So I spoke to the doc's office about the continuing pain and discomfort I've been having despite starting Naproxen 3 weeks ago. I told them Naproxen has helped but seemingly not enough that I can't even use my hands for simple tasks such as opening a door, brushing my teeth, or even washing and drying my hands which was very painful over the last week.
They have taken me off Naproxen completely. The doc has put me on Predisone for 2 weeks and after that I am to take Advil.
I don't understand going back to Advil which doesn't typically help either. I can only presume that the Prednisone will help the inflammation enough to relieve my pain but I don't get going back to Advil.
Just wondering, does this sound odd to anyone else ?
I'm beginning to wonder if this Rheumy has ever treated anyone with PsA before.
I seem to have a week or so of extreme pain then a day where it seems to die down, then it will continue again for up to a week. Has anyone else had this experience ?
That does sound strange to me. Did you share your concern with him? Perhaps, try to call and ask for a different approach to help alleviate the pain and progression proactively vs. reactive.
It seems that some Rhumey's want to take the Naproxin, Motrin, Aleve, etc mode first. What seems to be the most important is for you to continue to return to your doctor frequently. My first Rheumy was so awesome, she even called me at home with concerns that I was not getting better. Not too many MD's will do that. I do think that the Medicine's that are out now are getting better and better. It's just you need a doctor that is up on the new research meds and try to suggest the next step. Most start with MTX then go to Biologics if no response. It usually is all demanded by your insurance as to how fast you go to the Biologics, MTX, etc. It's a shame that insurance makes us suffer for so long before our pain is controlled!
Nothing unusual at all except the doc didn't explain it to you. The interaction between naproxen and predi is considered "moderate" which is pretty darn high. The estimated relative risk (RR) for peptic ulcer disease and GI hemorrhage of 14.6 is compared to those who used neither. Oral corticosteroid alone use was associated with a doubling of the risk (estimated RR = 2.0) You'll need something after you come off the predi (it takes a month or two to recover) Advil is the least likely to cause a gut problem. Considering the meds we take, our risk for GI problems is pretty darn high to begin with. Considering we are on this stuff for years I'm pretty impressed your doc has a long term view. After a course of steroids like you are on, the Advil should work.
I didn't see the doc, I called the office to ask what to do. Logically, maybe he should of had me come in.
I think if I'm having trouble he should maybe try me on something new but schedule me back to see how things are going.
just putting me on something new and expecting it will work until my next appointment in 6 months doesn't seem logical.
I realize the problems with naproxen but not replacing it with something else doesn't make sense. Advil isn't exactly good for me either. Esp if I need 6 a day for it to help. The doc knows that.
I presume once I'm finished the prednisone, things should calm down. I hope that is the case. At this point I'm calling the doc's office every 3 or 4 weeks.
thanks for your thoughts everyone. It really helps me to get your input. Anyway, I'm still wondering about his experience with PsA. We'll see how it goes.
Dini have you tried Celebrex? I see my rheumy every 3 months so six months is a long wait! You could always try calling your rheumy and have her call you back to discuss the current situation.
Dini said:
I didn’t see the doc, I called the office to ask what to do. Logically, maybe he should of had me come in.
I think if I’m having trouble he should maybe try me on something new but schedule me back to see how things are going.
just putting me on something new and expecting it will work until my next appointment in 6 months doesn’t seem logical.
I realize the problems with naproxen but not replacing it with something else doesn’t make sense. Advil isn’t exactly good for me either. Esp if I need 6 a day for it to help. The doc knows that.
I presume once I’m finished the prednisone, things should calm down. I hope that is the case. At this point I’m calling the doc’s office every 3 or 4 weeks.
thanks for your thoughts everyone. It really helps me to get your input. Anyway, I’m still wondering about his experience with PsA. We’ll see how it goes.