I am currently waiting for blood work to come back from the labs (to rule out Lupus and Sjogren's) and definitively diagnose my PsA. After an initial consult with my Rheumatologist yesterday, she wants to start me on Methotrexate and I'm freaking out a little bit.

I seem to be backwards here, because I started with arthritis type pain in my hands and my knees as a teenager and then developed Psoriasis at age 30 (7 years ago). My arthritis pain was mild and really just bothersome until the past two or three years, so that the pain now keeps me from sleeping very well and recently can barely walk up stairs. The pain comes and goes and moves around from joint to joint. And my Psoriasis has always been fairly mild and easily controlled with topical creams such as Elidel and Triamcinolone.

I'm hoping to avoid Methotrexate so I'm working with a dietitian on an anti-inflammation diet to see if I can make any changes before my follow up appointment in April. Is your Rheumatologist as hard to get into as mine?

Anyways, I appreciate any insight and words of wisdom...and will probably be trolling the boards here in desperation as I try to figure this thing out.



Hi, Krissy, and welcome. I hope your blood work is helpful. Are you freaking out about the disease possibilities? PsA in particular? Methotrexate?

A lot of us take methotrexate and a lot of us think that it helps us, so you get lots of information about that if you ask for it.

My first rheumatologist was very hard to get an appointment with - as in months. My current one - a couple of weeks and a really competent medical assistant who gets back to me the same day if I have a question and if I have another question about the answer she'll talk to the rheumatologist and get back to me the same day on that, too. I hope you find a rheumatologist who is a good fit with you.

Yes, I think I'm freaking out about the Methotrexate. I've been reading about side effects but then again my Rheumatologist's reasoning for putting me on it is to slow down the degenerative process. So, right now I feel like I have to choose the lesser of two evils. I'd love to hear about your personal experience with Methotrexate.

Thanks :)

There's a lot of talk about MTX, and you might want to start off by searching the forum. What you'll find is that there is a range of side effects, with some people having nearly none, and others needing to stop it, and everything in between. Personally, it did nothing for me, and after 6 months of being nauseous all of the time, I was switched to leflunomide, another drug in the same class. If you are put on MTX, make certain that you get a scrip for folic acid as well.

Welcome, Krissy! I was scared to death of MTX as well. Dietary changes provided minimal relief for my overly-aggressive PsA, and I ended up unable to take mtx due to liver issues, so moved straight to biologics. I'm not a med-taking kind of person, and the number of meds in my collection now is staggering. Most are just-in-case types of things, but still. The important thing to come to terms with is that PsA causes damage that your body can't repair, so needs to be treated aggressively in order to slow the damage so you can have a better quality of life in years to come.

The biggest thing is to be as healthy as you can be all-around. Pursuing an anti-inflammatory diet may be in your best interest, as well as keeping active (as your body will allow) and finding a good balance between movement and rest.

Howdy, Krissy! Welcome to the group! So sorry that you need us, but glad that you found us :stuck_out_tongue:

The drugs are scary. I think quite a few people, when first diagnosed, are afraid of the medications and look to diet for a solution. Changing diet is a whole lot less frightening than a 5 page drug information sheet that lists everything that could possibly go wrong!

To me the disease is what is really scary. The flares that I have had have been debilitating and have given me more insight than I would like to have into what my life would be like if I didn’t have these drugs available to me. I used to be terrified of methotrexate, and honestly I am still a little afraid of it. But, if my doc wants to add it to the list, I won’t hesitate to try it. I want to feel better and live a semi-normal life.

I do follow a strict antiinflammatory diet for IBS, but I haven’t seen any impact on my PsA symptoms. I know that there are certain things that I can’t have such as too much salt or any alcohol. They do make my psoriasis symptoms much worse. I have also spent quite a bit of time trying to identify food “triggers” for PsA symptoms, but it has been a waste and a bit of a hassle too!

I like eating healthy because it just makes me feel better all around. I’m also more sedentary now due to pain and it helps me keep my weight maintained. PsA puts sufferers at higher risk for other health issues so it’s good to eat well.

I get in to see my rheumatologist pretty easily now. It’s usually a week or two after I call. The office also has only RNs on their clinical staff, and they field questions and get you in faster if needed. April seems like a really long time to wait for an appointment even for a specialist. Unless you are really attached to this one, you might want to check out another office. It is better to do it now while you are early in treatment this way the new doc has you from the beginning.