How did you get a rheumatologist and neurologist to work together?

hey brother in Christ.....my wife takes it for her RA,,,,SEEMS TO HELP HER.......she is on a low dosage and has been for about a year and 1/2......plus she is on other meds for her fibromyalgia......hope you get better.


terry

I was actually being serious. Let us know how it goes. I have RA and osteoarthritis in my spine.

I had asked on the RA section of this site about taking pills or injections of methotrexate for my stomach's sake, but I haven't seen where anyone was taking it for MG. My rheumatologist was actually the one who initiated the call to my neurologist, and then she returned the call. The neurologist also gave me a direct email line to her and she always responds within a few hours. They want me to take this and to get off Cellcept and Prednisone. I have been blessed with very personable doctors who have seen me even without appointments and are willing to work together. The Bible mentions the "beloved physician" - Col. 4:14, and I am understanding that statement. I've experienced some of the horrors of uncaring doctors, and I was pretty quick to find a new one. Thanks for your comments and prayers, and I will try to keep you posted on how it works for MG. I would still like to hear from anyone who has used it.
@Kimber71 - I have RA [spondyloarthritis] in my upper spine and eyes along with the MG. Prednisone helped, but I hate being on it, so they think this methotrexate [low dose chemo] is best.

Steve,

Yes, I took Methotexate for over a year. However, I had to stop when I had a MG Crisis and my doctor's determined the Methotexate made my breathing worse due to my COPD.

I would recommend trying it, just let the doctor's know if your breathing gets worse.

Bruce

When I told my neuro that I was ready to try something other than prednisone, she told me the choices were cellcept, Imuran or methotrexate--and that she had patients doing well on each of the three. She said it was my choice to pick which I wanted, as they all worked for some folks and all had problems for other folks.
I haven't made the choice yet--still tapering prednisone without MG coming back to see if I am in remission.

my neuro has said that the side effects of methotrexate are not as bad as those with prednisolone so he is putting me on it this month and then in about 6 month taking me off the prednisolone im just worried about the sickness though i already get a bad gut from the other pills

To all, thanks for your input, it does help.
@Stacy20 - I asked on the RA site if people preferred the pills or the injections for methotrexate, and it was overwhelmingly in favor of injections in order to help with the stomach problems. I will start next week.

From our links group under 'Current and Emerging Treatments"


"There are no good
quality published studies of methotrexate in MG. However,
methotrexate is still often used as second-line treatment
in patients who do not tolerate or are unresponsive to
azathioprine for several reasons: (a) data extrapolated
from other autoimmune disorders suggest that it should be effective in MG, (b) expert panel guidelines support its use
as second-line treatment in MG, and (c) many physicians
have extensive personal experience of successfully using it
in MG..."

"Adverse events associated with methotrexate are usually
mild such as alopecia, mucositis, gastrointestinal intolerance,
and mild elevation of liver enzymes. Nevertheless, severe
adverse events including hepatotoxicity, hematopoietic
suppression, and pneumonitis may sometimes occur"


I hope it helps.
Good luck to you.

I've been taking methotrexate (MTX) for the last 5 years to treat my RA. I've had very good luck with it and have had no significant side effects. I tried cutting the dose recently because my joints were feeling really good and guess what- my MG flared up! Best of luck to you-

Please keep us posted on how this goes. I'm on plaquenil...it has helped my MG a little and my arthritis a little, but neither much... I think I'm going to need more help, and likely MTX will be the drug of choice. Praying for you!

Hi - I am about four months in -- I can see some improvement. Side effects for me have been increased hair loss -- however I am blessed with a ton of hair -- so no one notices and a few odd rashes. I have learned to take it at night and be lazy the next day - as it does make me tired. (My colleague with RA gave me that tip.) Take care, god bless and most of all -- Good Luck!!

Thanks to everyone for the replies. I just gave myself the first injection, so I will let you know in a few weeks how things are going. By the way, I'm not needle squeemish, but that shot was really easy and painless. Burns a little after it goes in, but very mild.

SallyMSN, do you still have to take a lot of Mestinon and Prednisone for MG on a regular basis? Just curious... Or does the MTX usually keep the MG symptoms at bay?

I still need an acetylcholinesterase inhibitor (huperzine or mestinon) to control my MG symptoms. MTX helps minimize MG symptoms but doesn't get rid of them completely.