Hi Everyone, some of you know that I am in New Zealand, diagnosed in July after sudden onset of RA in Feb, so I only started treatment 4 months ago. My rheumy started me on on MTX 10mg and Folic acid 1 a week and gave me a Prednisone shot IM. He said he was going to tackle the RA aggressively and explained about medication and the MTX dosage thoroughly.
After 3 months he has put me on 15mg MTX as the disease is still active and said I will see you in 3 months. I had to call in and ask his receptionist to ask him what I should do because I couldnt tolerate the headache and fuzzy vision, (I asked if I should take more Folic acid) so am now on 12.5mg and he prescribed Remicaide for the stomach even though the headaches are the main prob. This is only my second dose week (last night) and so far so good. I dont feel fab but I can do 12.5 but not 15. Initially I has happy to take the MTX but now starting to dread it. BTW blood tests all good, I am lucky.
My question is, (although it seems things are very different in the USA, and its puzzling hearing how you guys have to apply for meds and treatment with insurance and stuff) how often do you see your rheumy and is 3 months normal or does it seem like a long time when you are still in the starting stages? Sorry if I am being a bit long winded!
Take care all and have a good week.
Wendy
Hi Wendy,
My RD appointments are also at 3 month intervals. I am seeing a new rd now due to insurance, and she is hard to get in to. But my previous rd saw me every two months the first couple of times then every three. But I was always able to call and aspeak to his urse if I had any problems/questions and sometimes the doctor himself would call me back. Also, I had a hard time tolerating the mtx at first and it took several months to get me to my current dose of 20.5 mg. I am tolerating it much better now without the headaches/stomach aches, etc.
Are you able to call your rd's office if you have problems? Hopefully they will be receptive to that and can possibly move up your appointment if you have problems. Hope you are feeling better very soon!
Tara
I was at 2 months intervals for the first 3 years while on MTX. Now that I'm only taking Humira, my appointments are every 3 months. I also had blood tests every 2 months while on MTX. I tolerated it pretty well but it did cause a lot of fatigue and occasional stomach problems. I like the Humira a lot better; it works just as well and no significant side effects.
Good Luck!
Alan
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Wendy,Wendy, I'm confused about how much Folic Acid and when you are taking it. It sounded like you are taking it once a week. It should be daily.
2-3 months does seem to be the average, but what a lot of new patients don't realize is that they need to call their doctor when either things are not working or new symptoms come up. You must call and get in to be seen because how else is the doctor to know what is going on.
By the way, they can still increase your MTX some more, add Plaquenil or some other medication. You should also have some anti-inflammatory like Celebrex or Mobic.
Ask your doctor to be more clear of what he means by aggressive. That is not very aggressive.
You may not be able to tolerate the MTX, but he can add other meds to complement it. Or, some people do better with injections rather than pills. Ask more questions.
Wendy,
I've been seen once a month since I started treatment in June. Maybe it's because I've had so many problems with the meds and they've had to be adjusted and sometimes changed.
Good luck!
Thanks all for the replies. Sorry, should have been more explicit, supposed to be at work ;)
Yes, I did call and get a message too and from him re the dose of MTX so now its reduced to 12.5mg. I do take Mobic, 15mg daily. If you read here it recommends Folic Acid 1 weekly 3 days after the MTX which is what he is doing, http://www.rheumatoid.org.uk/article.php?article_id=155
"Folic acid, 5 mg tablets, are given 3 days after MTX to reduce toxicity, especially mouth ulcers."
So it seems all ok for now and I will see him in 2 months now, just wondered if its normal. I will call in if I need too and I guess he knows that I know that
There is still so much to learn, RA is so different for everyone, I wonder stuff all the time. Stuff you cant find on the Arthritis websites even. For example, if you manage to get your RA into remission, do you still have to continue the MTX or treatment you are on indefinitely? And if you are in remission, do you still get aches and pains? After I posted this question I managed to quickly do some reading on the net, and now understand about the biologicals and how you have to apply etc. Thanks everyone. Take care. Wow, thanks Deanna, I am lucky I guess, not to have mouth sores. I am very happy, its Tues morning here in Auckland and I have no side effects from the 12.5mg MTX dose this week. I think him jumping me from 10 to 15mg was too much too quick. Yesterday evening I even managed to walk the dog down to the beach and walk with my dodgy feet in the sand ok. I had shoes on. It is so good for the soul, I had the beach to myself and Jezzi and I had a wonderful time. She swam and I gave her a bath at home and then did dinner and went to bed at 10.30pm without feeling exhausted. Wonderful! I will keep an eye on things and take more folic acid if I need to. Thing is he only prescribed so many. Not sure if you can get it OTC here. Wendy
Wendy
Here is a pic of our beach, I am a few minutes walk from it and miss going down there as I couldnt walk and too tired to drive down.
3 months does seem the norm here....Hurm....when I was a wee baby they saw me monthly, then once I was a little older and it was under control I was seen every 3 months. When I went into remission it was every 6 months. When I'd start back into a flare, I'd have one appt to give me meds, then an appt 3 weeks later as a follow up for the meds, then every 3 months there on out. Hope that helps?
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