I've been reading these boards for a while and received some valuable information. I was diagnosed in April with sero negative ra. My first appointment consiste of X-Rays, blood work and a cortisone shot in the shoulder. My hands were much improved for 2 weeks. Next appointment mobic twice a day and a month to see if my condition would resolve itself. It didn't. He brought ought the methotexate pamphlet at my next visit and a know i lokked horrified but didn't say anything. Midatream he decided I should take 5 milligrams of prednisone instead. It worked like a charm for 6 weeks. When I returned he decided that is what I should continue doing while cuttung back on the mobic. I don't think this is a good plan at all and would appreciate some input. Couldn't figure out how to make paragraphs, sorry!
Sorrry for all the typing errors.
Talk with your doctor about your concerns. Like future joint damage, meds, etc...
Trust your instincts. If you are not comfotable find another rheumy.
Hitting the enter key will drop cursor down for paragraphing. I do not think anyone here will be offended by errors. If you have been reading fo a while you have seen plenty.
Hey I just realized I'm good at something!!! Mistakes
Welcome dottie
I agree about the pred not being ood for long term use. It's said that MTX, AND DMARD's work best with those in the early stages. I'd also use the search feature and look for AP posts, and natural supplements that help as well. Sometimes the answer ir right in front of us.
Hi Dottie and welcome. Do your research and talk with your RD. The sooner you start treatment the less damage you'll have.
Prednisone doesn't stop damage from occuring but it can slow it down. You really don't want to be on Pred. for long term. Search Prednisone on this site and read the stories and experiences of the posters that have been on Pred, then you'll understand.
MXT has been around for a long time and there are millions of people using it for arthritis. Some of us don't have any problems with it and some do. I've been on it for over a year and have nothing but a small amount of fatigue the next day. I'm far more afraid of the arthritis disease process than I am the meds. Take care and keep us posted on your progress. Lindy
Thank you so much for the replies.
I agree with your thinking wholeheartedly.
I was thinking maybe plaquenil as a starting point.
But I was willing to take MTX. The doctor said why risk all the side effects. He said when the inflammation is controlled there is no damage.
I don't like to change doctors so soon but I may have to.
I worried about requesting records, along with just about everything else, lol.
I wonder if new doctors do theoir own testing and if they would require my records?
Again thanks so much for your replies.
Dotty
Well I don't know what he's smoking but it doesn't take swelling to cause damage.
Welcome.
I started on Plaquenil and did well on it and an anti-inflammatory called Relafen for several years. I had no side effects except for nausea for the first week and a half. I just recently added methotrexate because I'm flaring too much. I still don't have damage - well, that I know of. I've only had x-rays of my wrists recenty. So, I think the Plaquenil was doing it's job.
I'm curious. Did your doctor say why he changed his mind about the methotrexate? My RD told me the very first day that prednisone isn't something he wants me taking long term unless I absolutely have to.
Hi Dotty, I was diagnosed with sero negative RA as well this summer. This was my course of drugs and where i am now
1. naprosyn 500mg twice daily---that was in late December , by the 2nd week in Jan I called the Rhumey back and told her it was no help. so she stopped that and started prednisone 10 daily.
2 At the FEb visit I was started on MTX 15 mg once a week. I was fine for a few weeks and then I started to get nauseous, and had a constant stomach ache. Plus I was really fuzzy and tended to mix up words( kids thought it was hilarious).
3. Stopped Mtx started Sulfasalazine 500 2 pills twice daily. I started slow 1 twice a day, when I got to 2 twice daily I broke out in a burning rash. So I am currently back to I twice daily and tolerate it fine.
4. She started me on Enbrel injections at the beginning of June, I am off the prednisone (she was tapering me....and I finally stopped it after 2 months) .
I am still having flares, haven't quite hit the right combo yet...My hair is still thinning , I assumed it was the prednisone...I have been off for 2 1/2 weeks now.( That was a previous post) . Hang in there ...I have meet a few people through my work ( at a doctor's office) That are doing great with their RA ...So I keep hoping! I would definetly try something more long term than prednisone....it is a questionable drug~ Chris
Hi Dotty....just wanted to say WELCOME
Linda
Hi Dotty,
Welcome to the board.
Hi Dotty - welcome!Hello Dotty,
welcome to the board....
Never ever worry about gtting a 2nd opinion or switching doctors. The new doctor can request the records if they need them. Your current doctor should encourgae you to get a second opinion if he doesn't then it is a sign that you need a new dr. It sounds like you would benefit from getting a different look at your situation
Hello Dotty, welcome to the board
kweenb, the rheumy said since i was doing so well with the prednisone, no inflammation, fully functional, etc., why would I want to take MTX with all the side effects. Since he had told me six weeks before that is what I should be doing I was quite surprised and concerned.
I have another question, how long can I safely stay on prednisone as I explore my opions, new doctor, waiting time for appointment, etc.
I certainly don't plan on stopping the prednisone until I find another option.
I am already worried about damage. I show no damage at all so I'm hoping I have a window of opportunity to work this out.
Would appreciate any ideas. This is is new to me and I feel everyhing is getting messed up already.
I guess my question is do I have some time to make some changes.
Thanks again for making me feel so welcome.
Dotty
Well that varies too. Some people can sneak away staying on pred for months at a time, and some people, for some reason, can sneak in a couple of years.
Just wanted to pop in and say welcome Dotty!
Lot's of good suggestions so far. Reading up on the side effects of Prednisone is probably one of the first things you should be looking into, as long term use definitely has it's consequences!
Dotty,What are the benefits and risks associated with long-term prednisone use when
treating rheumatoid
arthritis or other rheumatic diseases? Does short-term use carry the same
risks, or are risks tied to dose not the length of time a patient is on the
drug?
A.
Prednisone is a type of corticosteroid
that decreases inflammation
relatively fast. As a result, it is a popular and useful treatment for
inflammatory types of arthritis, such as rheumatoid arthritis. Recent evidence
has shown that in addition to its ability to help people feel better by
decreasing joint swelling, joint pain, and fatigue, it also has the
capacity to slow joint
damage.
In general, rheumatologists
tend to use corticosteroids such as prednisone or prednisolone early in
the disease to get quick control of the inflammation and until other disease modifying drugs can
take effect.
While it is unclear if doses of prednisone of 3 mg or less have clinically
significant toxicity, doses of even 5 mg per day carry the increased risk of:
Higher doses may have other potential toxicities including:
Certainly, there are patients with rheumatoid arthritis who remain on
prednisone long term.
In those cases, the doctor and patient must weigh the
benefits of the drug, as well as its potential side effects, and consider the
alternatives available when making the best treatment decision.
Thank you so much for the extremely valuable information, I had no idea of what a great response I would get. Cordelia, I really appreciate the information on prednisone.
I have an appointment with my family doctor next week, I will seek his input and go from there.
It was these boards that gave me the idea that prednisone as a sole therapy might not be such a good idea.
So I thank you for the info I gained even before I posted myself!
I think a new rheumy may be in order.
I'll keep you posted!
Dotty
Dotty,I have a little different take on things. Pred has been made out to be the devil itself for those of us with inflammatory arthritis. Actually, in early RA, prednisone (up to 10 mg.) has a DMARD effect. Here's the link that may prove interesting to you:
http://www.medscape.com/viewarticle/452880_5
Others say it will melt your bones. I've been on low dose of prednisone for more than 10 years, and my recent bone scan shows my bones to be better than most 30-year olds -- I'm 62. A lot of the problems with pred come from high dosages over time -- and your personal constitution.
This is not a popular opinion (as you've seen), but it is the other side of the coin. Personally, I don't see the harm in a short course of pred at under 10 mg until the doc can figure out a course of action. Would I use it forever? No, probably not (especially if I were younger). Have I personally had any ill effects from prolonged dosage at 10 mg. or under? No. But it has allowed me to have a fairly normal life.