Looks Like Biologics are the Endgame

General
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And I’m fine with that.

Had my rheum appointment on Friday. Slight bit of trepidation as I walk into the room with yet another different fellow this time, and I swear the guy looks 12 with a bit of beard hair. Super nice though, and assuages my fears with the fact that he’s actually read my case history and I don’t have to start from scratch. So, hooray for that.

Go through the symptoms - every joint on my right side aches pretty much all the time. Of course, I could walk today, because it was my appointment day and so my hip decided today was the day to feel fine, but usually I can’t without the aid of a cane, knee is starting to go, foot starting to go, shoulder, elbow, hand, all of them ache a lot, cycling through the severity. Severe fatigue, severe brain fog. Again, none of that right now, both a blessing and a curse, but there you are.

Severe back pain too, that’s a particularly fun one when you need to sit in an office chair all day, I explain.

Weird chest feeling I had before? Suggested I get with my primary and get a stress echo. Had one before with nothing found, but I’m going to do it again. Not looking forward to being on a treadmill.

I hadn’t mentioned this before cause it’s not something you admit, but I was still smoking - until Saturday morning. I’m vaping now (which is way more confusing than it should be). Should have quit years ago, but, well.

However, best part of the visit? Fellow Doc and Actual Doc get together, print me out some biologic information, say we’re increasing your mtx and prednisone right now, but if there’s still no improvement, read up on these medications.

I flat out tell them without looking at the sheet that I’ve gotten to know these guys pretty well, and that if that’s the endgame, I’m more than happy to take them.

Could be 4 months from now when I’m to set my next appointment, but still, if the MTX increase doesn’t work, I may be able to get on the ol’ injectibles. And oddly, the idea of stabbing myself every 2 to 4 weeks makes me a lot happier than it really should.

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Can’t you do the stress test on a bike? Not sure if that’s more comfortable for you… but it seems like it would…

I like the eager fellows who read everything before the meetings instead of always the same old man who feels like he knows you and everything about the disease so stops looking at you…

If your taking Prednisone with the MTX how are they going to see if the MTX does anything in 4 months? You can’t stay on the Prednisone forever…

Congrats on quitting smoking! How is it going with the vaping?

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Not sure on the stress test yet, it’ll depend on where I go, I guess? Will find out.

Agree on that. My main rheum is an older guy, I think wizened is the word, but the fellows he’s training up have all been super good so far. Makes me less worried when I see a new guy.

Regarding the pred and mtx, I honestly think they’re just ticking the boxes to get to the biologics. The extra mtx and pred will give me some relief, judging by the past, but it’ll go downhill again. I’ve been on the steroids for a few months now, and while I’d prefer not to keep taking them, I’ll do what I can to get to the point where I’m not in agony.

Going well with the vaping. Not missing cigs, which is interesting. Perhaps because I can smoke inside my house now with my wife not minding? That’s probably a big part of it.

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Let’s hope it will give you good relieve then! I was just thinking if it works perfectly you might have to wait even longer to see if it works without the Prednisone as well…

Well you still have something to do with your hands and mouth… and I’m guessing there’s nicotine in there? So both sides of the addiction are happy

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I would like to think that there is no endgame. Two decades ago, there were no biologics, and so people thought that MtX was the endgame then, but look what happened. Medicine is becoming more advanced all the time, and there’s nothing to say that in a couple of years there won’t be something even better.

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That’s a good point, darinfan. Still, it’s the current endgame, and I’m pretty happy with it right now. Maybe we’ll go into overtime afterwards, but I’ve always sucked at penalty kicks.

@Cynthia yup, contains nicotine, but, theoretically, nothing else that’s bad. Reports are coming in of them not being healthy, exactly, but they are better than regular smokes, and I figure a good way to start weaning off them.

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Great news dilorenzo - humira has really improved my life no end although I wasn’t really very keen to go on a biologic and my first attempt with enbrel wasn’t great. I try to give up smoking every week - hoping to last a whole week at least fairly soon …

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Yeah I know it might be bad for people who don’t smoke… but its definitely better then smoking…