I saw my Rheumatologist last Monday,and it was a follow up visit after being started on Methotrexate at 10mg per week in addition to the 60mg of Otezla that I have been on since January,to give him feedback as to how I was feeling on this regime.
Up until that consultation I had been feeling really good,pain was greatly diminished and my fatigue was hardly noticeable,and this is what I told him.He felt that the progress was good and said not to come back for three months,whereas before I was seeing him every six weeks.
However just a couple of days later I crashed, pain returned as did the fatigue and I am still this way.
Is this normal after such a good early response to meds,should I wait it out and see if I improve? or is it possible that they may have stopped working,maybe the methotrexate dosage needs increasing? To be honest I wasn't even realizing that you could still have a flare even when on DMARDS.
That's a really good question. Flare's certainly can & do happen whilst on any meds, no matter how well they've been working. I think I'm a 'good responder', though looking back at the notes I kept when I started treatment there were a lot of ups and downs, a lot of doubts, rather more than I remember. I suppose the acid test is how long the flare lasts and how bad it is. Just over a week can feel like an age ... but of course it isn't really. I think if I was in your position I'd be bracing myself to do the wait & see thing. But if, even when you've taken a deep breath, you still think that you're back exactly where you were before starting meds then why not phone your rheumy and update him on the situation?
PsA is basically a right little swine, to use the technical phrase. It does unexpected things. It's fantastic you've responded well up to now though, that has got to bode well.
The answer appears to be that you give it time. Flares can and do happen. I've actually been having this discussion with my rheumy, and have an appointment later this morning. It will be the same discussion. I'm not sure that the biologic is working. I feel like I'm back to where I was before I started it 2 years ago.
I too have many ups and downs with this disease. I have come to realize I don’t worry about anything, especially new involvement, unless it lasts a week or more or if it is recurring. Sorry that your feeling so bad, amazes me how when we hit a low how much it effects our entire being and messes with our minds. I always find I feel pretty well when I have planned appointments so I often take photos or keep a log of symptoms.Hope you have turn around soon.
That's a really good question. Flare's certainly can & do happen whilst on any meds, no matter how well they've been working. I think I'm a 'good responder', though looking back at the notes I kept when I started treatment there were a lot of ups and downs, a lot of doubts, rather more than I remember. I suppose the acid test is how long the flare lasts and how bad it is. Just over a week can feel like an age ... but of course it isn't really. I think if I was in your position I'd be bracing myself to do the wait & see thing. But if, even when you've taken a deep breath, you still think that you're back exactly where you were before starting meds then why not phone your rheumy and update him on the situation?
PsA is basically a right little swine, to use the technical phrase. It does unexpected things. It's fantastic you've responded well up to now though, that has got to bode well.
Thanks Sybil.I haven't been a member here long,but always smile at your posts,your sense of humour coming through to keep it real.
Thank you for your advice everyone,I will sit it out and hopefully things will turn around.Sybil,your sense of humour is always evident in whatever you have to say,a special thanks for that,for me at least ,it really helps to keep everything in perspective.
It’s just Sod’s law isn’t it? Every single time bar one I’ve been on a relatively good spell when I’ve seen my rheumy - I flare every 3-4 weeks for 3 days but never ever when I have an appointment - such a pain - try to look on the bright side - it’s just a blip - you will feel better xx
I’m New to the site but have been fighting PsA since 08. I’m Currently dealing with the same scenario. I’ve been on Otezla for a year and was feeling better than anything else I’ve tried (Remicaid, Enbrel, Humira, Methotrexate) I hit a wall in January and have been down since. My Rheumatologist said I plateued and added Methotrexate again. I’m still down and recently was diagnosed with Reynauds too. I hope you get through your flare quickly.