Tuesday, September 17, 2013

RA update: travel success + methotrexate = proceed with caution

Some good news and bad news. At my rheumatologist visit last Friday I was able to tell her that there's a definite difference in pain relief when I take both methotrexate and Enbrel. I went on Enbrel alone for two weeks (dosing on Fri), was sick about half the weekend, and my relief lasted from about mid-day on Monday-Thursday. By Thursday evening, it's like a wind-up doll that's kaput and someone took out the key. I am toast, and in searing pain.

On the MTX plus Enbrel, my relief is from Monday AM to Friday afternoon. That's not bad. I'm dosing only 4 pills rather than 6. I was having way too many adverse side effects from the MTX -- GI problems, depressed mood, severe fatigue, aches and pains. On the lower dose I have little mood effect, and less-severe overall symptoms. [The only problem that has cropped up, and it's a weird documented side effect, are nose sores/nose bleeds. Oy, it's annoying and painful at times. Will have to mention that at my next visit.]

So that's the overall good news. The bad news is my last labs showed a spike in some of my liver numbers. MTX affects the liver and there's enough concern that they asked me to come back in 2 weeks for another blood check. I already come once a month for blood work, so my guess is that staying on MTX is in jeopardy if my numbers don't look good.

Some other good news is that I was able to successfully travel for work last week. Successful as in I didn't need wheelchair assistance, I managed stairs, and was able to work well at the conference during the day. Thankfully one of my colleagues (thanks, Lee!) who was attending the conference volunteered to help carry my bags at times, and drove the rental car so that I didn't have to endure long walks or drives.

At night I was toast by about 7:30, and went back to the hotel to crash, re-medicate, apply all my liniments to my sore joints and get in the sack so I could be productive the second day.

I actually had to go into the office the day after the trip; it was questionable whether I was in good enough shape to get my sorry ass into the office, but I did for an important meeting. However, I was out Friday, and then most of the weekend I was in misery, recovering from the travel's impact on my RA and fibromyalgia.

I know for a fact that if I hadn't done the Enbrel/MTX combo, I would have been much worse off post-travel. So, I hope that, despite the pretty nasty MTX side effects, I won't have to discontinue it since it has done some good in getting my constant pain at a liveable, if not enjoyable, level.

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