Methotrexate Update

Tonight I’ll take my fourth dose of mtx.  My first two DMARDs both took a couple months before I noticed any difference.  I assumed this one would take a while, too.  I’ve heard people say it can take 3-6 months to kick in, but I’m feeling better already.  Placebo effect, or does it work this fast?

I have NO all-over morning stiffness now.  None!   Instead of easing myself out of bed and hobbling down the stairs, I hop out of bed like I did twenty years ago.  I can walk down the stairs like a normal person.

The swelling in my hands has gone down.  My rings fit!  When I could no longer wear my wedding ring (size 5) and it appeared this was going to last a while, we bought a plain gold band (size 8).  Last spring when I started getting worse, even the large ring was too small.  Now, after three weeks on the mtx, I can wear my size 5 ring.  Can this be real?

My achilles tendons don’t hurt.  My wrists don’t hurt.  My knees don’t hurt.  My hips don’t hurt.

There is one weird thing though.  Although overall I feel better, my elbows hurt worse.  What’s up with that?

The horrible nausea I experienced with the first dose is no longer an issue.  Whew!  I haven’t lost any more weight, and although I wouldn’t mind losing a few more pounds, that was a hard way to do it.  The first week was awful, the second week was medium, and by the third week I had very little nausea.

The down side:  My thinking was pretty scrambled the morning after my last dose.  Most likely it was scrambled with the first two doses, too, but at the time I was too sick to notice that I wasn’t thinking straight.  I feel enough better that I’m more than willing to arrange my commitments so that I don’t have to do much thinking on Wednesday mornings.

One small snag:  My rheumy wrote the prescription for four weeks and no refills until she sees me again.  I understand the need, but my follow-up appointment wasn’t scheduled in four weeks, it was scheduled for one month. That’s not quite the same, and although the difference is subtle, it means I’m short.  Last appointment was 9/21; next appointment is 10/23.  Doses taken 9/22, 9/29, 10/6 and 10/13 mean that I don’t have a dose for 10/20.  I hate to bother the doctor between appointments, but I don’t think she intended for me to miss a week.

Overall, I’m relieved that the side-effects were short-lived.  I was pretty apprehensive about starting yet another med – this one in particular – but now I’m feeling pretty positive about the methotrexate.

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7 thoughts on “Methotrexate Update

  1. I’m sure your doctor won’t see it as a bother. Obviously it was a mistake because of not quite thinking it through. My doctor prescribed 28 pills for me once to last a month. (It is a weird combination where I take 5 pills a week of one strength and 2 a week of another so it wasn’t a standard 30 day supply kind of thing) When I realized, I called him. He laughed, said it was because the month he wrote it (February) had 28 days and he wasn’t really thinking.

    I’m glad you are feeling better with the side effects. And how awesome that you feel so good in the morning. I can’t even imagine being that way again. It must feel so unbelievable and wonderful!

  2. So glad the side effects are better. And it’s fantastic the pain and swelling is gone. Definitely call the doc — that shouldn’t be an issue. Good luck — hope everything continues to improve!!

  3. Great to hear the mtx is working for you!

    Strangely, my elbows didn’t get bad until long after I’d been on medications that seemed to help everywhere else. My left elbow still bothers me more than most other joints.

  4. You may wind up needing to add something else to the methotrexate, but it is GREAT that you are having a response, and such a quick one at that! I wonder if you might be developing nodules in your elbows? Some folks who are ‘methotrexate responders’ can still develop ‘methotrexate nodulosis’. I’ve had this but not very bad – not bad enough to make me stop the methotrexate, and it may not all be related to the methotrexate. MTX seems to keep swelling under control for me for the most part, but it’s not a cure-all necessarily and I still have pain issues while on it, but I wouldn’t want to go back to not being on it.

  5. Bother your doctor. Make sure you have the meds you need, at the proper dosing, until you see her again. That said, it’s wonderful that methotrexate seems to be working so extremely well for you. It didn’t do that for me. I was sick the entire three months I took it — foggy headed, nauseated, horribly fatigued, miserable, really. I was close to begging my rheumy to take me off it. When he did, he put me on Arava, along with the sulfasalazine I was also already taking. I haven’t noticed any difference in number of flares or pain levels on Arava, but he tells me the inflammation is down in my body. And once the MTX finally worked its way out of my system, all those nasty side effects stopped. Whew!

    Wishing the best of luck to you regarding the MTX. May it continue to be your miracle drug.

  6. Okay :-) I phoned the doctor’s office. Thank you, all.

    The nurse said to have the pharmacy send a fax and she’d authorize one refill as long as I promise not to cancel my appointment next week. ???? I reiterated that I’m partial to walking and have no intention of cancelling any of my appointments with them.

    No extra bumps on my elbows. It feels as though I’m being stabbed – like maybe I set a push-pin on my desk and leaned on it. In the past it only felt that way when I tried to rest on my elbows (so I no longer do that). Now it always feels that way. Seems minor compared to everything else. In a weird coincidence, Dr. Rob’s newest post is about elbows. Quite amusing.

  7. Pingback: Methotrexate for RA « ∞ itis

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