There are a lot of biologics, and even the ones that are similar affect different people differently. You may get great results from a different one. At this point there is no way to pinpoint which drug will have the best effect on any given individual. Time, trial and error, and, as Coaltrain says, a balancing act will help you get it sorted out. Work with your rheumy- you seem to have a good one- and see what you can figure out. There is a fair amount of suckage involved with all of this. I'm sorry you are having to find that out.

Thanks Alto and Bcatz!
I will try to relax and give it more time. Went to 2 mg prednisone this morning. That may be my max without having to take more meds for sleep, racing thoughts, etc.... No additional MTX yet. In fact I don't take any at the moment. Didn't like it much but will ask rheumy about adding low dose at next appointment. Is MTX my only choice of a DMARD to take along with Enbrel?
Greg

Plaquenil is a good option to add to a biologic. There are others too, but it and Methotrexate are the most common.

Hi Greg,
Arava is often used when someone cannot tolerate methotrexate. See what your Rheumy says.

On another tack altogether, have you noticed how many people on this board are teachers or nurses (or have been). I'm not sure just what that's telling us but it is interesting.

Just concentrate on finding something that works for you and worry about work later As coaltrain says, it sure is a balancing act.l

I have seen a few teachers and nurses on the board come to think of it, I recently read an article that many teachers get auto-immune diseases. It didn't really explain why but I'm sure stress doesn't help.

Even though I bumped the predisone to 2 mg today I had an acute attack of pain in both knees requiring a narcotic pain med to survive the day. My wife keeps asking when I'll try the Humira. I told her not for a while. Of course, if I was home resting instead of working I'd feel much better but I don't want to take another sick leave after just taking one. My one hour commute each way doesn't help me either.

I know I keep mentioning and worrying about work but it seems as though a lot of people take disability or retire early. I'm not ready for that yet but I'm not gonna be able to do this for another 6 months if things stay the same,

One more thing: I called and spoke to a nurse at Enbrel. She said that if it helps it is usually within 3 months. She said it can help as early as 3 weeks so the average person who responds to Enbrel usually gets help somewhere in between. When my next rheumy appointment rolls around in 4 weeks should I be considering switching biologics I've I'm not improving or adding a DMARD to the Enbrell? As you can tell I've been avoiding talking much about adding a DMARD because I fear shortness of breath, fatigue, etc..... Even on the Enbrel I find I'm winded after walking up a flight of stairs. Thanks!

Did the extra prednisolone help?

There is a test that can be done to help decide what kind of biologic would be best, but most doctors do the trial and error method. I think it's the vectra d test - and it may not be all the accurate. I am only remembering a little bit as my doc doesn't do the Vectra d since it's not an "insurance standard".

I realized I felt better between shot 8 and 10. But I knew I felt better by shot 12. I wasn't all better - maybe 60-70%. Back when I took methotrexate and Enbrel - it was amazing. I maybe hurt a tad bit once or twice a week.

Rest up a lot this weekend. When weather gets to the point you normally would work on yard and house, consider alternate plans. (paying a kid to do it or just doing a little at a time) Preserve yourself as much as possible.

What do you teach?

Have you asked about or tried injectable meth? Shooting it up rather than taking the pills often reduces or even eliminates some of the side effects. Might be something to add to the list of questions for your next appointment.

I teach middle school computer education Bcatz. I may call and ask if I can do low dose MTX. As far as my lawn goes I plan to not do a couple things this year. Maybe I can hire someone to do a Spring Cleanup? Maybe I can hire someone to mow every other cut and I'll do the extra? I may pay someone to spread organic fertilizer as well? This is all, of courses, temporary in my mind while I'm still working full time.

The extra prednisone didn't help yesterday but I feel ok this morning. I took 2 mg again today. I also slept straight through last night which I've never done on prednisone before!

Altocief, will the injectable MTX eliminate shortness of breath, fatigue, liver issues? I'll look into that later.

This is a tough disease for a dedicated and addicted lawn care hobbyist such as myself. I will do things for sure regardless of pain. I just need to learn to take it slower and pace myself better. Getting help here and there is something I will price out very soon.

Thanks guys!

With me it got to the point where all I could do was go to work after a while. I was so exhausted that all I did was sleep when I wasn't working. The thought of taking care of 6 acres and 3 buildings didn't even come into the equation at that point.

I still do it all myself but that is all I do. What used to take me a couple hours now takes a couple days. Really hard to get used to and very frustrating but I've now come to terms with it after having to stop working 3 years ago.

The bad news is I already had to reduce the methy prednisolone due to insomnia and manic type racing in my mind, Been down to only 1 mg since Monday. The good news is that my pain is much lower since my 6th injection of Enbrel. I'm hoping and praying that it's not just some fluke and that the medication is finally providing me with some relief. I'd say I was in 80 percent less pain today. I was able to walk around work at a reasonable pace and take the stairs. I was even able to use a screw driver last night for a long time before my thumb began hurting, I'll take 80 % improvement in a heartbeat! I can treat the rest with NSAIDs.

Almost forget, The fatigue is still with me. In fact it's worse this week. I've been struggling to keep my eyes open for the past 2 days. I took a 2 hours nap after work and I'm going to bed now. I hope that there isn't a correlation between Enbrel's effectiveness and an increase in fatigue, Oh well, one day at a time!
Greg

You might be stuck with the fatigue and a nap every day might just be in order. If you can feel better and find a nap/sleep pattern that works, that will be great! I know it's not fair to lose your time like that but it's definitely a far cry from bedridden.

Great news on the Enbrel. Hang in there - a few more weeks and hopefully you'll be finding a steady level of wellness.

My son is in 8th grade - God bless you with all those egos! :)