Also, I thought 15 mg of mtx was not unusually high. The starting dose is 7.5 mgs and they work up from there until they get a good result (with 25mg being about the highest they'll go).
15mg is not terrible high. I'm at 25mg and I doubt they'd give me anymore than that. I've heard of some people taking up to 30mg....but I couldn't tell you one person here that's on that much. I do believe 25mg is the max dose amoung our group here.
Repeated injections into the same joint can be dangerous. Good you're going for the MRI and seeing a new doctor. There's some underlying cause for your continous trouble in that one knee.
Hope you get it all straigtened out soon....it sounds horrible. Good Luck.