I am going to babble for a moment, but there is actually a point/question here, so please stick with me!
Went to the Rheumy yesterday..not handling the mtx well regardless of what I do. Am thinking that maybe we should try injectible mtx and bypass the god awful GI problems. He says no and suggests Arava, since the mtx is keeping me in a holding pattern of not necessarily getting "better", but not getting any worse. Fine, cool, bring it on!
Next thing I know, he's handing me info on Orencia, which my insurance totally doesn't cover, and then also Enbrel, which insurance sort of covers, but my copays get pretty steep. He hands me the prequalification forms and hands me off to his nurse to "get the ball rolling"..............and I am left sitting there trying to figure out what just happened. I don't necessarily think my Rheumy is bad, its just that he jumps about, talking very fast and assumes that I am keeping up with him.
So, last night when my mind had time to process everything, I have come to this: Do I want to move laterally, try Arava for awhile and see how it goes? Do I thank the powers-that-be that the Dr. wants to be aggressive and go for the enbrel and hope the increase in cost is outweighed by the hope of a "remission"? I worry a little about starting the Enbrel, because if it doesn't work, I have limited options. I have also in the past had other docs who pushed hard for me to be on drugs and later I find out that he was getting kickbacks from the company.(needless to say I have trust issues!) My RA is not as bad as many of you, my inital bloodwork pegs me at moderate leaning into severe and while I have lots of pain/stiffness, most days I can function at my job, just slowly. I feel torn between the question: is simply being functional good enough for now, or should I go for it an try to get my life back?
Sorry for the ramble, but thanks for any advice!
I would say "go for it and get your life back". Right now you can somewhat function but what happens in the future when you have bone damage ? Ask your doc about some links for financial help. My doc gave me a card from Abbott Manufact. that makes Humira and it pays my copay of about 0.00 for six months.
Good luck & best wishes for whatever you decide.
CinDee
Arava may be a 'lateral' move according to the books, but that is kind of mis-leading. Just like MTX can be a wonder drug for some, so can Arava.
Testing shows that the biologics and mtx work better together than either drug alone.
I can't stand the MTX either but I get along fine with Arava. I'm also on a biologic
Go for getting you life back. Your best chance for that is going ahead with the Arava and the biologic. It takes so long for them to figure out if they haven't been aggressive enough and then you're left with permanent damage. Look at your options, pros and cons, and then go for it. Even if your mild, you deserve the best treatment you can get. Mild with this is still a big pain and destructive.Hi Laurat
I've been on highest dose (25mg) of MTX, by injection for a number of years and about 2 years ago the docs added on Plaquenil. Last April I was at my lowest for years. Have had worse pain, but wasn't coping well and having a lot of flares. My Rheumy started me on Arava as well: so I'm on a triple cocktail. For me, it's been a new beginning. Haven't had a cortisone injection since then and am feeling generally much better.
Doesn't work for all, but it did for me. We're all different. Keep persevering and you'll find your mix.
Take care
Dawn
I don't know if you can take prednisone until you figure the rest of it out. Its helped me a lot while I wait (ugh) for the second infusion of Remicade to help me, taking 2 MTX (per week) and 2 prednisone(per day). Still stiff but the terrible pain has stopped!
Hurts,
I have bad reactions to prednisone. Not somewhere I want to go!!!
thanks
Laura T