Steroid injections or methotrexate

[arvine]

just had virtual appt with rheumy, explained chronic all over pain, I dont find him all that helpful as usual, said could be fibromyalgia, apparently been tested for inflammatory and RA, wasnt aware bit that was negative, by passed possibility of still having pmr, did say could try steroid injections or methotrexate which could be oral or injections but takes 3 mos to determine if helpful, I have read a lot of negative info about methotrexate said I would think about and call him, really doesnt seem to have time or interest in my condition, frustrated

[PMRpro Ambassador]

I think you are actually being unfair to him - he is offering what is available and you are rejecting what there is. Fibro is indeed a possibility that can't be ruled out. And he didn't bypass the PMR question - he has offered steroid injections and methotrexate, which does work well for some but you have to try to find out if it suits you and if it works for you - no alternative to that.

[arvine in reply to PMRpro]

Perhaps, but given the fact he has said prednisone worst medication out there, and because inflammation markers have never been raised for years, and the factvbeen on pred for 8 years he said doubts I still have pmr, , and diagnosing possibilities without actually suggesting in person appt, guess just dont have confidence in him, and of course chronic pain contributing to my attitude Im afraid. I regret not seeking out a different rheumy long before now, as we know takes ages to get appt with a different rheumy, just so many issues over last year or so, as I have posted , I procrastinated, my problem

[SnazzyD in reply to arvine]

I suppose you have nothing to lose in asking for a second opinion; if you don’t like this one, you may as well wait for another. Sometimes a fresh pair of eyes can yield a different approach. But as PMRpro says the suggestions are all that is on offer if you have PMR or other inflammatory condition. RA test can sometimes be negative but if it is RA Metho is your go to. It is very tricky if you have different conditions riding together and at the end of the day, these diagnoses sometimes can only be an educated guess. Like many people here, nothing is assured in any direction and it might just be worth a trying Methotrexate. Like any drug that affects the body’s immune system there can be drawbacks, but it can be life changing in a positive way and is for many.

It really doesn’t help one’s spirits and resolve when one feels dismissed. There ways of saying, “look, I’m stumped” when patients desperately need someone to give a name with certainty to their daily misery. I have read about long periods of pain caused by a disease then triggering changes that cause you to still register pain when the agent has gone.

If there’s one thing that has got me through awful treatment from various doctors since I was a child, loss, trauma, severe illness every decade, damaging treatments, Fibro etc is therapy. It all but banished Fibro.

[arvine in reply to SnazzyD]

Thanks Snazzy

[Pixix]

Whynot ask to try the medication available for fibromyalgia? I’ve had fibro for 13 years no, & would say ‘chronic all over pain’ describes it very well. I have other issues which mean I can’t take the medication, but many say it’s very helpful. Compared to my last rheumy appointment I think he’s being helpful, & actually offered help to you (mine paced the room while telling me to reduce from 5mg to 0 in six weeks, & to ignore it if I felt sick again, & then threw 2 leaflets across the desk, for fibro (already had the leaflet) & hypermobility (he wasn’t the first to diagnose it). My solution has been to work more at the GP level (normal doctor). Not sure what you were expecting to gain from the appointment…he offered you steroid injections or methotrexate….personally I’d jump at the chance of regular steroid injections, but think you already have them!?! Have you searched this site for methotrexate & read up what people say who are taking it? That could be one way forward? Or do you think you are clinically depressed, and could do with some medical help for it, perhaps? Just trying to help you…

[AtopicGuy]

I believe you've already trialled oral prednisone, so your doctor should be making an informed decision based upon how you did or didn't respond. I've had a course of duloxetine for fibromyalgia, so it's no big deal to rule it in or out (out, in my case). I have friends who swear by non-steroidal immunosuppressants (methotrexate or hydroxychloroquine) for various conditions: you just have to be patient and find the one that works best for you.

[arvine in reply to AtopicGuy]

Thank you

[arvine in reply to AtopicGuy]

Been on pred for 8’yrs forvpmr, currently 4!mgs although rheumy doesnt think still have pmr, osteoarthritis, back hip( consult for hip replacement coming up) hands fingers alljoints, muscle pain, suggested fibro on a virtual appt yesterday morning, thus suggested steroid injections or methotrexate

[AtopicGuy in reply to arvine]

The great thing about non-steroidal immunosuppressants is that they don't care which autoimmune disease is causing the problem. If you can find the one that suits you, and it works, bingo!

[KASHMIRI1]

Methotrexate isnt that bad and you wont know until you try. It takes up to three months to be fully effective, I split my dose and take half in the morning and half twelve hours later. One thing about it is that you can stop it without a taper and you wont get reduction side effects. You will get regular blood tests to keep an eye on your liver function. I also take pred currently at 4.5 mg. I hope things go well for you

[arvine in reply to KASHMIRI1]

Thank you