I have another question...I'm just full of questions today
Pat; I spent years on weaker DMARDS such as Plaquinel and did really well. RA is however a progressive disease and eventually it's likely you'll have to increase your dosage or move up to something stronger. I'd only advise you to pase yourself. Nothings going to stop it but they will slow it down. Don't change to stronger medications hoping to be totally pain free. You'll have to accept a certain degree of pain.....but if it's gotten to the point where you just don't think you're doing well enough; ask for a change.
I always ask myself "Do I have more bad days than good?" if so; it's time for a change. BUT; just because you have a bad day....or even week for that matter doesn't mean the medication has stopped working. Sometimes that's just the way it goes.....even when you take the stronger medications. I've learned that one the hard way.
Good luck. I know it's all very confusing.
Lovie,
Thanks for the good advice. I guess like you I want to stay on the meds with fewer side effects as long as possible. If it gets to a point that I have alot of pain or can't walk then I will have to do more about it. Sometimes when you have a bad day you think well I better take something else but as you say you still have bad days when you are on stronger drugs. Like all of us I don't like taking drugs but sometimes we have no choice. Thanks Pat
Plaquenil is a good drug by itself and one of that has some of the least bad side effects. What you want to track is whether damage is occurring. The SED rate is a good indicator and all the rest of the blood work that they do. Also how are your joints doing? For instance, if a particular joint starts having problems, you get it investigated and damage seems to be occurring then you know something more needs to be done.
Some people are very lucky to get on something MTX early in their diagnosis and lucky that they also respond well. This is the ideal situation and what doctors hope for all of us. But some of us need a little more help than that. If Plaquenil does it for you, no signs of damage are occurring then celebrate. It doesn't mean you are not going to have bad days unfortunately. I wish good days, every day, for every one.
Pat; now don't wait until you can't walk.....that might just be a little too long; but like you say, you want to hold off on the stronger ones as long as possible. Your doctor can help you decide.
I do have to say though that even when I was on MTX @ 25mg & Humira weekly there were still plenty of bad days mixed in there too. Don't assume that you won't have bad days on stronger meds. I think sometimes that's a problem some of our newer friends have. They are chasing a cure.....or seeking remission when it just might not be possible.
If you exhast all your meds too early in this thing what then? If you race right through several different medications without exhasting one before switching to another you might just find yourself left without options. That's something you do not want. I see people all the time pushing for biologics when there are still options available that they have not tried. MTX though can likely be used for many years alone.
Keep in mind that there are many folks that have very severe RA. For those folks you have to do what you have to do.....but for many folks like myself you've got a lot of wiggle room if ya know what I mean.
So really, what is typical for a doctor to put you on first? I get so confused trying to figure out which line of drugs people are on. Did they start with Prednisone? Or MTX? Or Plequinil? ETC.There is no right or wrong in which drug you start with. A lot depends on the dr's preference but it also depends on the patients. I would suspect though that most American pateints are started with MTX as a DMARD. Some may add pred, some may not. More and more drs are moving away from Plaquenil simply because for the majority of patients it hasn't proven to be as effective as MTXThanks to you all for the great info. I do appreciate it. Have a nice evening PatI would second what Lovie says. Don't assume that because you develop a flare - even a MAJOR flare - from a drug, you have failed it. I have a bad flare in Dec. that ran until the end of February. I was ready to move on, but on the advice of some board buddies, I upped my prednisone by 10 mg. Stayed at a high dose for 2 weeks, then slowly tapered.A smart doctor will prescribe a short course of prednisone first; especially if you test sero-negative. If you respond well to prednisone it becomes obvious to the doctors that you have some sort of inflammatory arthritis. It's used almost as a tool for dx'ed.
I'd warn all to steer clear of long term prednisone use though. Long term it can cause horrible side effects. It shouldnd't be prescribed in high doses long term. Even a low dose long term can be dangerous.