Hi Mari31. My bloodwork showed I was in great health, but I felt awful, I hurt a lot, and I was swollen. The Rheum started me right off with methotrexate and folic acid, saying a lot were helped on that alone.Well, I am not a lot of people, after 3 months, zero improvement. During this time, I was also taking Celebrex, for the inflammation. After 3 months, Humira was added, and relief came very very quickly. In less than a week I felt so much better.

My Rheum takes the aggressive approach, as your Rheum wants to do. My Rheum does not feel I am making enough progress, wants to see less swelling, so I am on my 4rth biologic drug - and this one has been the best. I am very happy with making the choice to take these drugs.

My experience with Humira and Enbrel, which I gave myself, with a sureclick pen is those two drugs really hurt. Orencia, given by an injection/syringe in my stomach, has been a huge help, and does not hurt at all.

I think you are fortunate that you have found a Dr that wants to treat this aggressively. The longer you wait, the more permanent damage that could be done. Good luck.

Hello Mari,

I'm sorry you had to find us but we are happy to help you. I'm not sure if your physician told you those numbers were low.

But, I have to agree with Sally. Your lab results are neither low or medium. They are on the high side. Of course people will chime in with higher numbers but please don't be fooled.

Just off the top of my head, I think the normal for the RF test is 0-14 and your level is nearly seven times the high side of normal. Also, the normal level for the anti-CCP level is zero. Being positive is kind of the gold standard for RA and your level is high. Maybe low high, but definitely high.

With these high lab results, in my opinion, an aggressive treatment plan is appropriate before your body becomes too damaged and/or too painful.

I wish you only the best of luck and good health.

Please stick around and let us know how you are faring.

Be well,
TheWino

Thank you all for your input. It helps so much.
Sally thank you for all the links and information. I will check into them. I don't know anybody that has this disease in my personal life, so it is all new to me. I keep thinking that since I have such a slow progression, maybe I am one of those rare cases that will not get much worse, but I know it is best not to gamble with my health. I will most likely go with my Rheumtologist's advice. She has lots of experience.
I will continue to seek support here and check in. I'm sure I will have questions about the specific medications once I start taking them.

Thank again!!

Good luck to you Mari! One of the hardest parts is getting an accurate diagnosis, so many people go for a long time without that, and like a previous poster said, can unknowingly accumulate a lot of joint damage because of that. Now that you know what is going on, you have more information on how to effectively treat it.

As was also said previously, methotrexate (and the vitamin folic acid) is generally the starting point before all other therapies, usually at 4 tablets (10mg) once a week. You'll get bloodwork every few weeks to make sure your liver is handling it fine (any potential issues show up as small changes in the bloodwork long before any actual damage is done to the liver, so the medication can be changed immediately if needed) and as long as that is ok, will slowly increase till you reach likely 8 tablets once a week (20mg). Methotrexate is really the starting point for the majority of RA sufferers. Some people get concerned about starting it, because it is also used as chemo, but the important difference is that it is used in a much smaller dosage for people with RA. Just like benadryl can be used for allergies and is also one of the most common sleep aids out there, so too does methotrexate have multiple uses, so don't let that scare you.

Nausea is the most common side effect of methotrexate, but there are several ways around this. Generally the nausea lessens as the body gets used to the drug. You can also split the dosage up in a 24 hour period (take 2 tablets at breakfast & 2 at dinner, for example), and if its too much, you can always switch to injection form (its similar to an insulin shot) to lessen nausea. Another common side effect is mouth sores, or hair thinning. Both of these get better by upping your vitamins (folic acid and biotin), and generally get better with time too.

Methotrexate does take some time to build up to the 20mg dose (some go up to 25mg), but it is generally the starting point for all other therapies and works well as a controller medication to reduce daily pain, stiffness, inflammation, and most importantly slow the joint damage. By doing all this it should also reduce the need to take pain medication such as Mobic.

If for whatever reason you can't take methotrexate there are other options out there. But even if you are feeling good, its important to note that joint damage is still occurring. There's nothing you did wrong to cause this, but it is something that you'll have to face, now, to prevent it from reducing your quality of life in the future.

Some people feel wonderful on just methotrexate, and some people add a second or third medication (just like how many people with high blood pressure may take 2 types of blood pressure medications, they each work in different ways to tackle the same problem).

It can be overwhelming to get not only a new diagnosis but suddenly face new medications. But aggressive/early treatment is important to help keep your joints healthy for many years to come. By facing this head on now, you're helping protect your future self.

Hi Mari,

You are lucky to have found a rheumatologist who treats aggressively.
This should save damage being done.
I think we all are pretty nervous about the medications for RA at first..
Good luck in your decision and treatment.

At first my symptoms were mild and I started on Mobic, then all my symptoms disappeared completely. After 7 months of being symptom free......then RA raised its ugly head!!! My sed rate was negative and my anti CCP test was high. RA doc was great, she and I discussed the various meds. I started Enbrel but not much success after two months. Then the doc added Methotrexate and folic acid. It took a few more months, but then the meds all started to gel and kick in. I suggest taking a more aggressive approach because joint damage cannot be reversed. I have never really had any problems with the meds and I now in my 5th year on them. I also feel much better than I did before I started the drugs. I have no bone erosion, all my joints work pretty darn good. My only noticeable thing is that my right thumb joint is always a bit more swollen and sometimes the back of my hands around the knuckles. My opinion is to start the drugs. Oh, and from a high point of 5 MTX pills per week, I am down to just 2 per week now. So it is possible to reduce the drugs once your body starts to improve. :)