Outcome of Telephone Appointment with Rheumy Nurse re Methotrexate

[Baner]

My 6 month Rheumatology review appointment due on Thursday this week has been moved to 27 January.   No reason for the change of date was given and as I had some issues I had wanted to discuss I made a telephone appointment with the Rheumy Nurse, which I had this morning.  She told me as my regular blood tests were good I will now be seen by a specialist nurse and not the consultant, and earliest appointment was January 27.  I said it would have been useful to be told this rather than just receive a text with change of date and no explanation.   

I am not concerned about this as have only seen consultant twice in the 12 months since I was diagnosed and both appointments felt rushed.  I’m hoping the appointment with the nurse will be less hurried.

My queries were about my weekly MTX injection, I told her there is now a warning sticker on the Metoject Pen, which Mrs Nails had drawn my attention to.  It advises patients to report various symptoms and to avoid excessive caffeine consumption, which I thought was a bit disturbing.  The nurse was unaware of this warning label but said it was nothing to worry about and should have always been there to save patients having to read the very long Patient Information Leaflet.

[MrsNails]

I think the Rheumy Nurses are invaluable - you can get to speak to them easily & there are Nurse Practitioners within the Team who know so much.

I only see DrD if necessary & l usually write to him if there’s any major issue (like l did in Lockdown) At my recent Appt - the Nurse said l’d better see DrD at the next appointment 😉

But any questions always ask them first & if they don’t know they can find out.

MrsN

[MarkWin]

I am sorry if I cannot help a great deal, as I am on MTX tablets. However, I have minimised alcohol and almost cut out caffeine in last few years as neither react particularly well in the mix of Prednisolone and Methotrexate! Maybe a couple of ciders or glasses of wine in a week, but I do treat myself to a 'proper' coffee (cafetiere) each morning. I have not necessarily had any ill-effects, but remain cautious as I seek to reduce to very low levels of pred. Good luck with your conversations with medical profession.

[Merryfield in reply to MarkWin]

Have you or anyone jumped right from straight pred to Medrol overnight? My doc prescribed this. btw, caffeine does seem to aggravate shaking.

[PMRpro Ambassador in reply to Merryfield]

Yes - it is merely another corticosteroid except 4mg Medrol is equivalent to 5mg pred. I have done it both ways - prednisolone to Medrol and Medrol to prednisone. Took one one day and the other the next,

[Merryfield]

Guess the Medrol gives a greater kick for a while. I suspect I will still be taking zolpidem to go to sleep.