I've just received an email from a GP at the practice I go to saying that my neutrophils are low - 1.8. I realise that this is not especially low but it's not something that has happened before. Also I've never received an email from a doctor in my life, very good of her I guess. I reckon she was in a hurry at the end of her working day because she says that if I'm due to take Mtx I should reduce the dose to whatever it used to be, but I take 10mg and only have 10mg tablets. And I don't think she has twigged that I'm on Humira either.
Anyway, of course it's a bank holiday tomorrow and on Monday too, typical! She tells me to phone the rheumy nurse on Tuesday and that will be before my next Mtx day so no worries on that front. But next Monday is Humira day. So should I hold fire on Humira just a day or two?
(P.S. might this be why I've got a permanent sore throat?)
Sybil,my Neutrophils are 1.9,and this is something I intend to ask my Rheumy at my next visit.I have only been on Methotrexate for 5 weeks,at a 10mg dose,and Otezla for about 11 weeks.Interestingly my neutrophils were low before I even started any medication,and I have been having fortnightly blood tests since starting the MTX,but will only get results from these when I see my Rheumy in a couple of weeks.
Can't offer any advice but I will be interested in what your Rheumy has to say.
Ugh, Sybil, so I'm wondering then what your white blood cell count is--is it still normal? I ask, because my doctor was concerned when my WBCs went low, but then he said he wasn't concerned because my neutrophils were fine. I guess there are several components of the WBCs, neutrophils being part of that--that's how I understand it. I'm so not educated about this stuff, though.
If it was me, I'd hold off on injecting the Humira for a few days at least. Especially since you've had a sore throat for awhile. Your doctor most likely wants to see if your neutrophil number goes up. Had you told her about the sore throat?
Every time I get a cold (runny nose, cough, etc.) I cut back on my Enbrel by delaying it a few days. When I had strep throat, I stopped injecting for 3 weeks.
I hope your neutrophils get their act together real soon and start increasing their numbers, however they do that!!!!
This has happened to me a couple of times. Soon rectified by cutting back on my DMARD meds for a week each time. I never stopped the humira. I was told it doesn't become a real problem unless they drop close to 1. Either skip the Mtx for a week or cut the tablet in half. It should do the trick.
Thank you very much for your replies ouch, Grandma J and Ali. ouch, I will let you know what my rheumy or rheumy nurse have to say on Tuesday. I will have to be pretty nifty with the speed dial as the hotline is open for such a short time and I can imagine they will be inundated with calls after the Easter weekend, but at least I'll be able to get back to the GP as well then.
Grandma J, I haven't gone to the doctor about my sore throat on the basis that I always have something niggling these days but the biggie - straight PsA - is good as gold right now. I've started to wonder whether a few years of PsA and meds makes people, well me, a bit more sensitive to pretty much everything as it's my house that gives me a sore throat / neck. I'm thinking coal fires, central heating .... I dunno but it all clears up the minute I step out into the fresh air.
Ali, yes I was waiting for someone sensible to instruct me to do the blooming obvious and cut the tablet in half. I have visions of it shattering and flying off all over the kitchen. I will find someone competent to do it if that is what the rheumy nurse wants me to do. I live in mortal fear of taking less or .... heaven forbid ... nomethotrexate as last year I turned into a psoriasis laden, balding misery after stopping it and it all cleared up wonderfully once I re-started. My rheumy is as keen for me to stay on it as I am. Ironically I do not seem to need it for PsA. Given what you say I think I will take Humira on Monday. 'Cos the numbers are not that low ....and I'm getting the message that Mtx is more likely to be the culprit.
Also ouch, I did a bit of googling, not much. It looked like some people just do have slightly low neutrophils and also that autoimmune diseases can make them low, as well as Mtx and possibly Humira too. Though I want to know more about all this now so will keep an open mind at this stage. It would be great if your treatment actually made them rise. Will you let us know how it goes?
Yes, Ali! Sybil, my pharmacy gives pill cutters for free if I just ask. They are a very inexpensive tool that are worth their weigh on gold for little pills! I am sure they cost less than the refill for 5 mg MTX.
Rachael, I am now 60. What a joy that is. I now get free prescriptions as well as fighting off the distinct feeling that it's game over. So a pill cutter may be a little more expensive than 5mg of Mtx which will cost approximately nothing but they do sound like a very good idea. I'll check with the pharmacy, thanks for that!
Rachael said:
Yes, Ali! Sybil, my pharmacy gives pill cutters for free if I just ask. They are a very inexpensive tool that are worth their weigh on gold for little pills! I am sure they cost less than the refill for 5 mg MTX.
Well, now I feel bad. Your medical for your age there is amazing compared to what we have here. My father is 70 and not even one of his meds are free, ever! So, if Donald Trump becomes president can I move in with you? O was going to ask Seenie but since the new movement to move to Canada is growing…
Rachel, it's our amazing National Health Service. In theory we don't have to pay directly for healthcare and just a standard fee for prescriptions unless we're receiving benefits or over 60 whereupon they're free. I can see it falling apart though not everyone agrees with me. What I fear most is a complex non-system - some monstrous mish-mash of pay through the nose, charitable options, first come, first served & luck.
Anyway, I'll check out the spare duvets, you'd be welcome!
Eventually got through to rheumy nurse. No Mtx for me this week &, no surprise, best not to go to see my friend who has projectile vomiting. Have to take husband to hospital for a routine operation, I might play super-safe & not cross the threshold. Those neutrophils better get themselves sorted out quick!