Yet another long winded stressed out post by yours truly......
Rheumy stopped my mtx 3 weeks ago when they found an infection while testing my bone marrow protein in a urine sample. I had no symptoms at the time. Lab tests showed the bug to be nitrofurantoin sensitive so was prescribed that antibiotic by my GP. After two 7 day courses of the drug, the first failed to clear it, my latest urine test results sample submitted on monday, show the infection has still not cleared, which was no big surprise as since finishing the antibiotics I now have symptoms. I spoke to my GP on the phone today and expressed my concerns about the infection persisting...he told me that he'll be prescribing a 3rd 7 day course of nitrofurantoin, which I'll be starting today, and if I still have symptoms after that then I need to come and see him.
I've had frequent recurring UTIs since I was diagnosed with a chronic bladder condition 3 years ago and it's caused endless complications with treating my RA, including a bout of sepsis a year ago. The bug I most frequently get is an e. coli type which is probably what I have now. It has already become resistant to trimethoprim and amoxicillin that used to kill it. Unfortunately it seems as if the same is now happening with nitrofurantoin, which also worked previously.
When I had sepsis I decided to go cold turkey and stopped all my immune suppressing meds, enbrel & mtx, and went on pain relief instead to try to cut down the number of UTIs I was getting, hence lowering the risk of getting sepsis again, which originated from a UTI. I lasted 9 months on just pain relief, most of that time being absolute hell with constant pain and frequent flares of debilitating severe pain in many joints resulting in me becoming nigh on housebound for the last 3 months. I eventually succumbed to the pain and 10 weeks ago started taking 10mg of mtx again, which thankfully began to improve things after 4 weeks. The only positive during my RA meds abstinence was I did not have a single UTI for the last 6 months, would probably have had at least 2 during that time if I'd been on immune suppressants.
So I'm in a bit of a dilemma and am seriously considering stopping my RA meds again due to antibiotic bug resistance, which I think has already become a serious problem and not some 10 - 20 years down the road as I've heard said by so called experts on the radio. Anyway, I've got an appointment with rheumy on the 18th to discuss my problems yet again. Probably a non starter, but I'm thinking of suggesting to my rheumy that I go on mtx, or different med, intermittently - perhaps 6 weeks on and 6 off. I'm thinking of this as I've now been off mtx for 3 weeks and though my RA has got a little worse I'm still ok with it. Anyways, it's nowhere near as bad as it was during my abstinence, even on so called good days. Obviously I need to ask rheumy about this, but was wondering what folk on here think?...who knows there may even be someone who's in a similar boat and taking their meds intermittently...stranger things have happened. I also need to ask my GP if my UTI bug is best left untreated if I don't have any symptoms as was the case this time. I'm sure one of my GPs or some other doc have mentioned this previously.
I could be clutching at straws, but I'm getting seriously concerned with my situation and feel I need to try something different as I'm once again starting to think that I'm batting on a losing wicket carrying on with things as they are.
It's gone 2:30am as I type this and I'm still wide awake. Suppose it just goes to show how stressed I am. Wish I was a stronger person and could handle all this crap a bit better.
Oh, surprisingly my bone marrow protein was ok.