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Rheumatoid Arthritis
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Posted 10/21/2015 12:21 AM (GMT 0)
Hi Everyone--

I received a diagnosis of Rheumatoid Arthritis last week; I'm looking at starting DMARD treatment--which I assume will mean methotrexate--at my next appointment in 2 weeks.

This past March I began to have rapidly progressive bilateral hearing loss. I was deaf by the end of June. It was attributed to an autoimmune disease. I had cochlear implant surgery in August, and while that has helped with my hearing issues, it didn't solve the other issues--including joint pain/swelling, ear pressure, etc. I went to the rheumatologist, had some initial blood work and physical, and diagnosed with RA. I had some follow-up blood work done to rule out some remaining things, but the doctor is ready to start treatment now.

I work full time, and am a PhD student. Both deafness and joint pain are causing major issues. I've heard both good and bad about methotrexate, but if relief can come from it, then I'm all for it. My hands and feet cause me so much pain! My professors are allowing me to finish the semester early so that I can start treatment without having to worry about school, and focus on getting better.

I am very new to the RA world. What advice can you offer? How should I prepare for treatment? What can I do in the meantime to ease the pain? (I cannot take NSAIDs because they can cause ear issues--I have enough of those!) Has anyone else had ear related issues with autoimmune links? Any general things I should know?

Thanks!
Posted 10/21/2015 1:23 AM (GMT 0)
Welcome, there are many choices out there for DMARDs. I started out on plaquinel which helped by itself for awhile, but took three months to kick in. When my hands got worse my rheumatologist added MTX, but I was allergic to it. I now take a combination of plaquinel and Leflunomide which has calmed a lot of my hand pain and swelling.

I do have a slight hearing loss, but don't know if it's from my arthritis or heredity.
Posted 10/21/2015 7:54 PM (GMT 0)
Thanks for the feedback.

I don't think Plaquenil is an option because it has ear problems as a side effect. My doctor is steering clear away from any drug that might cause ringing or pressure. This includes aspirin, NSAIDs, etc.

I'm not sure on the biologic piece. I know my rheumatologist distinctly said DMARDs, but I'll press her on the biologic when I return to her office. I was under the assumption that biologics were given only after DMARDs failed, no?
Posted 10/22/2015 5:14 AM (GMT 0)
Yikes that sucks. I have not had any ear issues since being diagnosed in 2012.

I was started on methotrexate (which I think is the standard starting point and usually required by insurance) and it worked for me BUT it quickly (with in 5 months) had driven my liver counts sky high.

Had been reduced and eventually taken off of it because the counts would not come down quick enough. A couple of flares and they switched me to Humaria, which initially started out like a god sent. Thought I was cured it helped so quick and good.

Then after about 6 months on Humaria I had basically a flare up that lasted for a month and 1/2 and through 2 courses of Prednisone and double doses of Humaria. Literally every joint in my body hurt and there were times where I was bed ridden. Only "side effect" with Humaria was jaw pain and misalignment which immediately went away with in a week of switching to Enbrel. Dr pointed at Dentist and Dentist pointed at DR ****.

Dr switched me to Enbrel and was I "warned" that it may take alittle longer to work. I've been on it for 9 weeks and have been doing well. only issues I have are my right index finger and left middle finger, but those have been getting less painful/stiff with each weeks injection, So hopefully I have found my med. lol.

The injections are so minor and easy to do with the autoinjection pens there is hardly any pain associated with them but I did have some minor reactions the first couple of ENbrel injections (localized hives at the injection site) which was handled with Benadryl.

Keep your head up OP, hope they get you squared away ASAP.

One thing that I have been working on figuring out are what are my "triggers" to a flare up. So far mine are lack of sleep and stress. Hard to avoid either when I am a police sgt that works nights,lol. but I try.

J-
Posted 10/22/2015 6:51 AM (GMT 0)
Welcome Meg! Sorry you are having to deal with the RA dx, but the good news is that it is much more manageable with newer meds. I agree with J and Alice. You will likely have to be on the mtx before your insurance will pay for humira or Enbril, and eventually you may want to do both, if you don't have side effects. So silly that you can't just get a recommendation for biological if that's what Dr thinks is best but the insurance doesn't want to pay for it. Even the copay is expensive, so if you do go that route, look into the assistance programs offered for either drug.
J, there was a past thread about triggers for flares. Everyone said stress was worst culprit. Watcha gonna do, though? Just having a chronic disease is stressful. LOL!
Posted 10/26/2015 9:27 AM (GMT 0)
Hi Meg :-)

Hope ur meds help you out..

I have had ra for 20yrs..

took methrotrexate in the beginning with pred

then went on remicade which helped me for yrs

now I will be starting Enbrel

I believe it to be true bout the insurance most won`t pay for biologics till other meds have been tryed

good luck hugs :-)
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