Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
Hi,
I am seeing my Rheumatologist this week. Since I only see him every 3 months, I don't want to waste the visit. I was diagnosed in January, took Plaquenil for 3 months, no improvement. Now I've been on Methotrexate 15mg/week for 3 months. My symptoms are worse everyday. I don't know if my doc will reccommend increasing the mtx dose or trying a new med. If 15 mg has done nothing, is it likely an increased dose will help? Or should I push for something different? I'd really like to hear about others' experiences.
I'd also like to know about others' experiences with pain meds. I am currently taking Celebrex twice a day and Prednisone tapers for flairs. There are times that the pain is terrible, but it's just a bad day, not a full blown flair. My family and friends say I should ask for pain meds, with all the talk about opioid abuse, I'm afraid my doc will treat me like a junkie. Any thoughts?
Thanks!
I think you need to assert the need for adding a biologic to the mix [and possibly decreasing the MTX dose]. I wouldn't be satisfied with just an increase in MTX if you haven't seen any appreciable improvement in all this time.
Once you have the inflammation under control, the pain should be under control.
What works for me:
7.5 mg MTX once weekly,
200 mg Celebrex twice daily, and
Humira every other week
I rarely ever take pain meds [Tramadol]. Seriously, maybe 50 mg daily for a week, then nothing for months on end. You shouldn't need pain meds.
I never ever take Pred as I rebound terribly when I go off it. [So why start?]
Be your own best advocate.
Keep a detailed diary of your symptoms (pain, joint stiffness, etc) and write all your questions down.
Most rheums will choose to add on a biologic at this stage (and may also increase your MTX dose since you are not yet at the max dose). Do not expect rapid changes....these meds can take weeks and months to work.
As for your comments about pain meds...
Everyone is different with respect to how much pain they have and will tolerate.
Just asking for pain meds (per your family and friends) is NOT the answer. Pain meds may help you feel better (which is great) but will not get at the underlying process and will not prevent ongoing damage (not to mention the non-joint complications of RA).
And a general comment about pain meds, specifically narcotics, that I mentioned as a comment in another post recently...Pain medication prescribing practices are going to change and expect to see it if your provider does prescribe narcotics. Many states (US) are instituting strict medication monitoring programs for prescribers and many prescribers are getting very concerned about being blamed for the opioid problem (to some degree this is the case) or contributing to it's continued escalation in this country.
Good luck and keep us posted.