Sunday, May 1, 2011

Love/Hate Relationship

I have a love/hate relationship with methotrexate.  I hate having to take it.  I hate the blood tests every other month that I have to get because of it, the dry cough that it has given me and the potential long list of side effects that come with the use of the drug.  Fortunately for me, nausea has not been a problem and while my hair has thinned after 8 years of use, I still have some.  While some people might question my use of such a drug, I have had to stop using it while on antibiotics several times over the last 8+ years and every time I realized, unfortunately, how much it does help. 

Like most of you I get blood tests every two months to ensure no new problems are occurring.   The worst potential problem could be liver damage.  Once your liver is damaged it is irreversible.  I did not know until recently though that most serious damage to the liver is not revealed in blood tests.  

I got my latest blood test results back from my rheumatologist (by the way, why does my computer insist that I am misspelling rheumatologist) last month.  I get a nice clean printout mailed to me after every blood test and usually everything is ok.  This most recent one however indicated that I was low on vitamin D.  It also included a prescription for ergocalciferol and a note to start 1000 iu per day after completion of the prescription.  My wife, who is a RN, filled me in on the blank spaces, believe me I have a lot of them.  When you are deficient in vitamin D, your body is going to get it from somewhere... it will rob the vitamin D out of your bones which could lead to osteoporosis.  So to make a long story short, I'm now taking extra vitamin D ... something I might not have realized I needed if it weren't for taking MTX and having regular blood testing done.  So continues my love/hate thing with MTX.


Anonymous said...

We all have that love/hate relationship with MTX! If you've been on it for so long now, you should not need to have your blood done every 2 months still. You could move it to every 3 or every 4 months.

Liver problems can be very serious, but are rare. Another lethal problem is MTX pneumonitis. If you have a dry cough, you should get a chest xray and a FULL set of pulmonary functions tests (pft's) that include spirometry, lung volumes and diffusion (dlco). Any problem in those should be followed up with an HRCT (high resolution cat scan) and visit to a pulmonologist who has experience with ILD's (interstitial lung disease). Lung problems could be from the RA itself, from medication treatments (mtx, biologicals), or even something not related to either. Lung abnormalities are common in RA and not always serious or progressive, so don't automatically freak out if there is a problem. Just be aware that you should monitor you lung health with RA and its treatments.

Squirrel said...

Ha, I love that your doctor wrote 'Have a great day!' at the end. I hope he/she doesnt put that on the bad test results though!!

tharr said...

I do have an occasional dry cough and am going to ask about a chest xray on my next visit to rheumatologist. Good points, thanks.

Squirrel, glad you noticed that. I thought that was weird too.

mary said...

I really hate the mtx. I dread my injection night because I know the next day I am going to feel pretty lousy. I also know that if I don't take it I am really going to feel bad ra wise in about 2 weeks. You are so right love/hate.
By the way my rheumatologist does a chest x-ray every year. This may be because my mother died of pulmonary fibrosis which mtx is known to cause or he may be cautious but either way I am always glad when it comes back clear.

tharr said...

Mary, I still take five 2.5mg pills each week. It does not make me nauseous so I do not do the MTX injections. It is good that it does help us but it is bad that we are dependent upon it to feel better.

Hope you're having some weather that allows you to get the bike out.

Anonymous said...

Drying out here in Syracuse after 20 days of rain and flooding. We were far luckier than a few doors down that got six feet of water in thier house. Hope you are still escaping the lousey weather.
My love hate relationship does not involve the MTX since I cannot tolerate it, but Arava and Orencia cause me similar aixiety.
Hang in there. Rubber side down buddy. Happy riding.

Deb said...

I did methotrexate for several years, early in my ra,until I developed difficulty swallowing. I had to stop taking it along with the Enbrel due to thyroid cancers. All is well now but this ra sure can be one tough disease. I love the fact that you keep on keeping on with your love for motorcycles.

tharr said...

Hey Phil, glad you are still above water. It has been flooded out down here, we are ok but supposed to get another round of severe weather this week. I'm hoping to get out and ride Tuesday ahead of the storms moving in.

Deb, you are so right, RA is a tough disease and most people don't see it as anything tough at all. Enbrel worked wonders for me for a few years. I hate having to depend on such drugs to feel good but am glad they are there at the same time. I would not be doing most of what I can do now if it were not for the biologics available.

Gillion said...

are you getting better now? Pei Pa Koa ( ) is one of the few Chinese natural cough remedies that have been scientifically studied. it's something like herb plus honey, and it's sweet, thick and black in color. If you have a cough, look for it! It used to be one of my favourite natural cough remedies.

if your cough persists, seek professional help such as traditional Chinese medicine physicians - I have had very good experiences with them.

Anonymous said...

I was wondering what Mrs. Tharr's might make of this article
The findings from this study are suggesting the inclusion of TNF Inhibitor with the MTX.
Do you know of anyone on this mixture?