Saturday, February 02, 2013
Entering a new phase of treatment....
Saw
the rheumatologist on Monday. The MRI and x-rays taken of my feet last
month show synovitis and bursitis, but not the degree of erosion that
typically accompanies rheumatoid arthritis. So this is probably
arthritis from Sjogren's, which is less aggressive but still needs to be
treated as plaquenil has been unable to keep it in check.
I decided to
do the methotrexate as it is an old medication and the risks and
benefits are well-documented (plus it's cheap). Due to my needle phobia,
I am going to try the pills first. If my stomach can't handle the
pills, I will somehow try to get over my phobia and do the
self-injections.
We discussed prednisone, but because it could cause
even more weight gain than I already have and worsen my diabetes if
taken long-term, I will save it for acute episodes only in short courses
as I have had success with that. I am hoping that if I can rein in my
Sjogren's symptoms that I will be better able to tolerate the
fibromyalgia.
So I started a low dose of methotrexate on Tuesday, 10 milligrams. I do that once a week for two weeks and then bump it up to 15 milligrams per week until my next appointment with the doctor in March. If all goes well I will go up to at least 20 milligrams. It can take months for the medication to take full effect, but by going slow I will be less likely to overdo it.
Because of the potential for serious side effects like liver damage, I have to get frequent blood work. I will be doing labs every two weeks for a month and then if all is well I can drop down to every eight weeks. I have no history so far of any type of kidney or liver problem, even with the various medications I've been on and having multiple ailments that can affect internal organs, but better safe than sorry.
As far as initial side effects go, I've had a bit of transient stomach pain, a bit of vertigo and accompanying nausea on the second day, and some brief bonus fatigue, but nothing significant. I detect an ever so slight improvement in the joints and cognitive function, probably not noticeable to anyone else but me. But even the most infinitesimal change for the better is motivation enough for me to forge ahead.
// posted by klbrowser @ 2:05 AM
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