Any advise plz

[Jayden25]

I am taking methotrexate and biological Cimzia injection two years into the Methotrexate and on seventh week of Cimzia. Feel like hell blood test result back, CRP has double upto 28 and my ESR has gone up to 90 should I stop. Feel like all inside is swelling from the inside to the out side.

[Victoria-NRAS Partner Moderator NRAS]

Hi Jayden

Hopefully it's just a nasty flare up and will go down again soon. Flares can still happen sometimes even if the medication generally controls the RA well, though they might happen less often. It might be that the Cimzia hasn't fully kicked in yet. Worth making your rheumatology team aware of this and perhaps seeing if you would be able to get a steroid injection. In the meantime do anything that gives you even a little relief in swollen joints, such as applying hot or cold packs. This article on flares might be useful:

susanoliver.com/patients13.htm

Hope you feel much better soon.

Kind regards

Victoria

[Jayden25 in reply to Victoria-NRAS]

Thanks Victoria will have a read now.had high inflammation for the last year but this is my highest result so far.trying to keep positive. Thank again

[helixhelix]

I guess that if you only started Cimzia 7 weeks ago it was added in because the MTX alone wasn't keeping the disease under control? So it maybe that your disease is really kicking off right now and the Cimzia hasn't had enough time to work yet.

But don't stop taking the drugs without talking to your rheumy team and telling them how it's going. But if your ESRhas gone up to 90 then not. surprised you feel rubbish! Hope it's a short lived flare and you pick up v soon.

[KB-Fibro]

Hi.

Sorry but i don't know what CRP or ESR actually mean! Would love to know as people talk about them alot. I haven't seen a rhuemy for a year as they 'lost' me on the hospital list. Feel like I've been left to deal with all of this on my own.

Sorry for not understanding.

I really hope you start to feel better soon

Kate x

[Livingston]

ESR is Erythrocyte Sedimentation Rate (you'll see Americans call it 'sed rate'.) It's a measure of how quickly the red blood cells in a sample clump together and sink to the bottom of the sample. It is used by doctors as a general guide to level of unwellness as it tends to go up when you are unwell/suffering inflammation/under physical stress. It is not very specific at all but in general terms, high ESR = patient is not very well.

CRP (C Reactive Protein) forms in the blood in response to infection/inflammation going on. It is more responsive than ESR in that it tends to rise more quickly as you become more inflamed/infected and fall more quickly as you get better. It is a bit more specific than ESR in that high CRP = patient with inflammation/infection happening.

Any decent doctor will tell you that both are quite crude measures and they don't tell you a great deal on their own. A patient with high levels of either will generally be saying that they don't feel very well. They can be used to help monitor disease activity over time and the numbers being high help add weight if you are telling them things aren't going well with your RD. One or other of them (doctor's choice) is fed into the calculation that works out what your Disease Activity Score is.

To further complicate things, in some people, ESR in particular doesn't seem to vary much at all. This makes it a less useful measure and causes problems if you are confronted with a (usually) inexperienced doctor who is depending totally on blood results to guide them, rather than considering the whole picture. As an example, the highest my ESR has ever been to my knowledge is 28. Although that is above normal, it isn't really high at all. However, I was so unwell at that point that I was hospitalised.

Everyone has their own 'normal' levels for all sorts of blood measures. A good doctor will use them as a guide, along with what they observe about the patient and what the patient says.

[Jayden25]

Hi thanks all, yes having a bad time atm as ESR has been in the eighty for last year.now it in ninety I feeling it so bad. Trying to put a brave face on but sometime I am unable to walk and that when it gets me, I can take every thing else. I will carry on with the meds till I go back. Thank you all.

[KB-Fibro]

Livingston......well that clears that up then!! Thanks for that 😊