Hi Folks,

The topic says it all. I have had the worst luck finding a traditional DMARD to go along with my biologic (Humira). Methotrexate curtailed my breathing and created significant chest congestion. I eventually chose breathing over taking the med. More recently I was given Arava (leflunomide) by my rheumy. I experienced some gastro side effects but I could have lived with that.  After a month I had major chest congestion. I even thought of waiting that out but when the peripheral neuropathy hit and my feet went numb I called my doctor and we stopped the Arava. This is really a bummer because I was noticing that me knees stopped hurting and my morning stiffness had faded away. Of course now I still can't feel my feet and what I do feel coming from them is very uncomfortable.

Next up would be sulfasalazine which is a sulfa drug. According to a doctor I saw last year, I am senstive to sulfa. At the time I was on Celebrex, which is high in sulfa or sulfonamides, and the doctor noticed the large, red blotches that looked like spider bits all over my legs. He took me off celebrex because of the sulfa content and my skin eruptions disappeared. I suppose I could try sulfasalazine but if if has more sulfa than Celebrex then I won't last long on it.

I inquired on more than one occasion about Plaquenil but he said "no" because my RA is too severe to benefit from it. I have read it was for mild RA but if it boosts my Humira a tiny but it may be worth trying. 

I don't know if there are any others than I would qualify for. I heard of a couple others used for RA with life threatening complications but side effects are great and I would require a lot of monitoring.

That leaves me taking my Humira every other week, 5 mg prednisone daily, Tramadol for pain, and Pennsaid topical anti inflammatory which is a stronger version of Volataren gel. My rheumy is a big time believer in using the muscle relaxer Robaxin for the spasms I get from RA or for my lower back problems so he prescribes that for me to use daily if I want. Finally I begged for etodolac (which is an NSAID) for sciatica. My rheumy caved in a prescribed it but he limits me to taking one in the evening because he doesn't like to mix NSAIDs with prednisone. The etodolac at the 300 mg capsule dose, is the mildest NSAID I've ever taken in terms of gastro problems or high blood pressure but side effects did occur on the 500 mg caplet.

Those are my meds and they simply aren't always enough. I absolutely need to mantain a healthy diet and do daily physical activity if I want to see any real improvements. That's understandable and I did get pretty far with the above combo of meds combined with diet and excercise earlier this year. My success, however, was short lived and considering my RA is quite severe I'm not sure if my Humira and Prednisone combo is enough to keep the disease steadily under control. I do realize that NSAIDS, Tramadol, etc... do nothing to protect the joints and prevent inflammation. I feel like I'm not adequately treating this disease (though I'm sick of all these meds) and that at any time my disease can erupt into a flare. Living this way creates a lot of anxiety. 

I'm 2 years in and I'm doing worse than when I started. I suppose that is typical but I would love a stretch of time when I actually feel I'm making progress. I think I felt like I was improving for only about 2 months over the past 24 months. That's only 8 percent of the time. It's simply not enough. Maybe that's normal but I'm sick of being sick. We all are!

You advice is most welcome and appreciated.

Greg