Wow - quite a predicament!

My first thought when reading your post - since your doc is going to be away for the month of February, I wouldn't try anything new until they would return in the rare case of an adverse reaction or, as you fear, go into a flare that can not be controlled.

For myself, the 2 medications I have been on so far (Methotrexate and Humira) both took at least 3 months for any effect. My point is that starting Humira right now may not help you at all, and if you quit the Prednisone at the same time you might get pretty bad.

I would just hold steady with the current meds and ask for an RX for enough Prednisone that you know will help you until March.

Let me add, I don't want to quit prednisone and will request a just in case prescription. I fear, however, she will say no. She seems so afameng on no main medication during flares and having been on steroids since September, I am scared she will say no more. I appreciate your advice. I'm thinking stay on arava IF she gives more prednisone in case I flare again. Fourth flare since September and this last was 2 weeks long and the strongest yet. It is overwhelming. Thx again.

*adamant, not afameng lol.

I think you're tapering prednisone too quickly, google 'tapering prednisone' .

are you on Mediare lionprincess?

i work full time and have regular group work health insurance through my employer.

the orencia infusion is about $535.00 for me per month, the uncovered portion if I were to switch to infusions. we were going to try that route and put through a test claim. The rheumatologist was interested in trying me on infusion versus injection. I am not switching due to cost.

the injection (4 per month) is $5 per month

Orencia injections worked for me at about 8 weeks which my rheumatologist told me is a usual kick in time table for most people. I was most people.

good gentle hugs

Ros

I think you are tapering the prednisone too quickly. You have gone from 20mg to 10mg in just a week. My Rheumy's advice has been to taper very slowly - e.g 20mg to 17.5 mg and stay there for 2 weeks, then to 15mg and stay there for 2 weeks. When down to 10mg, taper by very small amounts 2mg or 1mg, or even 0.5mg and stay on each level for 2-3 weeks. I have done this a few times over the last 4 years and not had any problems.

Arava usually takes 6 weeks or more to kick in so it's unlikely to help at all in two weeks. I would be wary of starting a biologic when she's going to be away for a month, in case you have severe side effects - that's apart from the cost. Orencia injections can take up to 6 months to kick in. I have never been on Humira.

Have you considered seeing another Rheumy who might be more caring and is happy to work with you?
Hugs and good luck with whatever is decided

that is a hard situation to be in. I agree I think your doc is tapering your prednisone to quickly. I'm no doctor but when my docs try to lower my dosage it goes like 20 for however long I'm on it. 15 for a week, 10 for a week and then 5 for a few days then sometimes they tell me just split my 10 for a week and to one whole and then a half one whole then a half. And then 5. Sometimes it's different not sure why but that's how my rheumy has done it the past few years. Also Arava does take a while to work from what my rheumy told me I had to get off arava because an allergy (I'm allergic to many things) Since your doc is going out of town express your concerns your having and I would think they would help you out by sending you a script or something. Also I asked a similar question this morning about infusions and got some good answers. Someone mentioned that infusions aren't any harsher of a medicine but something that can't be taken orally etc. And someone else mentioned that it may be cheaper being an in office thing may be covered more than a prescription at the pharmacy. Which made a lot of sense to me after I read it. I was worried If my med stopped working since I've tried so many what if I couldn't afford the next step so it eased my mind some. I hope you find the answers your after. I may not have had RA for 10 years plus or anything (experienced ra) But I have experienced ra and all the medical nightmares over the years I have had it. Hopefully this helps :-)

If your doctor will give you humira in office, I'd bite if cost will work out. I don't understand the no-help til after deductible. I think some of the "coupons" are specifically for those who have a high deductible to get them by.

Humira has a pretty good track record too. Was Enbrel not mentioned? When I took it, it worked in 2 weeks flat!

Ok. She officially put me on 15 mg when I saw her on my fourth flare. I choose, because of extreme pain, to take 20 and try to get it under control. I then went to 15 once I got while of the pain, and in the hopes of seeing whether or not arava is working I chose to go to 10 mg 5 days later. my appt is Thursday so I'm in s time crunch.
*Her instructions on taper are 20 a week, 15 a week, 10 a week, 7.5 a week, 5 a week, 2.5 a week done. Seeing as I was down to 5mg and jumped back to 20 for a couple weeks at most and not months, I wasn't too concerned with adrenal failure etc. My taper was my fault. I suppose her taper is fastert than yours angelpuss.
Now.
*Azulfidine, not mentioned but I will ask 51%.
*Angelpuss, yes considered switching rheumys but I have all normal bloodwork. Nothing is wrong with me on paper. Not even sed rate! In spite she is treating me aggressively I feel...so I will switch perhaps if I can get positive blood results on anything whatsoever so the next doc I see also is aggressive.
*Stupidra, I read your post on infusions:) Thx for the advice!
*My insurance is not Medicare ros by the way.
*Bcatz, enbrel not mentioned. I called orencia and spoke to insurance specialist. They give copay coupons. My insurance, everything is subject go deductible. Everything. Once the deductible is met, then everything is covered 100%, except medicine. After it is met, meds are a copay with three tiers. Orencia guy told me that the copay, once kicked in, can get the discount. My copay after deductible would be tier 3 or 60$ I believe, and he can voucher it to 5$ a shot. Until then, it's 100% out of pocket. I went to my pharm website and the price for orencia shots are like 700 and humira, 2500...a month. Until deductibleand my deductible is high. I gave up and didn't call humira, I will call them today.

Maybe I will stay on arava and ask for a script for prednisone, and maybe she can infuse me in office a biologic on top of it. Who knows. She did give my first shot of metho in office and the price was cheaper than oral and shot metho from the pharmacy, so it may be cheaper...

Thx everyone for your help and advice!

Side note, I am so sorry for typos. I find it difficult correcting on this cell phone! Thx again everyone.