Advice please

[lors49]

Hi, I'm a first timer on this site, diagnosed with rheumatoid arthritis October 2014.

I am currently on 15mg mtx once a week. 10mg folic acid taken on different day to the mtx and 5mg daily of prednisone or through i'm sure what i sould be taking for pain relief. My breathing is differcult and my back is in a lot pain for most of the day unless i take prednisone. Is there a amount of prednisone i could take without running into other problems or is there another alternative.

I would be very grateful for any advice. Sincerely Lors

[nomoreheels]

Hiya Lors & welcome. Any changes should really be reported to your Rheumy team, especially any changes in breathing whilst taking MTX. I'm pretty sure you'll find the information in your patient information leaflet.

What concerns me a little is you're saying that you're taking prednisone daily then you say "unless I take prednisone", it's unclear whether you are taking it daily. As it's a steroid & should be taken continually (until your Rheumy tells you to start tapering it) generally as near to the same time each day as possible, your Rheumy will have explained just when he wishes you to take it. It's been prescribed to help reduce the inflammation you in order to give the MTX the best chance to work & he's the one who will determine if you need a different dose, it's not something you can do yourself, none of the meds we take are. Pain relief again is something you need to discuss with your Rheumy I'm afraid.

I would think you'll be due another appointment soon but if not I would contact your Rheumy nurse & explain as you have here how you're feeling. She should be able to answer your questions.

I'm so sorry if this sounds a little negative or unhelpful especially for your first post but I hope you understand we can't really help, your questions need to be answered by your Rheumy. If we can help or give advice in any other way we'll be more than happy to share our experiences. Have you had a look at the NRAS website? It may be worth a browse through, it will maybe help you understand a little more nras.org.uk specifically the use of steroids which you'll find here nras.org.uk/steroids-in-rhe...

[lors49 in reply to nomoreheels]

Hi, no worries its all good thanks for you advice. I was diagnosed with Rhem in August 2014 Started on my mtx in October. My GP doesnt know much about Rhem however i do speak with her frequently, she has been adviced by the specialist to start me on mtx 10mg once a week and prednisone 20mg for a couple of weeks so that the mtx can kick-in then stop the prednisone. The medication has been very helpful as i know longer require the use of my crutches, however i am still inflicted with pain and wanted to know is this usual. I started taking 5mg prednison a day to try and subside the pain.

My GP has spoken with the Rhem-specialist sent several referrals, currently i am still waiting for an appointment. I am not aware of a Rhemy nurse as in NZ our system are different although it would be a brilliant idea.

[nomoreheels in reply to lors49]

Right, I see. If it's only a fortnights course then it's ok to stop taking it abruptly. I was concerned that you were just taking it as & when you needed it, but it's still a little unclear whether you're taking 20mg prednisone a day as advised or 5mg a day. If your Rheumy prescribed 20mg daily that's what you should be taking for a short course to have greater effect & reduce the inflammation & in turn the pain caused by it. What does it say on the pharmacy label on front of the box?

I take a 3mg steroid daily but that's long term not a short course.

I didn't realise you were in NZ, I don't know Rheumatology guidelines I'm afraid & it's possible you may not have a Rheumy nurse. I would have thought your Rheumy would have given you contact details if you do have one but it would still be worth asking. Sorry, yet more questions but we'll get there!