Mine came on fast too. I can only say that it most certainly is a process finding relief and what works for you. An understanding doc is crucial in my book. I wouldn't expect a miracle after only a month on MTX. It takes a little bit to get going. How many are you taking? Oh, and personally, Plaquenil was useless for me.

just did 3 pills once weekly, they did blood work.& now say take 6 a week? 2.5 mg

Welcome to the club no one wants to have joined, Danelady! An important first point is that this disease is just plain freaking weird, and it does not present (or resolve) itself the same way for everyone. It could certainly be that your doctor is not the best fit for you, but it's also possible that your doctor is excellent and this is just the normal, frustrating, time-consuming process of figuring out what works best for you.

While you are moving forward with treatment for the RA itself - the Plaquenil and then methotrexate seems to be a standard protocol in the beginning - it's important that you take good care of yourself, stay on top of the pain, and take steps if necessary for the depression (although getting depressed, and then angry, or vice versa, is actually pretty normal for this).

Keep a daily journal of your symptoms so that you can present your doctor with as much hard evidence as possible at each visit. One element of RA that frustrates me is that at each visit, my doctor is relying on me for feedback about how I feel, and that can vary a lot from day to day. So that journal becomes very important. I also photograph my hands weekly, and that's helped me track the progress and see how the meds are working. If you add some other factors to that journal, you may also begin to see links between your physical activity, sleep, and diet that influence how you feel overall. While tweaking those things won't cure RA, feeling better in general is always in your best interest and will help you cope.

Unfortunately, horribly, RA is a lifetime diagnosis. But it is manageable. Learn what you can, be a responsible patient, and then get on with your new life. There are still many wonderful things ahead of you.

Thank you so much. I’ve been on the Plaquenil for sometime & they still have me taking it with the methotrexate ? Do you think I should just get off it? i don’t feel it’s done a thing. also do your elbows & shoulders hurt as well? What really stinks is , I have my own dogwalking & pet sitting service for 5 years now. I hv 4 dogs myself & a lot of cleaning to do. I’m
always walking & I sleep great, eat pretty darn healthy too. So this is extremely hard for me:( & i’ve been suffering since December

As someone who makes good use of her dog walker, I know how much energy that job requires.

I'm the blunt one here, What I say is based on my 25+ years of experience with this disease and countless hours of reading posts on various RA forums.

Plaquenil is, for most people, fairly useless., I was never on it. I went straight on MTX and it took about 6 weeks to see a little difference, but about 3 months to see significant improvement. I started with 5 mg [2 pills] and I believe by the third month I was up to 4 pills [10 mg]. Over the years the dose was increased until I maxed out at 25mg and Humira was added to my regimen.

I believe the reason I never went on Plaquenil was because my insurance was very good about letting the doctor use the drugs he wanted.....I didn't have to jump through any hoops, as many insurances require [i.e., the cheaper drugs first....work up the ladder].

Doubling up on your MTX dose might produce the right results, but it'll take a few weeks to kick in.

Do you have an orthopedic surgeon? If so, it might be worth an appointment to see about intra-joint Kenalog injections into one or two major joints that are the most painful. Results are pretty fast....the long lasting Kenalog will last a couple months or longer. If you're diabetic, this might not be for you. But this is what got me through for a long time. It's a VERY powerful drug and there's a limit to how many you can have in one joint per year....two.

Others are fans of Pred pills. I am not. The intrajoint Kenalog is a corticosteroid, like Pred, but the metabolic dynamics are different.kk With the injections, the drug wears off and there aren't a number of side effects that the pills may produce.

The other major issue I am picking up on is your relationship with your rheumatologist. If you can honestly say that you've been forthright to him/her about the pain, progress, your needs....and you're not being heard....then you need to shop around for another rheumatologist.

Part of the treatment success in this disease starts with having a solid, open dialogue with your rheumatologist. You need a collaborative relationship. If it's a one way street, find another and then fire the first one. Some of us have had to fire several rheumatologists.

With some rheumatologists you have to lay down and die before they up the drugs or change treatment modalities. So don't be afraid to exaggerate the pain.....in any case, DO NOT BE STOIC or a brave little soldier. If it hurts, scream.

Understand that the first year is the hardest. With the right drug mix, you'll do a lot better.

One thing my dog walker has done is hire people to work for her. So you might want to think in terms of expanding the business with the idea of limiting the amount of physical energy you expend.

Let us know how we can help you.

Thank you soooo much. that really helps. I do have some helpers with the petsitting & ive cut down on big dogs for walking. I cannot even tolerate a pull it hurts so bad:( so we play in the yards , at least my legs are still good

So sorry. If you feel you need a second opinion - do it! I'm a bit confused if you were diagnosed 6 mos ago when you were put on Plaquenil.

I'm sure others have told that biologics are the current standard of treatment and you should discuss these meds with you doctor.

I think they put me on it in jan? then 4 weeks ago I saw my doc & really complained about the pain. so she started methotrexate 2.5 mg / take 3 once a week , last thursday I did my 4 th treatment. got blood work, now she says take 6 , every week. I know i’ve got to give this time. But I am sooooo stiff in bed at night & morning.& my hands & elbows hurt so much! I just can’t stand this! i’m getting so sad, I can’t get shit done. it’s just not me. Plus ya worry about all these drugs & what they’re going to do to ya? Does anyone else hv it in there elbows too??

Yes to elbows, wrists, fingers, toes, feet, shoulders, ankles, hips and I have 4 dogs too! I walk them all individually every day @ least a mile each and it does suck that what I used to enjoy tremendously has become more difficult as the treatment needs have changed for me.

When I was new to this (not quite 2 years) I was repeatedly told it is a process - finding what works for you. Sooo true and my patience has been tried. I want relief NOW! But, I've also used that time to learn about the disease and also to get over my fear of any drug's side effects. The NEED for DMARDS far outweighs the risks. Don't worry.

It may also take awhile to feel comfortable asking for help and letting things just not get done. Hang in there and vent here. That's what I do! Oh, and snuggle with my pups as much as they'll let me :)

Thank you so much! your words have really helped. I definitely snuggle with my furkids a lot.& my hubby does try to help me. I told him he must read about this disease & understand what i’m going through. I can’t wait till thursday when I take 6 pills. Maybe i feel better

I am so sorry Danelady. This is a very confusing and disgusting disease. I have had it for 9 years now. But... it can be lived with.
I did not understand it either in the beginning. In fact, my doctor pulled his little rollie chair up to me and looked at me with sympathy and said " You have RA..."
I thought... SO WHAT? Give me some pain meds and I will go home. ... Then I went home and began to read about RA.... and I became terrified and realized it was NOT arthritis.
It will take you a while to wrap your head around it. It will take a while for you to accept it. And it will take a while to learn your new limits. Mine was like a death. I had to grieve the life that I have prior to RA and start a new one.... in many ways... so many things were different.
But you are not alone. And it takes time to figure out what works for you and what does not work. That's the way it was with me. I now have a full and happy life again. It is different. It is slower... But in some ways it is much more peaceful.
I wish you the best of luck. The best thing I did was find a doctor that I trust. Thankfully she lives in the same town as me and I trust her. I also have a regular MD that oversees other things. We have a great relationship, too.
There are many twists and turns on this journey... but others are going down the road with you. You will find great support here.
So sorry that you are struggling. Just know that I understand.
Ginger xo

Thank you so much! They have me taking 6, methotrexate now every week. I don’t feel much better yet? the mornings are really bad, everything really hurts. i’ll see my Doc may 3,& I sure hope we figure this out? my knuckles & elbows are the worst. I am being more patient with myself as far as cleaning

danelady... my toes feel like they are broke.. if you have a broken toe you understand it is painful to walk. my elbows hurt so much i cannot put them down on anything... and at night just the sheets on my ankles hurt... that is just part of it.. everything hurts... i have had it for now 6 yrs and still have trouble finding the right meds. A good Dr I think will make all the difference...and its so hard to be patient when you hurt... best of luck to you...

oh my! I don’t think my pain is that severe. I feel bad for you☹️ Right now my feet hurt when I wake. my hands constantly hurt though. this is aweful ! how do they expect ppl to work? water bottles are sooo hard to open now too. I’m glad I have this group it’s so nice to have ppl who understand :) I sure hope you get some relief. sending hugs

take each day as they come..some days are harder then others but support will help you thru. hugs back..