Must have spoken too soon when writing recently that things were going well with mtx (started in september last year) as apart from tiredness, the aches and pains were bearable enough to manage without painkillers/anti-inflammatories for most of the time. However over the last couple of weeks have become extremely fatigued and last night the pains and heat were all over the place; fortunately the paracetemol and diclofenac helped enormously. My question is how can you tell what is a flare as opposed to disease not yet under control - or is it one and the same thing. Feeling pretty stupid asking this question but I have thought about it before because in my mind flares are something different from your normal state of being and I don't mean before having RA. Another thought, can you have a flare with the drugs still being effective?

.....eve x

Hi jenni
I read this again a couple of times and it provides a really good description of what happens during a flare and although the article says that at the start of the disease symptoms are similar to a flare I couldn't find anything that related to when you know the disease is not under control with medication. I have not yet reached the point of remission and think I am getting a bit tied up with the two steps forward, one or two steps back aspect of this disease, ie that a flare is just a worsening of symptoms regardless of where you in the process of controlled disease. One thing the article did mention was use of antibiotics which was intriguing so I googled it and found it comes from a group who recommend the use of antibiotics for treatment of RA. Has anybody ever gone that route? I really appreciate your support jenni.
.....eve xx

Hi eve

I have been thinking more about your post.

Try and think about ra in applies to you personally terms. Scale the different aspects if it out if 10. 10 is worst imaginable. Things like pain, number of body areas effected with 5 pain levels. Physical limitations. Mood. Wonky looking joints etc. Have you got a general score level from that?
My general score for daily life is about a 6. Beyond 6 I'm in trouble and at 8 I can't move.
After a spell at 8 I find it hard to get back to a 6 or under. Perhaps 5 years ago my day to day level was a 4. It's taken lots of flaire ups and general progression to get me to a 6.
Everytime you flaire the ra progresses. You are never the same after one, not quite.
I have severe and largely uncontrolled disease.
Without adequate treatment the ra goes in jumps and starts.
If it was a smooth progression that would be much easier to manage. I have known many over the yrs who had terrible ra for some time to find it settled down to a daily level near a 1 or 2. Also people who were settled but now have wildly raging ra.
To treat the flair or progression with big guns meds and mix of rest and movement is essential and it drives me mad that the dr surgery aren't interested yet send 4 letters about a diabetic wee test because they get money for that! Grrrr!
As for antibiotics pennicilamine was used in ra for many yrs. Some did ok on it
But ultimately its not as effective as the newer drugs and mtx stole its thunder about 25 yrs ago in the uk. The side effects made it difficult to tolerate.
Anyway much love and support
Jenni x