Sulfasalazine, Methotrexate and Plaquenil give me severe allergic reactions. Leflunomide holds the disease back but doesn't stop it from spreading so two weeks ago I discussed anti TNFs with my consultant.
I researched both Enbrel and Humira but to be honest I just don't want to move up the chain so quick. I've had some very good advice from a lot of sources (including an Indian rheumatologist on Twitter!) to give up the DMARDs and go for the biologics but you know, I just don't want to take that step right now.
I'm living a fairly normal life, I'm not badly swollen, I'm in pain but it's not unmanageable. Compared to this time last year I'm a new person. Last week i spent a day in the garden doing some light duties. Don't get me wrong, even that took me a few days to get over but I couldn't even do light duties last year so the Lef must be doing something.
My main concern is that the disease is on the move and now affects (in total) knuckles of both hands, right wrist, a total of three fingers across both hands, left elbow, right shoulder, sacroiliac, both knees, left ankles, both big toes, balls of both feet. I've got plantar faciitis in both feet and now I think it's gone into my fourth right toe. It's all manageable, I can live with it but I don't want it going anywhere else.
Foolish I may be but I've decided to give DMARDs one last go. I'm suggesting a mix of Lef and penicillamine. After all, I've only got to wait three months to find out if that works and if not then I'll have no choice but to go for the biologicals. I'm just scared that if Humira doesn't work (and there's a 30% chance it won't apparently) then my choices are becoming ever more limited by the day.