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RA related fatigue

My 39 year old wife was diagnosed with RA 6 months ago. Extreme fatigue was the reason she went for the exam that revealed the RA. She's been on methotrexate for 6 months and her fatigue is even worse. She had cancer of uterus 3 years ago and I understand that a history of cancer precludes some RA meds from being used. Has anyone else experienced long term fatigue and what is the choice of treatment after methotrexate given a history of cancer? Thanks

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aubreyh - I'm so sorry about your wife's extreme & chronic fatigue, a symptom from which I, too, suffer. I have not had cancer of any sort (praise God!) but in addition to RA, have fibromyalgia, chronic fatigue and spinal stenosis. My initial reason for seeing a rheumotologist (at the insistence of friends) was because of the debilitating fatigue, so I can pretty-much relate to how your wife is feeling. A year after seeing the rheumo (4 visits), she diagnosed me with the fibromyalgia. RA can also cause extreme fatigue/tiredness. Methotrexate did nothing to relieve the pain & inflammation from my RA so I cannot speak to it's side-effects; not do I know what medications she may be unable to try because of her cancer history, but would assume she should not take anything that would raise her estrogen levels. I will tell you that most/many RA patients require a "cocktail" of medications to control pain & inflammation and reduce the risk of further joint damage. Additionally, such extreme fatigue forces me to wonder if she might not also have fibromyalgia and suggest she ask her rheumo about that possibility:( Lastly, I commend you for being such a supportive husband! Those of us who suffer from chronic "invisible" illness need and appreciate that support. Your wife is blessed.

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Have you tried Cymbalta for the fibromyalgia? I heard it was great by several people including my other in law

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Thanks

Checking with doctor tomorrow

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I strongly second the cymbalta!

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Thank you

We are going to talk to doctor tomorrow

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Thanks so much for your insights. We are changing her cocktail of meds now and hope to see better results.

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See if she can try the injectable form of methotrexate, the by mouth does give one fatigue

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Thanks

We are meeting with doctor tomorrow

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We got her own injectable now. Thanks

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Thanks so much for your insights. We will get back to the doctor to discuss. I'm thinking about taking her to Johns Hopkins. Does anyone have experience with any medical centers that specialize in RA?

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I have read that John Hopkins has an excellent autoimmune department.

It would be great if you could get her there. I too have had extreme fatigue prior to diagnosis and the reason I went to see the doctor. I am tired a lot but not to the extreme I was prior to diagnosis. I am on Cimzia --a biologic medication for RA but I believe it is not given to people who have had cancer. IT has many side effects that are very serious and you can get cancer while on this medication . I didn't do well on methotrexate but I also have an autoimmune bowel condition which was made worse by that drug. Wishing your wife and you all the best

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Thanks so much

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I am sorry for your wife dealing with this! Fatigue is something that goes hand in hand with RA. MTX seems to increase fatigue but it gets better with time. If you're taking her to John Hopkins I'm sure they will be able to come up with a therapy for her that will work with her cancer history. Like another person said, it takes a good doctor to come up with a cocktail of drugs that will work for her. I was diagnosed at 25, now 48, and my cocktail is Arava and Mobic daily, MTX 8/wk and Rituxan infusions every 4-5 months. After trying every other biologic for RA, this cocktail seems to be working! I also stopped working which has really helped a lot. Good luck to your wife and your family and God Bless!

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