Holiday?

Hi all,

I was diagnosed with RA in late April this year and I'm now on Methotrexate, Hydroxychloroquine, Sulfasalazine, and Naproxen with Tramadol/Co-codamol for pain relief. I had a steroid injection (in my backside) in April which is now wearing off and the flare is coming back. My RA is in both hands/wrists and both feet/ankles so I don't think localised injections would work too well.

We're due to go on holiday in August and I was going to ask for another injection to see me through that comfortably.

Question is - how often do they normally give steroid injections?

Thanks for any help

Mo

[EasternBunny]

Hi Mo,

I was diagnosed in February and got steroid injections into both wrists in early March. Unfortunately my RA was still not under control and spread to my legs so rheumy gave another steroid injection into my backside as well in June. He said that usually you have to wait 3 month to get another steroid injection. Previously I called the helpline as I became unable to walk for a few days. They were really helpful and arranged an emergency appointment straight away. Maybe it worth to give them a call.

[Hidden in reply to EasternBunny]

Thanks EasternBunny, I've already called the helpline (it's an answerphone/message service) about a week ago but I haven't had a reply. I've also had an appointment cancelled at short notice because of staff illness. I don't seem to be having much luck lately! But I will try again.

Cheers

Mo

[Livingston]

Hi

assuming you started your DMARDs soon after diagnosis, they should be achieving some sort of effectiveness round about the end of July, hopefully in time for your holiday.

Meantime, are you making good use of your painkillers? If you are taking full dose & they aren't helping, it might be worth trying to juggle the timings a bit to try to get ahead of the pain, rather than letting it build up too much before you take them. Failing that - speak to your GP - there are lots of other painkillers.

Steroid injections into joints are usually only given to manage those that are particularly troublesome and they can't be done too often as this can weaken tendons/ligaments supporting the joint. Usual gap advised is at least 3 months.

Steroid depot injections (into your backside) are for short term management and again, can't be given too frequently. Your rheumatology team could advise you, but again I think a minimum 3 month gap is advised.

Some people experience a spiral of diminishing returns with injections - what works brilliantly the first time can be a bit less effective every time it is repeated.

I don't mean to be negative (I'm going more for pragmatic) but managing the symptoms is going to be part of your life from here on in and getting the disease under better control won't necessarily mean you are pain-free. It might be worth asking for referrals to Occupational Therapy, Physiotherapy and Orthotics. O/T can help with ways of doing things that put less stress on your joints, as well as aids & splints. Physio can help tremendously in reducing pain. Decent orthotics can be very useful in reducing foot/ankle pain.

Hope you feel better soon.

[Hidden in reply to Livingston]

Hi Livingston, thanks for the reply. I'm trying to use the painkillers as little as possible because a) they turn me into a zombie and b) I've heard that codeine can be highly addictive. I'm careful with them but have already worked out a plan to use them effectively.

I'm also going through the process of podiatry, OT and physio consultations - so far I've had all except the latter. My GP has been very good and has kept in regular touch with me in assessment meetings. I also have pleurisy that is proving antibiotic-resistant.

I don't think I phrased my original question very well, what I was trying to ask was if it would be a good idea to have another steroid injection now and be able to ask for another before my holiday in August. 3 months sounds like a reasonable length of time, and takes me to just before we go away.

I'll certainly discuss it with the rheumy clinic (when I can get hold of them!) but am beginning to think it would be better to wait and feel better for our holiday.

Thanks again

Mo

[wiliby in reply to Hidden]

I think it would be a good idea to have one now and then again before holiday. I was started on same meds as you, triple therapy is aggressive approach but one I am thankful for! Anyway, the aim at this point is to dampen down your flare as quickly as possible to allow your meds to works effectively and using steroid seems to be the most successful. A previous member likend it to putting the fire out before it's out of control.

I've had one recently and RA nurse was happy for local clinic nurse to do it, she emailed them same day with dose ect (for a holiday as well)

Good luck, are you going somewhere hot? I feel amazing going abroad (the canaries work for me)

[Hidden in reply to wiliby]

Thanks wilby, I'm going to try and contact the rheumy clinic again today and will also talk to my GP about it as one of the doctors there is qualified to give steroid injections.

I don't do well in heat and can't sunbathe due to skin problems, my partner is the same, he never sunbathes either. We're off to Iceland! Can't wait.

[Hidden]

Just back from a consultation at the hospital, rheumy nurse gave me another steroid injection in the rump. I was cheeky and asked about a "holiday injection" to be told that of course I can have it if I need it but I have to ask nearer the time and we'll discuss how I feel then.

Had a great (short) chat that put my mind at rest over a few things that have been niggling me.

***** Big gold stars for all the NHS staff, they're wonderful! *****