Flare..any tips?

[lulul]

Have woken up with red swollen knees elbows and feet...Could barely get out of bed so have crawled back in with painkillers on board and hot packs. What next?? Any tips on getting through the next few hours?

[Hidden]

Lyn-w has a good blog on flares here..

my advice rest and take plenty of pain killers.. got to the maximum permitted dose but dont exceed.. ask Gp for steroids?

[LavendarLady]

Hi Lulul, I also use ice packs on swollen joints - heat packs can actually cause more inflammation. Or put your hands into a sink of cold water - that also helps. Pain killers obviously and I agree with Summer, a steroid injection can work wonders but don't go on the tablets - my consultant told me that if you go on the tablets you will never get off them. So I have a steroid injection about every 3/4 months sometimes 6 months to bring down an inflammation which has refused to respond to anything. Also get your GP/consultant to check your drug levels. If on MTX it might need to be increased. If not on anti tnf, worth enquiring about that with your consultant.

Plenty of rest until joints begin to settle down and try to sleep a bit as well. Hope that helps. LavendarLady

[Hidden]

im on the 2nd lot of steroids in 2 years my tight lot wouldnt give injection. im in full control of dose.. decreasing in appropiate manner ..determined by myself im feeling good as doing it carefully.. have been allowed control of the reduction by gp.. as he speaks to me like a grown up and he treats mt with respect.. not the high flier he thinks I am though!!. more like a dodo!!

[LavendarLady in reply to Hidden]

Hi Summer. When I was first diagnosed I was given an immediate injection of steroids - by then I was in a wheelchair and literally could only move with difficulty. Hubby had to do everything for me. I was then taken straight into hospital, had dripped in steroids over 4 hours for 2 days running and then was released 2 days after that. I had to go back into hospital just before the Easter for 2 days for more dripped in steroids. The upshot was a massive increase in weight but at least the pain and inflammation was being brought under control. I was on MTX by tablet and Hydroxychlorquin for several months before going onto anti tnf (Humira at that point). The Hydrox didn't work for me which is why I think, I got the anti tnf earlier than most. Still had to have regular steroid injections up until a year ago when I managed to go 6 months (and lose some weight) without needing them. My Rheumy Consultant who I see every 3 months but can contact his secretary for an earlier appt if needed, is very good about giving the injections when he knows I am suffering and one of the GPs at my surgery (who is a bone man) will also authorise one if needed when I can't get to my Rheumy. I think because I am a lawyer and a professional like yourself, I am treated with respect and I always ask questions which require a proper answer not being fobbed off. Perhaps they are afraid I would sue! Particularly as I was misdiagnosed in the early stages and suffered for 2 months unnecessarily and was put through a load of unnecessary tests as the GP thought it was cancer because my bloods were low.

Have you spoken to your consultant about steroid injections when needed.? He can authorise your GP. My own GP is very unhappy about steroids and keeps sending me for bone scans which actually show an improvement although she won 't admit it! Lavendar x

[Hidden]

oh dear . yes perhaps they are afraid you might sue??

I have a better professional relationship with my Gp than my consultant.. he will tell me all and discuss in a balanced way.. its an uneasy rleationship with consultant.. would use the word ineffectual for her.. she admitted to me in june

after a slight prod from me (gp letter dec!!) she had forgot to refer me to pain clinic./ pyschology my mum came with me in June.. her opinion was.. she doesnt inspire confidence.. got my self a bone scan she had thought of it/ bothered.. and this is how.. went to retail pharmacy were I used to wotk .. got a pharmacist colleague to a medicenes use review.. all pharmacists in retail can do this... we did it together.. sighting . any issues with meds etc.. naturally we sighted long term use of steroids as a problem... the pharmacist.. ie my former collegue then writes to the gp.. the Gp then organised a bone scan simples.. it is the only cheat I have been able to do.. as well be responsible for me own steroid reduction. I put on over 1.5 stone it is come off.. I have passed dose threshold. on the downward direction,. were weight loss shloud be possible.

I thinks its amazing that you do such a high powered job with RA. and you are so practical and caring too. I do hope to meet you.

Alison x

[LavendarLady]

Hi Alison, thanks for that. Hope we can meet up some day. LL x