All posts tagged: methotrexate

No More wonder drugs for my RA

I am at the end of the biologic wonder drug line. I have completed the ACR (American College of Rheumatology) treatment plan. I have also completed the EULAR (European League Against Rheumatism) treatment plan. Both are similar. Whatever is next? My doctor’s treatment approach centers on drugs. Are there any rheumatologists who offer more to their treatment plan than drugs? I am out of drugs. My doctor was angry with me when I brought her the statistics on Actemra. She said I read more than her other patients.  She said that Actemra was safer than Medrol. That is so wrong. My last possibility was Actemra. It turns out that I did have histoplasmosis. My doctor told me I couldn’t have had it, but I did. I had it when I lived in Nebraska. It is a contraindication. Actemra may reactivate the histoplasmosis. There also is a possibility that I had diverticulitis. Another contraindication as bowel perforation is a real possibility for Actemra users. So, my article on Actemra was timely. I am not depressed over this. …

RA treatment in the 1920s

In the early days of the twentieth century very little was known about rheumatoid arthritis.  It might have been called chronic infectious arthritis, proliferative arthritis or atrophic arthritis. Rheumatology was not a specialty. There were no rheumatologists. It was not a good time to have RA. Arthritis treatment at the Mayo Clinic  included bed rest. Patients were admitted to the hospital and put on bed rest for several weeks. They were given a balanced diet. Physical therapy was an important therapy. It improved range of motion, strengthened muscles and prevented deformities. Heat and massage were used  to improve circulation and to remove toxins. Bracing and casting were used to support joints and reduce contractions. Canes were prescribed. Shoe corrections were prescribed. Vaccine therapy, fever therapy and sympathectomy were popular treatments at the Mayo Clinic based on the theories of the time. As medical knowledge grew these therapies fell out of favor. Salicylates were drugs of choice. Remember this was before sulfa, penicillin and cortisone. It a was long time before ibuprofen would be formulated. Any …

EORA or YORA another RA category

Imagine my surprise when I learned about the initials YORA and EORA. YORA is an acronym for Younger Onset Rheumatoid Arthritis as is EORA for Elderly Onset Rheumatoid Arthritis. I came to a new understanding of where I am in the scheme of things. Rheumatoid Arthritis (RA) can strike at any age from babies to the elderly. The elderly’s association with RA can be of long standing disease or it can be a new development. People who develop RA after age 60 are considered EORA. That is me. There are some notable differences with elderly onset RA. Initial symptoms may include large joints. With younger RA  onset small joints of the hands and the feet are usually first signs of joint involvement.  The shoulder joint may be a presenting joint in older onset.  My shoulder was involved initially as was the joints in my hands, wrists, feet, elbows. Initially I was in severe pain. Older adults may have more generalized symptoms. My grip was weak. I lost weight. I couldn’t sleep because of the severity …