Decisions, decisions ?

[petalnumber2]

My dilemma is all about drug treatment !! " "Nothing new then",

I can almost hear everyone's thoughts !! For a start I have been having trouble with my chest for some time, regularly coughing up clear mucous. A recent chest X-ray revealed inflammation in my lungs. So, today I have been doing some reading about biologics, particularly side effects and I read a bit about Methotrexate, which I have been on for some time, side effects !! Can cause inflammation in the lungs !! Well that's answered one question on my mind.

My rheumatology doctor has suggested putting me on Abatacept, but having read the leaflet he gave me, it says not suitable for patients who have had cancer. Well I've had a mastectomy and am on a drug to help prevent a re-occurrence, so why would I use another drug which knocks out the T cells which helps to prevent cancer !! I really am in a dilemma.

My thoughts are to stick with Methotrexate. But, if anyone knows more about all the drugs we are treated with and has a different view, I would be grateful to hear from you.

Regards to all, June xx

[patricia1193]

Hi Petal .That is a very difficult dilemma.The methotrexate does cause lung problems and all the biologics have some heavy side effects.Are you only on methotrexate or with a biologic?

[Gigi71]

I am wondering about methotrexate as I have a chronic cough, although a long term RD sufferer I was changed from Azathioprine to mtx two years this August due to getting non melanoma skin cancers. I was also offered Rituxamab in place of Humira. Rituxamab is meant to be a better option if you have had or prone to cancer. Chest X-rays showed as abnormal with a nodule and opacity, however it was noted on a X-ray I had a year previously for costochonditus and hadn't got any worst. I developed a dry cough at the following Christmas mostly at night. My GP thought it was my hiatus hernia. Last year after a failed catteract op in October, I had to stop mtx for 4 months. I had to take water tablet to bring down the pressure from glaucoma. I had a successful op at the end of November. I then got a chest infection and antibiotic's cleared it up, over Christmas I got gastroenteritis so it was January before I restarted mtx and the cough started again this time it had developed into a crackly cough at night and after meals. I had another X-ray and my GP is referring me to a chest clinic. So hopefully will get some answers, I should add have never smoked. I do hope your doctors can offer you a more suitable option. X

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[petalnumber2 in reply to Gigi71]

Hi Gigi71,

You certainly have a good few health problems to cope with, it must be a nightmare when it comes to medication.

My cough is worse at night and regularly wakes me up, and yes, after meals too. I'm also regularly short of breath.

My Rheumatologist Doctor has been on holiday and returned a week or so ago, so I haven't been able to talk to him about the chest problems or talk to him about my concerns about using Abatacept. Perhaps I should see my GP and discuss these issues with him. xx

[Gigi71 in reply to petalnumber2]

Hi petalnumber2. I do have a very good GP, who has some training in RD however when it comes to biologic's he leaves that to rheumatology. It also takes an age to see him. My next rheumy appointment is with the nurse in July and with the rheumatologist in October. I have a youngish female rheumatologist who is very approachable. I decided my GP was the one to see regarding my cough in the short term and as I say is referring me to the chest clinic. My GP is in a different health authority to my rheumy. That does make life more difficult, the chest clinic he is recommending is the same hospital as my rheumy so they can liaise. I am also waiting to be seen by the Pain clinic for the osteo in my back. I seem to go from one crisis to another. I dropped a round paving slab on my leg a month ago, don't ask !!! And I got a haematoma on my leg it's now infected and am on antibiotics that also would be given for chest infections, it's not making any difference to my annoying cough.

I do hope some of my ramberlings is of some help to you in deciding who to see about what. Please ask your rheumy about Rituxamab as may be a better option for you. It works better if you are sero-positive than negative. They still recommend mtx with it,but you can go on a low dose. Good luck X