Well the title says it all - yesterday I spent nearly all day asleep. I got up and went out for lunch, hoping I'd keep going but felt exhausted after. Then slept until the early evening, when I was able to summon strength of meet some friends I'd not seen for ages. I'm pleased to say I do feel much better today. The swelling and pain has returned to my right hand and I now have it in my lower back persistently, which is new for me. I'm currently sleeping on a friend's sofa bed - she's very kindly putting me up - but that coupled with a lack of bath I think might sometimes make things worse.
I'm convinced, in my case, that the tiredness owes more to the methotrexate. I have felt very tired before but was able to combat it with a routine of swimming each day. This week I've felt far too tired to contemplate it. I had asked my rheumatologist whether I could come off it - we're meeting on 10th May when I hope they'll put me on biologics. Even if they don't I will insist on coming off the methotrexate as it's made no difference except to make me even more tired the day of and days after the dose. I could always come off it anyway, I suppose.
If they don't put me on the biologics I wonder if my only option is to cease treatment. I've tried the sulfasalazine and minocycline and now methotrexate. While an ultrasound has shown some erosions in my right foot, and that does concern me, none of these treatments have been effective so none of them will have stopped that elsewhere. At least off them I didn't feel as tired and I could keep some control over the condition by swimming each day. Other than the risk of further erosions what else might I be risking stopping all treatment? It's not as if it's worked!
I understand you frustration I was on mtx for 3 months and I must say that the pain and swelling got worse and worse each day I kept telling my DR and was told that I needed to allow the mtx to build up in my system and after the 3 months He had me come into his office gave me a cortizone shot and the next day humira and ever since then I have felt so much better almost immediatly it was amazing! I am still on mtx and humira and ive asked when i can start lowering my dose of mtx and my DR said not untill all the pain and swelling and stiffness is gone which i hope is soon, Mtx takes a while sometimes to build up but it does help!
The fatigue isnt just the mtx it is also the PsA....it is my biggest complaint each DR appt I was told to try b complex vitamin and it has helped some but not anything major I am still exhuasted all day even after waking up from sleeping for over 12 hours and doing almost nothing the day before i know fatigue is something that many people with PsA complain of some say diet helps alot too
Try to stick with you current course! i would encourage your dr to give you the biologics and i pray that will help you the way it has helped me!
Hi Michael,
I can so relate to your post. Outside of sleeping on a friend's couch, I could have written your message myself. Lately, the fatigue has been my biggest complaint. I've slept as long as 17 hours straight and still not felt rested. I also tend to implicate the MTX in my fatigue, and I wonder if it's worth risking all the MTX side FX when I keep a constant headache and still feel like crap. (I failed on sulfasalazine, and Plaquenil seems to have run it's course for me.) I know my rheumy will respect whatever decision I want to make about this drug, but it's so hard to know what that decision should be. Like you, I still experience swelling and pain in addition to this horrible fatigue. I'm taking B12 injections and, of course, using folic acid to help with side effects.
The current wisdom seems to be that early aggressive treatment may reduce the likelihood of complications, such as further joint damage and resulting disability-- which makes the decision to discontinue treatment even harder. Biologics also have their side effects and the expense might end up being prohibitive for me. Still, if I'm going to risk side effects, I'd like to also be getting some benefits! I wish I had answers for both of us. I hope you will keep us posted on what you find out when you talk to your rheumy. Hope you get some relief soon!
I too could wrote the post,i am on 3rd week of mtx…i was tired before
but now sick and tired. Md said needs more time…my question how much time
Byrd Feeder said:
Hi Michael,
I can so relate to your post. Outside of sleeping on a friend’s couch, I could have written your message myself. Lately, the fatigue has been my biggest complaint. I’ve slept as long as 17 hours straight and still not felt rested. I also tend to implicate the MTX in my fatigue, and I wonder if it’s worth risking all the MTX side FX when I keep a constant headache and still feel like crap. (I failed on sulfasalazine, and Plaquenil seems to have run it’s course for me.) I know my rheumy will respect whatever decision I want to make about this drug, but it’s so hard to know what that decision should be. Like you, I still experience swelling and pain in addition to this horrible fatigue. I’m taking B12 injections and, of course, using folic acid to help with side effects.
The current wisdom seems to be that early aggressive treatment may reduce the likelihood of complications, such as further joint damage and resulting disability-- which makes the decision to discontinue treatment even harder. Biologics also have their side effects and the expense might end up being prohibitive for me. Still, if I’m going to risk side effects, I’d like to also be getting some benefits! I wish I had answers for both of us. I hope you will keep us posted on what you find out when you talk to your rheumy. Hope you get some relief soon!