I'm just wondering if it's foolish not to start treatment/medication.
I've had RA symptoms (mainly my feet) for about 12years. My symptoms are very similar to my granfather's RA symptoms so I wasn't really surprised when I was officially diagnosed through blood tests & x-rays (about 2 months ago).
I'm 41 and although sometimes I have trouble doing some simple things opening jars,tearing sugar packets,etc.etc other times my hands feel relatively fine, no trouble. My feet always hurt but most of the time it's tolerable.
I've got 2 small boys 4 & 6 years old and being around for them is my main concern. I'm currently taking Medrol & the Rheumatologist wants to put me on Methotrexate. My quandary is I don't feel the need to attack my immune system over something that isn't currently debilitating. I'm just thinking out loud & all advise/comments are welcomed.
Thanks
Eric
Eric,
Eric
When I first got RA i refused treatment because of the side effects of the meds and because I didnt feel that unwell and maybe i was in denial.Ten years down the line and boy do I wish I had taken the meds.I have severe RA now with joint damage and most days where I need lots of help to function. It doesnt happen to everyone but this is what I have experienced.Good luck with whatever you decide but think wisely and get loads of info.
kelly
Welcome Eric.
I do beleieve DMARD treatment is a good thing; even if you don't have too many symptoms as of yet. If it was me I think I'd ask my doctor about other options such as sulfersalizine or plaquinel. Something in the line of weaker DMARDS maybe.
I took weaker DMARDS for many years with fairly good success. They bought me a lot of time in my opinion. I was slowing the progress without subjection myself to all of the side effects that you'll find with stronger medications such as MTX and Biologics. If you were dx'ed 12 years ago it's obviously a mild/moderate form. You could easily benifit from these weaker DMARDS.
Do a little research. It is certainly in your best interest to do all you can now to "Slow the progression" but I can certainly understand your hesitation about the medications. That's smart.....but be smarter and research your options. MTX doesn't nessesarilly have to be what you start with.
Good Luck!
Thanks guys, my x-rays showed some minor joint damage mostly in my feet and my left elbow some in my hands but nothing major. Are there any warnings when the disease is becoming more aggressive? What drug related side effects have you experienced. Thanks for your patience.
Eric
[QUOTE=hula]
But believe me, I want this to stop where it is and not get any worse.
[/QUOTE]
Same here, I guess I’m just having a little problem coming to grips with the seriousness of it all.
As I was saying abotve I took weaker DMARDS such as Sulfersalizine and Plaquinel for many years with no side effects at all. After about 9 years I did change to MTX because the other combinations weren't as effective as they were in the earlier years.
As far as side effects go; I still haven't had any that would make me want to stop taking my medications. MTX does make you tired but that gets better with time. When I increase my dosage I do notice it's a little worse. I will say I think MTX has caused more mouth sores; cold sore type then I had before (But I have always gotten these) I didn't experience any increase in infections until I started Humira; and even then many people around me including my co-workers and family have had far more infection such as sinus infections/bronchitis than I have had. That can vary greatly from person to person.
I think there is certainly a chance you can experience bad side effects; but there is also a very good chance you won't. I do believe though that predisone is something you'll want to steer clear of in the long term. It shouldn't be prescribe for daily use unless all other avenues have been exhasted with out success. It's doubful your doctor has even prescribed this though considering you aren't experiencing much pain. I feel like some doctors let their patience continue on predisone long term without thinking about the long term effects that can be very serious. In short courses it can really be a life saver; but it should be cut back quickly.
Definately ask your doctor about Sulfersalizine or plaquinel. You'll likely get just as much benifit from it right now in at this stage of your disease as you would MTX. You can always move up so to speak....but it's rarely that you'll be able to step back. That's just my opinion and I'm certainly no doctor; but I'm an experienced patient.
Some doctor's will jump right over some of the weaker DMARDS without even considering the weaker ones and I think that's a big mistake. Many people like myself manage very well on the weaker ones.....at least for a while anyway.
I hate to be so long; but I keep thinking of things for you to consider. The reason I encourage the weaker DMARDS to start is because it's been my experience that over time everything looses it's effect. If you start out with weaker ones you can work your way up over time. If you start out with the stronger ones what's next? Once your body gets use to the stronger DMARDS the weaker ones will likely not work. RA is a long term illness and you are still pretty young. You've got plenty of time ahead of you to use the stronger medications if nessesary. You may find that you won't need these medications for many years. I hope that's the case anyway.
Also; please keep in mind that some of the stuff you read about these medications is far more scary than they actually are. Try not to be too concerned about side effects from medications. Certainly not MTX. It's been around for a VERY long time. We have one friend here that's been on it with great success for 15 years. I've been on it more than 4 myself. I'm a huge fan to be honest.
I agree with Lovie. My doctor tried to be aggresive and put me on mtx which I took for one month (I was diagnosed about 6 weeks ago--I'm new to this). I had mouth sores the whole time. Then when I went for the one-month check up, my liver enzymes were really high, so she took me off mtx and put me on sulfasalazine. I started taking it last week and so far, so good!!! And my mouth sores have healed!
Thanks guys for all your help, I guess I have a lot to think about.
Lovie,
I thought Medrol was Prednisone? I've been on Medrol 12mg daily for the last 4 weeks and it’s made a big difference but now they want to start ramping it down and start me on Methotrexate 10mg weekly.
Pred and medrol are both steroids. Same drug family.
MTX 10 is a light dose. I would not be too afraid of side effects. With blood work every 8 weeks, you can be assured they will catch anything neg happening before any real damage is done. The damage in your feet and elbow is real and can't be easily un-done. Do stop the damage while it is still pretty easy to live with.
[QUOTE=Pepper]The current treatment of choice for RA now is to do it with aggressive meds NOW... early rather than later... since it has been shown to slow or sometimes stop joint damage. When I was diagnosed, the way they treated it was start slow, then go harder... so I missed out on the new way of thinking/treatment. I strongly recommend treatment NOW. My RA has been out of control for years now and its hard to lose so much. I wish I could convince another person I know who is in deep denial now. The cost is so high and even I didnt realize how it could go ten years ago myself. Good luck. [/QUOTE]
This seems to be the course of action my Doc. wants to take. I’m starting to understand why but, I’m still hesitant.
[QUOTE=marian] Pred and medrol are both steroids. Same drug family.[/QUOTE]
Thanks for the clarification.
[QUOTE=marian]
MTX 10 is a light dose. I would not be too afraid of side effects. With blood work every 8 weeks, you can be assured they will catch anything neg happening before any real damage is done. The damage in your feet and elbow is real and can't be easily un-done. Do stop the damage while it is still pretty easy to live with.[/QUOTE]
Yea........... I’m starting to lean towards getting my script filled. I’ve been staring at it for the last week or so.
Hula did your Dr write a script for Folic Acid with the MTX? I take it and have no problem with mouth sores.
Dew22 if you choose MTX please ask for the Folic Acid as it will counteract many side effects.
dear Pepper: Denial is a common reaction to this 'stuff' , we can't see the damage being done inside of our body, so until we see the pain and swelling in our hands and feet and other areas we don't 'get' it. MTX is the drug of choice and I'm also taking 'remicade' & prednisone because of an extreme case and flare up!.....I'd like to get off the pred soon, and reduce MTX (6) 2.5. But right now I just want the MTX & Remicade to WORK., good luck.
sarah
eric, darlin, Your xrays.. showed Minor joint damage... that IS YOUR CLUE, to start asap, on meds!!
I'm new to the board, but my Dr, strongly advised me and still tells me the best time, to START is NOW to preven the disease..
Think of it this way, you could be in a wheelchair in 5 yrs, thats how fast this disease progresses!!.. Scary isn't it?
sigh, I've kinda been in denial too, I've been taking the meds and starting Humira..but I need to do more.. I think. I was in denial, ohh for a yr, still taking meds, but missed appts and my Dr finally said.. isn't it time, to get out of denial? Hasn't your body shown you this.. and he's right. This illness its very impt.. imo.. to be very proactive.. so good luck!~
QUOTE:
Thanks guys, my x-rays showed some minor joint damage mostly in my feet and my left elbow some in my hands but nothing major. Are there any warnings when the disease is becoming more aggressive? What drug related side effects have you experienced. Thanks for your patience.
Please let us know where you go with this as it is a major topic on the board. New people are questioning all the time!! It is normal to question medical procedures. ((I questioned my cardiologist over and over about having MITRAL VALVE surgery, 'are you sure'????? I kept saying....she acted offended but you know what I didn't want to do it unless they could PROVE to me I realllly needed it!! It is hard to prove you need the mtx except through the blood tests and you know something is wrong with your feet. (that's where my started, with lumpy, silly putty feeling behind my toes....couldn't walk, had extreme pain and swelling so I couldn't ware my old shoes!) New shoes helped, bu the weird feeling was still there. Please keep us informed.
sarah jane
Dew22
I agree with Bonnie. Mtx isn't that bad if you take the folic acid with it. It tends to burn my mouth (the MTX) but the folic acid helps. My friend just got dx about 3 weeks ago and her first round with MTX made her feel sick but the 2nd dose she felt a world of difference. She has the same story as you. Problems (minor) for years, so the DX didn't suprise her. Just hang in there and take the meds. They are low enough that it shouldn't hurt you to bad. I work at a Dermatologist office and we often prescribe MTX for a varity of things. Just keep up with you labs.
Hope things get better for you soon!!