This is not a dumb question, just a complex one. I fought RA for ten years and went through many meds until my rheumy found the right mix. For many insurance companies, you have to try "lesser" drugs before they ok the biologics that actually may work better. It is terribly hard to find the right drug and some people haven't achieved that point yet, so they still are in terrible pain and have trouble moving, walking, dressing, etc.

Hope you have pain-free days!

Lynne

Biologics (as I understand it) are usually added when one or two DMARDS (mtx is one) don't work alone. In my case I was on 3 - Plaquenil, sulfasalazine and mtx. I ended up having a severe reaction to sulfasalazine. So that left me on the other two...but I was getting worse. Rheumy decided to go the biologic route with me.

Typically they'll start you on something you can self inject at home - all insurances vary in what's on their "approved" list. I started Enbrel, then failed it, then went to Humira - eventually failed that one too .

Enter new rheumy - said I needed further treatment but only option at this point were infusions (IV). So i'm now on Orencia infusions, which I get once a month. It's a 30 minute infusion, so I'm in/out fast - which I like!

If you feel like you are not controlled on your mtx, you should speak to your rheumy about the biolgics - it can take quite a while for relief though - everyone's different.

Good luck!!

Without biologics, I cannot get out of bed. That means my flares are so bad, that I literally cannot pull the covers off my bed, because I am so weak. This is not cumulative damage, but just the pain of the flare, makes me lose use of my joints. I also cannot dress myself, because I cannot bend my feet, knees, shoulders etc, enough to put on clothes.

I have a lot of damage in my joints, but when on a good biologic, or in combo with a DMARD, I function more or less ok. I have limitations, but I am still able to ride a bike (walking is much more difficult) and cook and clean, play flute. I have learned to accept what I can do, and really rejoice that I was not born in the days before they had these wonder drugs.

I would say if you are not that severe, you may never get to the point I am at. I wish I had been treated more aggressively in the beginning, or at least complained more. That was before I had the internet, and learned from other people.

I have only been dealing with this disease for 7 months. It was triggered by a horrible bout with pneumonia in July. I started out with one joint involved, and within 4 months I had 35 joints involved. Yet, I test sero negative, which is suppose to be milder. I have had 3days in this month where it was very difficult and painful to walk. Because I had a really bad reaction to prednisone and a bad bacterial infection in my stomach this has set my treatment back. In the meantime either from natural progression or the stress to my body, I am having more painful days and greater pain. I have symptoms I didn't used to have like low grade fever. If I haven't improved in the next six weeks, my Rheumy is going to add Enbrel. She said she would have already but was concerned because I have young children at home and it would seriously compromise my immune system. She is also concerned about a tumor my gyn thinks is benign that they are waiting to reevaluate in August. She is concerned the Enbrel might make it malignant. I don't know enough either, and I have so many questions and only so much time to ask my Rheumy when I am there. She is very busy. I want to keep asking questions of people who have been doing this longer than me that are on this site to help me until I can get back to my Rheumy, but I am concerned about overwhelming others with my needy questions. I hope that this gives you another perspective. That is why I keep checking out the posts because it gives me perspective. Thanks for posting your question. Elizabeth

There are no stupid questions here =)

Bioligics are reserved for people who don't react to the dmards.
Some people have mild to moderate RA and some have moderate to severe. Not saying that RA isn't painful for mild to moderate, everyone deals with things differantly, but I know for me, I have Severe RA. My flare come on most of the time with no warning.
And I am one of those who can't hardly get out of bed or dress myself.
The pain is so bad that there are no words for it.
It wasn't from having it a long time, because when mine came on it was all at once.

Hopefully they can get yours under control with out having to use biologics and keep yours from progressing any further.

Good luck and Welcome :-)

Thank you for all of your replies. i see RA does affect everyone differently. I am sorry for those of you dealing with so much pain. Mine started about 5 years ago when my wrists started hurting and became inflamed. I mentioned it to my GP many times but he seemed to ignore the issue. I had what the ER called a pinched nerve in my neck about 2 years ago and it pretty much left my upper right arm numb. When I followed up with my GP I told him I needed to discuss treatment for my wrists (never thinking it was RA). I just thought slight arthritis. I was sent for an MRI of my sholuder/arm due to the numbness and discovered i have a ruptured tendon. Well also with that diagnosis the radiologist noted I had an enlarge lymph node (under my arm). For one year my GP sent me to a breast specialist, and are you ready for this? I had 3 mammos in less than 1 1/2 years, 2 chest xrays, 3 chest CT scans, a biopsy on the lymph node, sonograms, extensive bloodwork, etc. After researching this online I learned RA can cause lymph glands to become swollen. I mentioned this many times to my doctor and he just kept saying possibly but we will rule this out first. I started believing I had lymphoma, or some other type of cancer. He scared the hell out of me. I never had so many tests than the past two years. The very first xray showed advanced arthritis in my wrists and hands but he didnt seem too concerned with that. Finally, after my last CT chest scan in october 2010, I called a Rhuemy myself and made my appt. She told me this looks as if it has been going on for awhile. Before starting MTX I was in so much pain, little movement bothered me. so here I am 4 mos later, taking 7 tables of MTX weekly, 1/4 of the smallest dose of Pred.Two Folic Acid daily and I just finished a round of Vit. D. I take ibuprofin daily also and I go tomorrow for my 6 week check up with blood work, etc. I am going to request going down to 6 MTX because my stomach has been bothering me. In the midst of all the testing I also had a bone density test and have osteopena and OA. My RA wants to start me on med for that also. But I'm not sure if i want to start yet.
Sorry for rambling here, you guys are great. It sure helps when you can talk with those who understand your pain. Thank you and hugs to all of you :)

Thank you for posting your question. I'll echo the other sentiments as well that it's not a stupid question either. I am new to this diagnosis myself and appreciate very much hearing (reading) the experiences others are going through with it. I helps me to understand this is a serious disease, it effects people in various ways, there are many options for treatment and so on.

I am one of those who have severe RA. It came on suddenly and was "triggered" by strep throat this last Dec. ("Triggered" just meaning that before the strep infection I had no pain/swelling or limitation of movement in any way that I can recall.)

Since then I have yet been able to get out of bed, get dressed, shower, open containers, carry a half gallon of milk from the fridge to the counter, squeeze the toothpaste from the tube, hold a 16 oz glass of water, etc. without extreme difficulty if at all.

My R-Dr. is starting me on Prednisone and MTX. I hope it works.

I like the support here too because I learn tips like taking folic acid which was not mentioned or suggested by my R-Dr.

Well, I've rambled and feel better for it. Thank you.

Hi,
No ? is dumb. The having a hard time getting out of bed, for me anyway is the fact that I'm stiff.Also if I sit or stand in one place to long Iget stiff. Usually after moving around for awhile the stiffness goes away.

I just wanted to tell you that instead of going down on your dose, you may suggest to your doc that they put you on injectable methotrexate. That will probably elimiate the stomache problems =)