Tuesday, July 29, 2014

Friday, August 12, 2011 V, Health Guide, asks

Q: Anyone have experiene re: sore throats and white skin in your throat while on MTX?

Hello, all!  I developed a sore throat yesterday, and looked in the back of my throat.  There is white skin back there, kind of like when you burn your skin lightly. Throat losenges don't seem to help. Tramadol does help, thank goodness.  Rheumy is out of the office until Monday and my PCP is out of the office until Monday.  So, I'm thinking I will not take my MTX tonight.  This is so weird.

 

Thanks!

V

Answer This
Answers (2)
Lene Andersen, Health Guide
8/12/11 2:55pm

you really are a walking compendium of weird side effects, aren't you? Smile

 

I don't know about the color of the skin - this is one of those things where most people don't have a baseline when things are fine to compare to when things are not, but a sore throat can happen. Usually, it means you're getting sick, but if tramadol helps and lozenges do not, it might not be strep throat or something similar. I think you're right in skipping your methotrexate until you can contact your doctor and if things get worse, go to your local Urgent Care to get checked out.

 

keep us posted?

Reply
V, Health Guide
8/12/11 7:39pm

Hi, Lene,

 

Yes, I have a long, sordid history of reacting to meds in a way most people do not. Sigh.

 

I didn't sleep well last night, went into work an hour late.  My throat hurts a lot.  Been taking Tramadol and Celebrex and that helps the pain.  Now it looks like cottage cheese is back there in my throat. I'm thinking thrush, and perhaps strep throat because my throat is so red and sore.  I had Strep A once, and I had athsmus ulcers all over my mouth and tongue and throat.  I wonder...??? Then I have been having sinus headaches. Both of my docs are out until Monday, and I hate going to those walk-in clinics, but if it gets worse I will try to find one tomorrow.  I live in a rural area, but I could drive to Columbia where all the hospitals and doctors are, I guess.  They probably have an urgent care clinic open on Saturday.  I just want it to go away.  I think I'll go gargle with salt water.  No MTX for me tonight!

 

Thanks for your response.  I feel better just knowing that you know what is up. You understand these "werid" things.  Undecided

 

V

Reply
Lene Andersen, Health Guide
8/12/11 7:49pm

it's gotten worse since you posted. Go see someone tonight, if you can, sweetie.

 

I'll be thinking of you.

Reply
V, Health Guide
8/12/11 8:05pm

I live in the country, Lene...like way in the country. No docs open here...just the emergency room.  I will go tomorrow morning if it isn't better.  I would go tonight, honestly, but there is no where to go. Hope you have a good weekend, Lene.

 

V

Reply
Lene Andersen, Health Guide
8/12/11 9:09pm

right. The country is wonderful, except in moments like this. Sending good thoughts your way and please let me know are you're feeling tomorrow.

Reply
V, Health Guide
8/13/11 10:54am

Your good thoughts worked, Lene!  My throat is much better...still some white blisters back there, but only half as many as last night.  I slept for ten hours, and I feel much better. Throat isn't as red or as sore.  I have a sinus infection.  I guess it was getting out of hand w/all that throat business.  I didn't take my MTX or my Advair or my evening dose of prednisone last night. I will get some antibiotics Monday, I guess.  I left a message on my rheumy's voice mail. My right ear has that roaring water thing going on, so I think I have my typical sinus/ear infection.  One good thing.  Seems like my immune system kicked in and is beating back the throat thing. Thanks so much for your adivce, and for caring. I was a little freaked out last night because my throat looked awful and it really, really hurt.  I hope you are well and have a good weekend, Lene.  Dont' know what I would do without you.

 

V

Reply
Lene Andersen, Health Guide
8/15/11 8:59pm

glad to hear you're better! It sounds like you were getitng sick, not really side effects, though. Let me know what your rheumie says?

Reply
V, Health Guide
8/13/11 1:10pm

Lene...my doc did not prescribe folic acid w/MTX.  What do you think about that?  She didn't just forget about it, either.  I specifically asked if I should take folic acid, and she said, "No."

 

V

Reply
Lene Andersen, Health Guide
8/15/11 9:01pm

next time you see her,, ask why she's not prescribing folic acid. When I took methotrexate, folic acid was an absolute necessity and always prescribed at the same time. Of course, this was back around 2002, so recommendations may change, but it was my impression that it was still part and parcel of taking methotrexate. I'd be curious to know why she doesn't think it's necessary

Reply
V, Health Guide
8/16/11 11:34pm

I saw my rheumy today, Lene.  She wants to put me on a biologic...either Humira or Simponi.  My RA is getting worse.  Sometimes I can only walk a few blocks before my ankles start throbbing, even with my orthotics.  My wrists are still swollen.  My knees and hips are better though, and my hands are better.  The fatigue is awful.  I struggle to work and back home each day and then sleep.  I sleep most of the weekend away, too.  My doc doesn't like this. So...I wasn't quite ready to hear this, so I put her off.  Told her we could try MTX for another three months and see, but I don't think I will wait that long. I just need a day or two to get my mind around taking a biologic.  I called my insurance company, and Humira is covered.  The doc just has to get the preapproval and also the preapproval from the specialty pharmacy.  I have the numbers for the doc to call.  My copay will only be 20.00 thank goodness.  Anyway, I think I will choose Humira. I may wait until Sept to call her back and tell her I am ready, unless it gets even worse. You know, before May you kept telling me to see another doc and that you thought I had RA.  I'm glad I found this doc when I did, because my RA is getting more and more aggressive for some reason.  Thanks again, Lene, for all you do for us here.

 

Almost forgot to tell you I asked about the folic acid and MTX. She said folic acid has been added to our food since 2006 and unless I eat a really unhealthy diet, I should not need folic acid.  She said a lot of docs still prescribe it, but it isn't necessary at the doses given for RA now since so much of our food are supllemented w/folic acid.  My pharmacist told me the same thing.

 

V

Reply
Lene Andersen, Health Guide
8/17/11 7:13pm

I think you're doing the right thing by moving up the date to start Humira. When your RA is as active as yours, it can cause a lot of damage in three months. Besides, Humira can take about two months to really kick in, so that would extend the process even further. One note of caution: I learned in that RA forum I attended last year that when you stop methotrexate, you have to do it very, very slowly, because if you do too fast, you may go into a Brenda's flare. Your doctor may be suggesting methotrexate and Humira at the same time and that sort of combination therapy is quite common.

 

I saw your question in another place about choosing Humira or Simponi and as far as I know, it doesn't really matter which biologic you start with. It seems to be more a question of which one fits into your lifestyle, but that's primarily a injection versus infusion question. You know my experience with Humira - I've been on it since early 2007 and I'm still every day grateful for it and what it's done for my life. I hope it works the same for you. Keep in mind that if it doesn't, there's another eight Biologics to try. There is hope.

 

I'll be thinking of you.

 

p.s. thanks for letting me know about the folic acid question. I was on methotrexate 2000-2004, so that was before it got added to foods. It explains something I've been wondering about - it seems that  it's only prescribed to people have certain side effects of methotrexate, so now I know why!

Reply
V, Health Guide
8/17/11 11:25pm

Thanks for the info, Lene.  I am going to wait until I am past this virus thing, that is hanging on still for some reason.  My rheumy did increase my Celebrex to 200 mg twice a day instead of once a day.  Actually, I was supposed to be taking that much all along, but I was afraid to do it because of the cardiovascular issues, and I have had high bp for decades.  I finally decided to take it, and it has made a difference. I am just amazed at how fast RA is attacking my joints. I know I have had RA for a while, but it wasn't like it is now.  Now it seems out of control. I am ready to try the biologic.  My doctor was not happy when she examined my joints yesterda.  She wasn't happy to hear that I sleep all weekend either. That is when she said we had to have a "serious" talk. So...uncontrolled RA is more riskly than the meds, right Lene?  I'm a little scared.  I know what is right in my mind.  I just need to think of the meds as helping me and not worry about what "might" happen. 

 

V

Reply
Lene Andersen, Health Guide
8/18/11 2:48pm

I know taking all these medications is scary, but they are tools to help you have a better life. Yes, Celebrex does have some side effects that you need to be aware of, but as long as your family doctor keeps monitoring your blood pressure and you keep taking the blood pressure medication I assume you've been prescribed, you've done everything you can to mitigate those side effects.

 

There are risks to taking the medications, but there are also risk to not take it. Uncontrolled RA can destroy your joints, which can destroy your life. Your ability to continue working, being active in your church, singing in your car, etc., depends on you taking the meds. At the end of the day, we all have to take a very clear-eyed look at the cost and benefit and to my thinking, it all comes down to what is your life worth? When you have a big problem, you need big solution and they come with a bigger risk. Biologics do have some risks, one of them higher incidence of certain forms of cancer, like melanoma or lymphoma, but you can do your best manage that risk by making sure you get annual checkups and wear sunblock. On the other hand, the Biologics also have a significant impact on the mortality gap, i.e., the fact that people with RA on average have a shorter life expectancy than others. There are studies that show that the Biologics improve your heart health and reduce your risk of heart attack and stroke.

 

Sweetie, your RA is really aggressive. I think you are at that point where you have to sit down and take a very serious look at what you're most afraid of: taking the drugs or losing your life. You can drive yourself crazy thinking about what might happen, but you have to remember to also think about what might happen if you don't take the medication. I know that on an intellectual level, you're right with me and if you were giving advice to someone else on this site, I know what you would say. Treat yourself like your own best friend and give yourself the best advice you can. Then close your eyes and jump in. I'll be right there with you, holding your hand.

Reply
Lene Andersen, Health Guide
8/17/11 7:19pm

sorry - forgot the link to the RA forum post.

Reply
suzzy, Community Member
8/14/11 8:45pm

Hi V i hope your doing better. i would make sure my rheumy knows about your throat.i was giving pills incase i got sores in my mouth since my lips was very red an burning a great deal while i was on mtx. i didnt go to my pcp  my daughter need my help for the weekend but im doing better.i got to ask my rheumy about my knees i was going to set down an my left knee felt like it was coming out of the socket the shorty after that my right knees was hurting while i was trying to set. i hope your weekend got better. take care God Bless

Reply
V, Health Guide
8/14/11 11:33pm

Hi, Suzzy,

 

I see my rheumy Wednesday, and I will let her know about my sore throat and I think I have a sinus infections...and an ear infection.  I have that rushing water sound in my right ear.  The right side of my throat was the worst, too. It was nasty looking...very red w/white ulcers all over it. Yuck! I am ready to feel better, Suzzy.  I am losing patience, I'm afraid.  I think my insurance makes me try MTX for six months. I have only been on it three months, but I am tired of sleeping away my weekends and haivng no energy to do anything but work, and a very little bit of housework. It should be better than this, right?  I just started taking more pain meds...I can't deal w/the way I have been feeling, so I upped the Tramadol. It is helping.  I just hate that "sick all over" feeling I get if I don't take all my meds on time. The fatigue is so difficult to deal with.  Hope you are doing okay, Suzzy.  It think of you often.  Please let me know what your rheumy says. Maybe one day we both will be better...........

 

V

Reply
suzzy, Community Member
8/15/11 4:44pm

hi V i was only on mtx for 2 weeks then my rheumy took me off of it he called the insurance company an said because of the bad side effects i caint take it surely your rheumy well do the same. the only reason they put us on mtx is because its cheap an been around longer. so if you caint take it im sure your rheumy can put you on something else.V i do beleive we are in a no win  with fatigue either the meds or the RA . i do think that it well be the way we are. i took off from work last friday slept almost all day an almost slept my weekend away . getting up this morning was so hard,im home now an want to go to sleep im so tired . this saturday i bearly scratch my arm an it had a red ring around it that has never happened before an it was very sore,its a little better now.i do believe that our roads have changed with taking the meds that they give us, every season well be something we will learn from an i hope other things dont get worse take care God Bless

Reply
suzzy, Community Member
8/15/11 4:47pm

this is what my rheumy gave me if i got sores in my mouth clotrimazole troche 10 mg but i never had to take them

Reply
suzzy, Community Member
8/15/11 6:05pm

v did you ever get my emails ?

Reply
V, Health Guide
8/16/11 4:08pm

Hi, Suzzy,

 

I didn't get your emails...maybe the server stopped them for some reason...??? That's okay...we'll try it at a later time.  I don't have the energy to do much reading right now.  Not feeling so hot.  I have a viral infection and I had a dr's appt today, so I just came home to rest. Doc wants me to start a biologic....Humira or Simponi.  I told her I would like to give the MTX  a little more time, but if not better in three months, I am ready to do the biologic. I may end up calling her before then...she will fit me in whenever.  I have to go back down to 10 mg of prednisone, too.  She said 15 is too hard on my body, so I will be tapering down to that the next few weeks.  I am so, so tired.  TT ya later, Suzzy.

 

V

Reply
suzzy, Community Member
8/16/11 5:09pm

sorry V  i can feel your pain while i was reading i hope you can get things worked out very soon. i understand about tiredCrymy rhuemy is cutting my prednisone to 1 an a half pills a day so when i go back the 26 i well be on 1 pill of prednisone. this is just my thoughts but as soon as you can i would do which ever biologic you choose. dang girl i hope you get to feeling better soon.

Reply
V, Health Guide
8/16/11 6:23pm

Thanks, Suzzy.  I told the rheumy I wanted to wait three more months on MTX but that was just because I wasn't prepared for what she had to say about the biologic. So, I may be making an appointment sooner than that. Yep, docs don't like us on prednisone too long.  She wants me to taper to 10 mg and then to 5.  Is your doc going to let you stay on 5 mg once you get there?  Is the Humira helping now?

Reply
suzzy, Community Member
8/16/11 6:34pm

yes im going to stay on 5 mg prednisone i really caint tell because it takes long time  for it to start working i think lene told me about 3 months so if this is what you going to do you need to do it so it well kick in before winter  im not trying to be bossy or anything . just want you to get feeling better oh and also i had to have blood work done before i could take humira plus the tb test so you are looking about a week  or two before you can start taking it

Reply
Martilla, Community Member
8/16/11 8:11pm

Hi V,

I hope you are feeling better, prayers your way. I went back to my first Rheumy and he said he will change my meds in a month if I don't get better and prescribed Prednisone in a different form to help with the itchiness.

I agree with Suzzi don't wait too long until you try the Biologic since your Dr actually is willing to prescribe it.

Blessings,

Martilla

Reply
V, Health Guide
8/16/11 11:26pm

Hi, Martilla,

 

I think of you often and wonder how you are doing.  Do you have a diagnosis yet?  I mean other than Fibromyalgia?  How are things going at work?

 

V

Reply
Martilla, Community Member
8/16/11 11:44pm

Hi V,

I do have the RA diagnosis, I went back to my first Rheumy and he gave my a course of steroids and wanted me to hang in there with Plaquenil for one more month and if I don't feel better he will change meds. 

Work is not so bad since I spoke my mind during a staff meeting about remarks made about my absences.

I hope you feel better soon and I keep you in my prayers and thoughts too.

Martilla

Reply
V, Health Guide
8/16/11 11:56pm

Martilla, you, Suzzy and I  are on the same road at about the same pace, I think!  Do you think your doc is going to suggest a biologic?  Have you ever tried Methotrexate? Are you still seronegative?  Sorry for all the questions...just want to catch up with you, girl!

 

V

Reply
Answer This

Important:
We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.

By V, Health Guide— Last Modified: 05/19/14, First Published: 08/12/11