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. 

V

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

I'll be thinking of you.

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

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.

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

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?

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

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

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

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!

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

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.

sorry - forgot the link to the RA forum post.