After Christmas, I'll have my second appointment with my RD, since diagnosis. At this point, I'm on Plaquenil 200 mg b.i.d. and Ultram as needed.
I take the Ultram at least once a day, often twice. It doesn't seem to help my pain at all: it just makes me sort of "high," so I don't mind the pain as much!
Here's my question: what can I expect my RD to say and do regarding my pain control? I don't expect that the Plaquenil will have "kicked in" yet: I've only taken it for a month. What I want is for him to add Celebrex to my meds (which seemed to help when I took it before) but not take the Ultram away. I'd also like some Ativan (which I've taken before) because I've noticed, since diagnosis, that I tend to get panicky at random moments.
All my life (pre-RA), my experience with Drs. is that they are ultra-leery of prescribing pain meds and anti-anxiety meds. (I'll only give you a 30-day supply, because this stuff can be habit-forming, you know.
I'm afraid if I tell my doc "I want Celebrex plus [Ultram or something better] and I'd also like a prescription for Ativan, thank-you-very-much," that he's going to label me as a drug-seeker. The fact is, I just know what works for me, and I'd like to cut to the chase and have some, please. What should I reasonably expect from him? In my early RA days, they gave me Xanax to counteract the raciness that Prednisone caused, plus the extreme stress I was living in. I don't know what the difference in long term use is between the two. But it's another option you should consider. Having panic attacks is important to address, although the RA doc might not be the best. I'd ask about possible thryoid or heart symptoms that should be ruled out as they can cause you have "panicky" feelings. You certainly could be having panic attacks. But a doctor needs to rule out any other potential problems. The thyroid levels in particular should be checked since thyroid disease is another autoimmune disease. It's a simple blood test on that one which they should probably have already done. But Ultram is prescribed by an awful lot of doctors, even those who hate pain meds. I wouldn't think he should have a problem with that or the Celebrex. If he does, then get your referral to the pain specialist or talk with your GP about all of these. For Ativan, you need to be aware that long term use can be memory loss. For that one, I'd want to be under close observation. That would be either a pain specialist or a mental health provider. But definitely do your research, consider what you are comfortable with and go for it. It's a hard adjustment to living with a chronic illness especially when you are not seeing any of the benefits of the meds yet.
Ativan is really good for calming but like you said,"they dont want to prescribe it more than a few months at a time."
If you have a good doctor, he will be cautious. Maybe he will think it's OK for now until he can manage your pain with other meds.
I would definitely ask. I cant see why he wouldnt prescribe the celebrex. Also, he really needs to get to know you.
My doctor said to me"What medication are you comfortable with?" No kidding. I didnt like him at first but now I really trust him because he listens to me.
Barb
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