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Next treatment ...NO DRUGS????? Options
RichC
#1 Posted : Wednesday, August 24, 2011 5:18:19 PM Quote
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Hmmm just had a RA Nurse appt and explained all my troubles plus the fact that i was no further along than when diagnosed a year ago .DAS score in the post !.

She said perhaps we could try sulfasalasine .. but then she went to see consultant ...who after talking to me stated .. well there is no point taking poison so stop taking the RA drugs MTX and Leflunomide .. but keep some leflunomide as a back up :O This for 3 months (will be 4 ..at the next appt)

Anyone else had this? , as i had no real bad side effects from MTX or Leflu (or rather the side effects were handle able )

Bit concerned that the disease will do more damage with nothing to fight it :O

Rich
"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
Sue10
#2 Posted : Wednesday, August 24, 2011 6:57:45 PM Quote
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Hi Rich

I can't believe that they are taking you off all drugs!! Surely there is a great danger of flares and joint damage............and then to wait 4 months. Can you speak to one of the doctors on the NRAS team for some advice?

Do hope you manage to achieve a satisfactory outcome.

Best Wishes

Sue
smith-j
#3 Posted : Wednesday, August 24, 2011 6:58:12 PM Quote
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Rich

How bizarre. Either you have RA or you don't and I thought the one drug which NICE indicate for treating RA is Methotrexate. I have failed on many drugs but I have always continued to take the Methotrexate. Every time you are in pain you are causing damage to your joints and you need something to stop this. As it takes at least 12 weeks for the Methotexate to start doing its job, surely it would be ridiculous to stop it for 3-4 months only to have to be told to maybe go back on it.

I don't know if this is possible Rich, but I would definitely go for a second opinion. You have been diagnosed one year and those first few months are the most important to try and get your RA under control before the damage starts.

I wonder if your DAS score is low and the Consultant has decided "there is nothing much wrong with you". As you know RA can change dramatically from day to day. When you did your DAS score did you say what was hurting on that particular day or did you base your pain over a longer time period? I do this and it gives a good indication of my overall pain. My DAS score is 6.4 at present and I have been on anti-tnf's etc. Sometimes you have to be "inventive" if that is the right word to get the RA team to take note of how you are suffering in general, not on the particular day they see you.

You really need to take this in hand now and not wait another 3-4 months.

Keep us posted.

Jackie
x

suzanne_p
#4 Posted : Wednesday, August 24, 2011 7:03:28 PM Quote
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hi Rich,

i can't believe i've just read this !!

i definately feel a second opinion is now the order of the day,

i started Humira today ( will post when i'm further down the line ) having failed on Methotrexate and Hydroxy .. but i am staying on them both while starting the Humira.

as Jackie says maybe your DAS Score was low, wonder why they don't tell you it there and then. mine is sky high hence this next stage.

i would also give the Helpline a ring timorrow,

i know you know your way around things but to me whatever your DAS score is having suffered for a year plus to come off all drugs doesn't seem the way forward,

do let us know how things go,

Suzanne x

JulieM
#5 Posted : Wednesday, August 24, 2011 7:06:54 PM Quote
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Well! This has to be the weirdest thing I 've ever read-doesn't make sense at all does it? can you get a second opinion?
YES I'VE CHANGED, PAIN DOES THAT TO PEOPLE.
jenni_b
#6 Posted : Wednesday, August 24, 2011 7:16:35 PM Quote
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Hi rich

I have often been where you are. No drugs while waiting because the mtx doesn't work at all.
Several ra patients will just stay on mtx to try and look as if they are doing something. For many this is because the mtx works in the background.
I just had a big stab of depo to try help me through the wait.
Nras really are excellent at writing in support of getting things moving. I find mp pressure also helps no end.

Waiting with you

Jenni
how to be a velvet bulldoser
dorat
#7 Posted : Wednesday, August 24, 2011 7:34:54 PM Quote
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That is very strange Rich!
I take it he was the consultant....not a porter or something?? It's unbelievable "listening" to you tell him you are no further on than when you started with RA and then taking you off the drugs!"
I think it's time to change consultants!

Doreen xx
RichC
#8 Posted : Wednesday, August 24, 2011 7:36:58 PM Quote
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Thanks all for your support ... unfortunately i didn't get back til 5 , so the helpline was closed , but will call after a dentist appt in the morning at 9am (if i can still talk after 3 fillings hehe).

My DAS score will probably not reach me for over a month as that is how long the notes take to get written up.

I know my score will be high as they had bloods that were done Monday( , and obviously had my joint count and Fatigue/ Pain etc done today so can near enough work it out myself) . Last two have been over 5 and i know this one will be higher as i have a couple of swollen joints . And rated my VAS score as 8.5 mm. She did have all the info to hand there and then .
Hey ho :(
I started a big complaint a while back and then decided the way forward was by joining the local "Link", so never pursued it .
I really don't care what i take as long as it works and i am not left high and dry.

Might just see if i can go to another hospital now .. as well as complain to CEO.

Again thanks :)

Rich :)

"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
Eve_V
#9 Posted : Wednesday, August 24, 2011 8:03:51 PM Quote
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hello rich
if one thing has been forced home to us all it is that early treatment brings the best results. You say that you are no further along after one year and I suppose the consultant's take on it is that as the mtx and leflunomide do not appear to be working there is not much point in continuing with them. It seems to me the nurse had it right suggesting another DMARD, but clearly you cannot be left for four months with nothing. If your blood tests are available at the consultation it is easy for the consultant to give you DAS score during the appointment. As we encouraged to be part of the team that manages our illness we sometimes need to be a bit pushy to get all the information we can to help ourselves. Could you perhaps ask him, either directly or via the GP, to give you an idea of what he is planning after your next consultation, he will of course have to consider a few scenarios depending on how things are with you then. I think the idea of your having to traipse around to find an alternative hospital because you are not getting the care you should be, with a consultant you feel confident with, is appalling. wishing you the very best with all of this
.....eve xx
Rose-B
#10 Posted : Wednesday, August 24, 2011 10:26:09 PM Quote
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Sorry to hear Rich that you had such a useless appointment. Quite eventful.

I can't add much more than the previous posts, but I think I would def ring RA helpline
to see what they suggest.

All bizarre you poor thing. Hope you sleep ok tonight and the stress does not keep you awake.

Rose
jeanb
#11 Posted : Thursday, August 25, 2011 7:47:18 AM Quote
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Oh Rich - this sounds pretty horrific to me. No drugs = possible further joint deterioration. I am wondering whether their thinking is that they will put you forward for Anti TNF at your next appointment? However, who knows what damage will be done in the meantime.

Your DAS score is horrific and I would have thought you are an ideal candidate for Anti-TNF - but what do I know?

Changing hospitals is a pain but a lot of us have done it. My treatment up here was abysmal. I remember asking my so called consultant to explain the way the DMARD's worked. His reply? "That's for me to worry about, not you my dear". I could have smacked him one! I think he took one look at me and equated the fact that I am overweight with having no brain - doh!

Anyway, I did loads of research and ended up at Bolton (16 miles away) but it is worth every mile. They are wonderful. NRAS could probably help with a list of consultants or something similar.

Take care but make a HUGE fuss!

Love Jeanx
RichC
#12 Posted : Thursday, August 25, 2011 1:00:38 PM Quote
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Well thanks all :)

... rang the helpline and talked it through with them ..and yes i can talk for England.
Booked a GP appointment yesterday anyhow to get some mild anti-depressants and just incase i needed to be re-referred elsewhere.

so .. plan of Action ..
*Email Consultants Secretary , with all my concerns and ask that a Consultant or the Nurse ring me to talk about the issues, and give them one week to do it.
*Attend GP tomorrow for Anti depressants and advice on referring elsewhere .. and then get a referral. ( can obviously cancel if need arises) after checking on Dr Foster

wait for outcome and then decide what action to take.( complaint , request for records etc etc.)

Thanks to the helpline for talking it through :)

That call alone was worth the membership :) asis access to here and all the lovely people on here :)
.. and yes the dentist hurt .. but no complaints there hehe.
Rich :)




"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
Sue10
#13 Posted : Thursday, August 25, 2011 3:28:08 PM Quote
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Hi Rich

So pleased the helpline gave you some valuable advise, lets hope that your consultant gets back to you pronto.

Hoping you'll soon be feeling better.

Best Wishes

Sue
ceri44
#14 Posted : Thursday, August 25, 2011 3:54:36 PM Quote
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Hi Rich
Pleased that you got some good advice from the helpline and your GP seems to be on the ball too. Hope they come back to you soon with an explanation (although I can't imagine why they would stop your treatment!)
Hope you feel better soon
Love Ceri x
sheila_G
#15 Posted : Thursday, August 25, 2011 9:50:38 PM Quote
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Well Rich. I think 'gobsmacked' is the word. I have never heard anything so ridiculous. This flies in the face of all we know to be true about ra, not least the importance of medication to slow down permanent damage of joints. As you may remember, I had to come off everything around November time and after 8 weeks, wow! the biggest flare up ever. I do not want to go there again and I don't want you to go there either so I hope you get this sorted asap. Good luck

Sheila x
AnnieB
#16 Posted : Friday, August 26, 2011 3:15:36 PM Quote
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Hi Rich,

I don't suffer as much as many of you out there. However, last year when blood tests came back dogey they told me to stop taking MTX for a while which I did. How I paid for it a few weeks later, if someone said that to me again I think I would have to think long and hard about whether or not to follow their advice, the pain was unbelievable.

Hope all sorted for you soon.

Anne x
LynW
#17 Posted : Friday, August 26, 2011 8:16:32 PM Quote
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Hi Rich

A bit late arriving here ... the consequence of having three kids close together all getting important exam results at the same time and requiring 'mum' to pick up pieces and re-assemble!

I am utterly amazed and can't imagine what the doctor must have been thinking about! When I came off meds, due to wrong information, for 7 weeks last year I ended up in a huge flare situation. Since then, now 12 months on, meds don't seem to work any more and the RA remains uncontrolled. It doesn't take much for joints to become permanently damaged when the disease is not controlled (doesn't happen overnight though so you have a little time!).

Here's a link to doing DAS yourself. I don't normally quote this willy nilly because there is a right and a wrong way of checking for fluid/inflammation in joints. If it's not done correctly you could end up with a whopping score! Check joints by pressing firmly at the sides rather than front and back.

Hope the GP appointment was a success and things are quickly and efficiently sorted for you. Do let us know how you got on. We ought to package the "The Waiting Game" and sell it to raise funds ... now there's a thought! LOL

Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

bevie
#18 Posted : Saturday, August 27, 2011 1:05:29 PM Quote
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Hi Rich, Can't quite believe what was said to you at your appt! Glad to hear you have got some advice and support from nras though.

Bevxx
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