All posts tagged: methotrexate

EORA or YORA another RA category

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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 …

Four years of RA

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  I was diagnosed with RA four years ago, this month. The first few years were whirlwinds as I was also diagnosed with two cancers that each involved surgery and radiation treatments.  My RA moved to the back seat then to the front and again back and forth. Now it is center stage.   In 2015, I was started on infusions of Orencia. Once I realized that the biologics only help your RA by about 50%, I settled in and appreciated that they helped that much. In July the next year, I developed a horrific flu. I haven’t had a flu for years. It was exhausting. Plus, the Orencia was not working any more. I started having bad flares. My rheumatologist stopped the Orencia. After a few weeks, I was started on infusions of Remicade, a TNF inhibitor. By the third loading dose, I was having a severe flare plus I was having a bad reaction to the Remicade. I was ill. It took two months for the Remicade to clear my system and for …

Remicade

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My treatment for rheumatoid arthritis, RA, is moving in the opposite direction of normal. Because I was diagnosed with two cancers and rheumatoid arthritis in the same year, the wonder drug biologics were off limits for me. They presented a higher cancer risk. Eventually as my RA worsened, quality of life became a factor. Methotrexate(MTX) injections help, but not enough. I had tried the triple treatment of MTX, Plaquenil and sulfasalazine without success. Leflunomide was next, but it didn’t work either. The small molecule DMARDs were exhausted as treatments.  The biologics were next. Rituxan was considered the safest both by my rheumatologist and by my oncologist. I was infused with Rituxan. It didn’t work. Next safest was Orencia. I was infused with Orencia. It helped. It helped about 50% which was the norm for it. I received monthly infusions. But my flares became much worse at 10-11 months. Orencia was stopped. Next is Remicade. Remicade, infliximab, was approved for RA in 1999. It is a TNF inhibitor. My rheumatologist had a serious discussion with me …

RA nodules

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Rheumatoid nodules are commonly talked about when rheumatoid arthritis (RA) is discussed. It might surprise you to know that only 7% of those newly diagnosed with RA have rheumatoid nodules. So they are not characteristic symptoms of newly diagnosed RA. Overtime, about 25% of those with positive Rheumatoid Factor (RF) develop nodules. Nodules are frequently present in the more severe cases of RA, those more likely to have rapid progression of joint destruction and to develop vasculitis.  75% of those with Felty’s syndrome, more common in white males, have rheumatoid nodules. Current smokers with RA plus nodules usually have more severe disease. In those with seronegative rheumatoid arthritis, about 6% develop rheumatoid nodules. The condition of having rheumatoid nodules is called rheumatoid nodulosis. The nodules form below the skin near joints. They are firm and frequently moveable. They are not tender and are not usually harmful. They are 2 mm (.008 inch) to 5 cm (2 inch) and may occur singly or in clusters. They are formed in three, under the microscope, stages: acute inflammation …

Rituxan- the final frontier

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Rituxan, the final frontier February marked the second anniversary of my Rheumatoid Arthritis diagnosis. After two years of treatment, my average pain level was reduced from 10+ to an average range of 4 to 7 every single day.  The constant presence of pain and a body riddled with inflammation continue to suck every drop of energy from my aging, aching body. My treatment was complicated by the addition of thyroid cancer and soon after that with the addition of  breast cancer. Both required surgery. Both required radiation treatment. Both required medication.  Both interfered with my RA treatment. The TNF antagonists, like Embril, are contraindicated for those who have recently had cancer. I am not allowed to have them. The ongoing treatment for thyroid cancer is to keep my body slightly hypothyroid. It helps prevent the cancer from recurring but it also increases the effects of RA fatigue. The ongoing treatment for breast cancer is anastrosole. It eliminates all estrogen in the body. It also puts me at high risk for osteoporosis as does Rheumatoid Arthritis. My treatment originally started with …

Finally, a life

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I really thought I was going to die last year.  To prepare, I filled out the final wishes form.  Next, I made an attempt to simplify my financial records. I said thank you to all the people who have been helping me the last few years. I had a garage sale. What the heck, I thought, I would be the one to get the money if I had one before I died. Just as I thought things were going to get worse, they were already terrible, I started coming out of the methotrexate fog.  I could think clearly again.  O happy days.  At least I had my mind.  Both cancers could return.  My RA could leave me immobilized.  Yet, I would be able to read.  My favorite thing to do.  Preston and Child’s Pendergast series. Baldacci’s adventures. All the fascinating medical books. I could be happy. The methotrexate injections, Plaquenil, leflunomide and the prednisone finally calmed the ever-present inflammation in my body.  This was after 2 years.  And it may not last long, but it is …

Methotrexate Injection

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Why injection?                                                                                                                                            To avoid side effects or to have more of the medication absorbed by the body. There is 25 mg/ml of medication The syringe is either tuberculin or insulin Both have a one ml capacity Both have very thin needles Have all your supplies ready Vial of methotrexate, syringe, alcohol swab. Also access to your upper belly or outer thigh. It’s easy as this Wipe off top of vial with alcohol Remove covers on syringe Draw back on the syringe to add about .5 ml of air Insert needle of syringe into vial Push in the air(avoids med leaks) withdraw the correct dose of your medication( …