Doctor's Visit

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Regular Member

Date Joined Aug 2005
Total Posts : 289
   Posted Today 9:23 PM (GMT -7)   
Had my 6 week followup from starting mtx.  Overall things have improved significantly minus the two bad flares while trying to decrease the prednisone so I really cannot complain and this is what I told them.  We are going to start decreasing the pred from 20mg to 17.5mg and so on until I am hopefully off of it.  Crossing fingers here.  I had only gained 4 lbs since being on high dose pred so I guess I should be pretty proud of that, or maybe I can only consider myself lucky since I have literally eaten myself out of house and home.  I got the okay to start water exercise today which is good.  My newest heal pain they are saying is probably rheumatoid related or the result of how I have had to walk for so long and it should resolve with rest, ice, and heat.  Hope so because if I can make this go away I want to really get out there doing stuff.   We have increased the MTX another 5mg so I am at 20mg weekly now.  Hopefully, my side effects will still remain low. They want me to get a dexa scan my next visit in January.  This is a bone density scan.  I am only 31 is this normal to do this so early?  Because if I can avoid it I would rather as I don't have that much money to spend.  Also found out my cough is related to my blood pressure meds so I need to get them switched too.  Are there people who respond to mtx alone?  I am really nervous about decreasing the pred as I feel it is really what is keeping the pain at bay.  At what point do I decide that I need something more like enbrel or something if the pain does come back?  I really don't want it too, I think I can say that I am actually scared it will and I was so close to just giving up 6 weeks ago, I just cannot go there again.
Thanks for listening

Harley Diva
Regular Member

Date Joined Oct 2006
Total Posts : 160
   Posted Today 10:58 PM (GMT -7)   
I'm glad your visit went well and also glad you are not having bad side effects. I know people who are on only MTX. Each person is different and none of us want to be on alot of drugs. I also have heel pain. It seems to be getting better though. I had the same kind of cough and I switched BP meds and it went away. My prednisone is now down to 5 mg. and I hope to drop it to 2.5 next month. I have to say other than a couple of flares the pain has not come back. I have been on the MTX about 8 weeks. I understand it can take a few months to get optimal relief with the MTX. Your Rumy should be able to tell you if you will need Enbrel or one of the other TNF inhibitors. I think they want to save the big guns until really needed. The bone scan is probably because you are taking the prednisone as calcium loss can be a problem. Explain your finances to the doctor, maybe an xray will suffice. I know how you feel about being afraid of going backwards. I feel the same way. A few weeks ago I felt like I was in a black hole. There are alot of options for us out there now and I trust things will get better. Take care of yourself.
Harley Diva
....RA, HPT,  drugs: Sulfasalazine, MTX, prednisone, bp meds

Veteran Member

Date Joined Sep 2005
Total Posts : 1744
   Posted 12/14/2006 6:55 AM (GMT -7)   

Hi Theresa,  it sounds like you've really been making some progress!  Congrats.  Most people try mtx alone first, as most insurance companies won't pay for the biologics until  you've "failed" one of the classic DMARDs like mtx or sulfasalazine.  My rheumy tried me on sulfasalazine first because in his experience most people cannot tolerate it very well, and he wanted me on a biologic.  I failed the sulfasalazine in 5 weeks and was approved for Humira.  I avoided mtx at first because I'm still of child-bearing age and wasn't sure if I wanted more kids.  I'm definitely not having anymore now, though, so adding mtx to the enbrel I currently take was a no-brainer.  Many people do well on mtx alone. 



Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan

Veteran Member

Date Joined Mar 2005
Total Posts : 3148
   Posted 12/14/2006 4:25 PM (GMT -7)   
Harley hit the nail on the head! the bone scan is "most likely" due to predisone. which can make you osteopenic even at 30...heck...even at 20!
well, from experience...i've never been put in jail for not paying a medical bill! even if itis mandatory you need one? and ins. leaves ya with a hefty copay? finance it! small payments are better than none. i was sending my hospital 5 dollars a month for an MRI for like 2 years...and when i could give more i did....and i eventually after like 4 years pay off a 2500 bill.
i would have a heart to heart with the doc about money. believe me, they understand...sometimes surprisingly so.
Active Severe Rheumatory Arthritis. Crohns Disease. A.Chiari Malformation & right brain venous anomoly. Partial Complex Seizures. MVP & Tricuspid Valve Prolapse. Rheumatic heart & lung. Previous Lymes Disease for 10 years.
Meds: Remicade infusions Q3 weeks; Intra-articular knee injections; Imuran; Mesalamine; Prednisone tapering from 120mg; Meclizine; Reglan; LidoDerm; Diazepam; Restaril; Dilaudid; Avinza and too many others. 

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