I got the appointment with a Rheumy at a University of Florida but the earliest available is March 16th. My cousin was on staff there (Shands Hospital - it is a research hospital on the campus of UF) and his mom had RA. He did research, talked to friends still on staff at UF, and he claims he is one of the best in the state and believes in aggressive therapy. Because I am in such early stages of PsA, I am thinking I will stay with my Rheumy who has put in on Methotrexate and wait for the until the appointment. My cousin told me that it is a chronic condition, that we needed a proper diagnosis and treatment plan not a quick one. Thoughts?
Also anyone who has been on Methotrexate - I am having side effects of terrible headaches. The first three doses the headaches were bothersome, but this time it was like the head-holding intense headache that you get when you eat something really cold too fast (brain-freeze). I have some nausea the day that I take the pills and the day after I am extremely tired - but that is nothing big - I have felt like that for years. My tongue gets really sore, but should help with weight loss, about which I have no complaints. I just can't stand the headaches!
People typically take folic acid when they are on MYX. Anywhere from 1-5mg a day. For the headache, drinking plenty of water should help out with that. At a certain point, switching over to injectable can help with some of the side effects.
Definitely do a search on methotrexate here. . . .lots of great tips.
I know it feels like a forever wait to see the rheumy, but at least you have started on treatment.
As Stoney said all the 'waiting' can seem like forever but most treatments need a good three months to work anyway so March will be about right for a call on what mtx is doing. It's possible that even the proposed rheumy will want you on mtx as it's frequently taken in conjunction with other DMARDS, including the biologics.
Water, water and more water is great for alleviating and preventing the headaches. I also used to work the time that I took it and onset of the headache (and nausea for me) so that I slept through the worst. Yep, make sure you're on enough folic acid too. I found injectable much more tolerable than the tablets.
It's a bit trial and error in the early days but if you can stay strong and push through many side effects settle down anyway. I probably should have tried harder with mtx but then I didn't have the support and first hand experiences of the folks here to guide me at that time. Mtx and I may be getting reacquainted in the the new year:(
Your cousin is right in that it's a chronic condition. There is no cure, just the best treatment plan and management possible. But by the very nature of the time it takes for the treatments to work does seem to work in minimum three month cycles even when that treatment plan is aggressive.
I got chronic headaches when I first started methotrexate - almost made me stop taking it! What helped? Folic acid 5mg six days a week, drinking water and basically just time - as I got used to the medication the headaches just stopped! I also changed from tablets to injections although I still had the headaches… Try to stick with it and use tylenol - they hopefully will subside
I was on MTX for over a year, although after my first dose of oral MTX put me down for four days, I switched to injectables. For me, being tired the day after was something I had to learn to live with. I don't know your schedule, but what I did was inject on Friday night so I could spend Saturday doing very little and taking a LOOOONG nap in the afternoon. Needing that down day never left the entire 16 months I was on MTX.
I also took Folic--5 mg (I think) six days a week (I skipped injection day). I never had headaches; I had GI issues the entire time I injected the stuff.
It's been a while since I was diagnosed and started MTX but I think I began to notice some improvement fairly soon after I started injecting. The first thing I noticed was that the horrible fatigue began to leave. Seemed like it was about three months in that I realized how much better I was feeling. A March appointment seems like a good compromise between how the MTX is (or is not) working and a new rheumy appointment.
This disease is chronic--you'll be surprised at the things you learn and the things that are affected by PsA. A good, aggressive rheumy who will find the right treatment plan for you is, in my book, an essential part of the equation. Your story is a reminder that I am SO fortunate to have found Dr. Abbas right off the bat and that while MTX or MTX/Humira weren't the right "fit" for me, Humira every 10 days is.