This is page 1 of 1 (This thread has 21 messages.)
Mumsnet hasn't checked the qualifications of anyone posting here. If you have medical concerns, please seek medical attention; if you think your problem could be acute, do so immediately. Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice.
I have had psoriatic arthritis for a number of years . It went into remission for both pregnancies and my plan was to try and deal with the pain with pain killers/ anti inflammatories for a year or so before trying for dc3.
The pain has just got so bad recently it would be easier to pinpoint the joints that aren't affected . I can barely walk or move my neck in the mornings which is so hard with the two Dcs .
Does anyone know if methotrexate is the first drug of choice to treat the condition or are there others?
My issue is that I do want dc3 and wanted to avoid methotrexate if I could .
Will be making an appointment with the rheumatologist soon I just wanted some insight first!
There are other dmards you can take but mtx does work. I am on mtx and sulphasalazine for mine but the rheumy is doing the hoop jumping to get me on biologics. If it's as bad as you say it is then your only real options are the immuno supressant ones. I inject mine weekly and after 5 months i am starting to see some improvement. If you are on fb then i am in a group specifically for psa in the uk and its a fab group!
It's 'Psoriatic Arthritis Sufferers UK' There are only 214 members.I joined in August time I think and it's a great little group.Although there is really only a core of us that post and ask a squillion questions.It's certainly made me feel better at times knowing I am not alone.
Re the mtx.Ir really can make you feel very nauseous at the beginning and wipes you out the next day,some not all people.But when I think back to July when I cried everytime I had to move my elbow to now where it's still painful but bearable it's worth it.
It's one of those awful diseases that keeps a lot hidden.My tendons have been attacked beyond belief so I may look completely normal but inside at times the body screams.
Have a read about mtx but I started on oral but could not cope on an increased dose as I was loosing 4 days a week to nausea,stomach cramps and tiredness.Injectable form is far more tolerable for me,no nausea and just a mild mtx haze.
You may find that you fit the criteria for biologics but you have to fight to get them due to the massive cost so only those in real need get them.
The point of the immunosuppresants is to slow the disease right down to prevent the need for future joint replacements and disability.
I have PA and was dx a few years ago. Initially I started on Sulfasalzine, along with steroids. However, I now take Methotrextate in addition to these. Though they don't take away all the pain ime - I take CoCodamol (30/500) and Diclofenac as and when required for that.
The Sulfasalzine and Methotrexate are keeping by blood stats stable and down, and helping to prevent any long term joint damage hopefully.
I did have a fair bit of nausea and tiredness with the methotrexate initially. My dose is now split over two days and I take folic acid a few times a week too. It has improved. I don't get very much nausea now and when I do it is more short lived. I do get tiredness and lethargy but that is from the PA more than the meds.
My dh was the same but was very pleasantly surprised that although the side affects knackered him for a couple of days the difference was huge and as I said only needed to take them short term. IMHO they are worth trying, it doesn't work for everyone but you can't carry on how you are - something has to change.
I have PsA but didn't want methotrexate as I was thinking about TTC. Started on sulfasalazine which I was allergic to and now on azathioprine which has helped so much (and is relatively safe in pregnancy unlike methotrexate which is a definite no-no).
They don't consider biologics until you've failed to be managed by a couple of DMARDs. Biologics don't have that much safety data in pregnancy yet, but look okay so far.
Also forgot to say, although they won't use them forever steroids give amazing relief while you wait for other meds to work. I had monthly IM depomedrone injections while waiting for meds to get sorted. Within 48hrs I went from a hobbling mess who couldn't squeeze a bottle of shower gel to feeling like I was 18yrs old again!
Op could have written your post. I saw rheumatologist a few months ago and had a steroid injection which has thankfully calmed everything. Manageable without pain relief now. If we have dd3 may consider going back on methotrexate as it suited me at least in the short term. Definitely worth a go. I had injection after dd1 too.