colo_girl:  Your rheumatologist is dead on.  The studies show that the combination MTX plus a TNF inhibitor is best at achieving remission or stopping the progression of disease.  It sounds like you are in good hands.

I have had RA for over 10 years, and I would strongly suggest that you locate a rheumatologist.  I am really surprised you are not taking a DMARD like Methotrexate in addition to or instead of the steroids.  Chronic steroid use can be really hard on the body.  There are many good treatment options out there, aside from steriods, NSAIDS, and narcotics.  Many of them actually control not just the pain, but the disease itself, preventing permanent damage to your joints.

Its worth the effort to see a rheumatologist.  Perhaps the rheumatologist can work with your regular doc regarding treatments, blood work., etc, that way you would only have to make a trip tothe rheumatologist once a year or so....

Hope you feel better soon!

Hi Brenda,  i chose the sleeve because you can still take nsaids.  i have had a bad back most of my life, now  i have arthritis in my hip and have lived on ibuprophin? ibuprofin? i bought the 500 pill bottles and took them like candy,  I haven't taken any pain meds since the first two weeks pre op.  I can't believe the change and i read a post today that said that vit d can help a lot with arthritis,,well any inflammation really.  I assumed it was the weight that i have lost, 50 lbs today my three month anniversary.  But i think ive heard a lot of people are vit d deficient.  And that is a bad thing.  i was 30 on the pre op labs and dr prescribed vit d  which i got.   Then i read on the main forum that the best kind is dry d 3 so i got some,  took about 70K a week,  i got 5,000 IU and took 2 a day or maybe 4? can't remember now, anyway in a month when i got retested it went from 30-52 and im still taking them.  I wonder if this is a response to the weight loss and the vit d3 dry. Anyway  i won my appeal because i said i will always need NSAIDs but haven't needed to take them.  Funny  i still carry them around with me but i haven't taken any.  But i'm sure i'll need them again, they are really the only thing that ever worked for me.  vicodin  codein,  all that stuff makes me sick as a dog.   gives me itches and hives  and i think i'd rather be in pain than sick like that.    Anyway,  the vit d thing i think has really helped me.   I had to stop walking about may of last year,  the pain in my leg,  i was limping all over, ,moaning and grouning.  so look into the vitamin dry d3  best of luck to you  jeani

Hi everyone!

A few years ago I had problems with my left knee and after several x-rays and MRIs found out that the cartilage in my knee joint has several tears. Luckily they were not bad enough to need surgery to correct it, so my Orthopedic doctor recommended Ibuprofen and Naproxen as needed for pain and swelling when inflamed. 

I haven't had any flare ups since late 2008 but this week it has been bothering me fiercely to the point I can't bend my knee.

I will be calling my doctor on Monday to make an appointment but want something to help me with the pain until then.

What do you recommend? Is there anything we RNY patients can take that would have the same effect as Ibuprofen and Naproxen?

Thanks!
Rose

Heather: 

When you read about the side effects of methotrexate it is important to realize a few things.  Firstly, they are a list of "potential side effects".  The vast majority of patients taking MTX never get any of them.  Also, many of them listed are done so because they are seen mostly when high doses of MTX are used in patients (for example to treat cancer) rather than the low doses used to treat RA.  The most common side effects are mild and reversible with using lower doses if and when the do occur.  MTX is considered the gold standard and first drug of choice for treating RA because after its being used for 30 years now by rheumatologists, it comes out way ahead of the pack as far as safety combined with its effectiveness for many patients. 

In addition, you have to compare the disease to the treatment.  While the vast majority of patients taking methotrexate will not get any side effects from the MTX;  RA itself can be devastating across the board causing the pain, stiffness, difficulty with doing one's daily activities.  Over time, it is a crippling disease.  Not only that, it is a deadly disease.  Patients with RA die about 10 years younger than their peers because of the systemic inflammation causing early onset cardiovascular disease.  Recent studies suggest that patients being treated aggressively to get their disease under control are most likely having less problems with these complications of RA (to include heart disease).  When I did my rheumatology fellowship in the early 90s, I remember our waiting room full of folks in wheel chairs and crippled up.  These days, it is markedly less so, in fact, the orthopedists tell us they are not doing nearly as many surgeries on RA patients as they used to because of the much better treatment these days.

It is just very important to make sure that you do get your blood tests done every 4-12 weeks on the medicine (to make sure your liver enzymes and blood counts stay OK), that you drink very limited alcohol if any, and that if you do get any side effects (like diarrhea, stomach upset, rash, hair loss,etc.) that you let your doctor know.  Also, your doctor should also have you on either folic acid or leucovorin to prevent side effects, so make sure you are also taking one of them.  These days with so many really good medicines available, a large percentage of patients are able to get under control and be in "remission" on medications.  If MTX doesn't do so, your doctor may talk to you about adding one of the biologics to your regimen.

Best wishes!