Ok well as some of you know I work in a hospital pharmacy when well enough!
Had fab time made a cream today use weighed out ingredients , gloved and masked up yes we make things in hospital pharmacies!!
Then I was handing out outpatient prescriptions mon, tue, wed are possible rheumatology days and today was one of them!! along with dermatology.. hence made a cream and few other clinics..
Anyway handed out methotrexte 5mg(start dose) to patient.. we do extensive counselling with patients and also used to take the stuff myself!!
I will be ok on this she asked me? she told me unsuccesfully tried two other drugs. sulphasalazine was one of them!, now I DIDNT have access to her medication history.. and we have strict rules regarding access.. my guess she had either been given hydroxychloroquine or arava(lefumolide)!! same consultant as me!!
Now here comes the truth aspect I could honestly say that most patients do very well on methotrexate and a large majority tolerate it.. it did put me on a spot as personally after the dose rose higher I couldnt not tolerate. I got 12.5MG before a major crash and born,, back to glos nhs having no money and not paying for biologics.. this poor patient I coulndnt say what I say on here to her!!. she was downcast, if this doesnt work she said I will have to put up with the pain!! this in appalling state of affairs nice guidelines two failed dmards should quality for ant tnf we are both on the third!!
Saw occuptional health nurse after work feet and wrists bad. it was review appointment.. currently working 3.5hrs daily next week get to work 4hrs if I can manage it.
Im having gold injections last two weeks had paradoxical reaction.. suspending this week re attempt next week on a friday so not have to go to work like a pain ridden zombie!!. oh hobbling back to car after work and occupational health appoint saw the mentioned consultant hurrying back for her 2pm clinic!