All posts tagged: methotrexate

Seven year anniversary and infection

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It was seven years ago this month. I was acutely ill with my first encounter of rheumatoid arthritis. My illness had not been given a name yet. A week before that I had seen the ER doc who started me on prednisone and who was  sending me to the rheumatologist that I would see in about another week. I had very little sleep. A few hours a night at most. I was in excruciating pain. Life was not good. I can look back with a sense of relief. I no longer have the kind of pain that made me think I had broken glass shards in my joints. It took several years after my diagnosis for my RA to settle down. I never went into remission. My inflammation has always simmered. Methotrexate was my base. I finally settled into 25 mg subq once a week. It helped. After a few years my pain was never quite the same as it was originally. My feet became central to my discomfort. Custom orthotics and Dr Comfort shoes …

Infection and off methotrexate

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I stopped taking Actemra. I had only two doses this time. Last week I stopped taking methotrexate. I had been on it since 2013. All this was at  a suggestion from my oncologist who was helping me battle a severe breast infection. The infection started in October 2019. I went to a wound clinic for a month. I had surgery to debride necrotic, radiated breast tissue 13 December. Then the infection returned. Perhaps it had never left. I also developed a severe cellulitis. The cellulitis covered my entire breast or what was left of it. Now the cellulitis is down to a couple of inches. The whole thing was caused by  the radiation treatment that I had for breast cancer in 2013. The radiated tissue became necrotic and infected. It is not uncommon. I wonder what part my RA drugs played in this long standing dilemma. This infection has gone on for three months. I do know that methotrexate should be stopped while a person is on an antibiotic. Methotrexate should not be used at …

Mary Man's RA Journal Icon

Disabling RA

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One of the big pleasures I have is watching the full moon make its way up and over the mountain. I see it from my patio doors as I am making dinner. Lately, it not only is a big, full moon but also a beautiful, warm yellow. When I first see it, the moon  is just peering over the top edge of the mountain. Then it seems to sit on the edge of the mountain top just before continuing  its journey up into the night sky. A moment in time. I was thinking of good things to distract from the pain I have in my joints and the nagging fear in the back of my mind that I am becoming more disabled with each passing day. My RA was diagnosed seven years ago in January. Since then, I have had three cancers and a hip replacement. Most of that time I have been on methotrexate, mostly injectable. It has slowed the progress of the RA. It could be worse. I’ve been on almost all the …

More About RA Drug Orencia

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Orencia Abatacept Abatacept, trade name Orencia, is a biologic medication for rheumatoid arthritis. Ads for it have been on tv.  It reduces the inflammation that causes some of the symptoms of RA. It is also used for adult psoriatic arthritis and juvenile idiopathic arthritis. Response to expect                                                                                                                According to clinical trials of Orencia use, up to 75% of patients had a 20% improvement at six months. About 50% had up to a 50% improvement. About 13% had a 75% improvement. In these studies, methotrexate was also being given. Pill, shot or IV?                                                          …

the joy of roses

Cancer Number Three and RA

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  It is almost a month since I had a robotic radical hysterectomy and it has been four days since I had my first chemo. I feel pretty good all things considered. Additionally, a minor surgical procedure placed a power injectable SMART PORT under my skin connected to a catheter that was threaded into my jugular vein and down to my superior vena cava creating fast access to my body’s circulation.  It is not as bad as it sounds. Sloan Kettering has a PDF that explains the procedure. My skin has been tender, but the lidocaine ointment works and relieves the discomfort. My RA is complaining with all joints hurting morning and again evening time. Walking hurts my feet even though I have custom shoes and custom triple layer inserts.  I am glad I take methotrexate injections, Plaquenil and meloxicam. I take 6 mg Medrol and can boost the dose into a dose pack if needed. So far, I am holding steady. With RA I think it is important to move. Aerobics are nice but …

My RA and CA and me

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If it weren’t for the third cancer hanging over my head, I would be a very happy soul. As it is I am just a happy soul. My roses are blooming. This is their big month and they are not disappointing.  Gardening and puttering through the various chores of my household reminds me of my housewife days. Good days. I aspire to the Hobbit life. Mellow and satisfying. Life in my home. I attend warm water pool classes at the Presbyterian Healthcare facility on Eubank. It is a long drive, but the classes are worth it. A comprehensive and aerobic workout that is manageable in the pool but not on land. Yesterday, I suddenly had a severe pain in my pelvic area that ran down the inside of my leg. Something new. Scared me. I thought about getting out but decided to lower my exercise level and see if it would pass. It did. I am no stranger to pain, back pain, joint pain and now this. Johnny Cash’s Peace in the Valley is sounding …

I thought I was going bald, it was just the MTX

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About six weeks ago, I started noticing my hair thinning. I thought it was odd because my dad had thick hair in his older years. I expected my hair would do the same. My hairdresser also noticed the thinning. It was real. Next, I started noticing bunches of hair on my comb. “My hair is falling out,” I thought. Right again. I quickly realized that it was the methotrexate (MTX). Hair loss only occurs in 1-3% of those on MTX. I have been on it for five years and the last three years I have been giving myself 25mg injections. It works for me. I am also on hydroxychloroquine (Plaquenil). Plaquenil can also cause hair loss. I started taking MTX every eight days instead of every seven. Every nine days starts an RA flare. I stick with the eight days. I also cut the Plaquenil to 200 mg daily from 400 mg daily. My hair is no longer falling out. However, my hair hasn’t grown since my last haircut. Unfortunately, it was the second worst …

Back from my hip replacement

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My hip replacement didn’t turn out to be as smooth as I would have expected but my hip joint is fine and all the severe pain I had before the surgery is gone. It is a relief and makes the experience I had well worth the effort. The surgeon said my hip was warn out so I’m very glad he decided to do the surgery. During Thanksgiving week I overdid walking with the cane and sitting too long. So yesterday during my physical  therapy appointment, my therapist and I decided I needed to stay with the walker when I went out and use the cane for practice only at home. My pain had increased and I wasn’t doing as well. Back to the drawing board. Time to let the inflammation in the hip heal and to follow the rules.  And to rest more. I enjoy doing my assigned exercises. Resting more is hard. I have had two RA flares since surgery. One was in the Rehab center as they had skipped my methotrexate dose. Why? …

Living with RA

On becoming the bionic woman

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I wonder how many of us are walking around with replacement parts. Joint replacement has become common and it is successful surgery. I have several friends who have both knees replaced or both hips replaced and they are fine with it. And now, I am about ready to embark on my first joint replacement. My left hip will be first on the chopping block. This is a bad visualization. I am trying hard not to think about what the surgeon will be doing. It is scary and gruesome. A Frankenstein thing. Instead, I am focusing on the bionic woman thought. I will be in much better condition once I complete the rehab process. I will have a fabulous new joint. Won’t I be lucky? I will. I have spent the summer in extreme pain. My doc had a tough time identifying my hip issue. After all, my hip had good range of motion without pain. An MRI revealed my hip deteriorating badly plus a bad labral tear with pieces loose in the joint. My pain …

RA treatment in the 1920s

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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 …