My 72 yr old Mom and RA Meds

I'm trying to do some research on alternative meds for my mother who has RA.  I was wondering what experiences people have had with the Remicade and Methotrexate combination.

My mom is having extreme pain in her leg, which she was told is stenosis.  She was given Tylenol 3 and Vicodin, both which made her violently sick, so she isn't taking them.  The doctor did not offer any other alternatives for pain management, other than to keep taking them and the side effects would pass.

She is 72, and has had RA for over 10 years. and it is pretty severe.  She has been on Arava for 7 years, but her RA seems to be progressing more lately.  She has started getting new nodules and is starting to have depression, which for my mom is VERY out of character.  She said every time she goes to a doctor their standard response is, no matter what the problem, it stems from RA and they can't help.  She asked her RA doc about changing meds, and the doc put it back on my mom saying they could if she wanted.  My mom needs direction, not to have this put on her to decide.

I want to do whatever I can to try and make her quality of life better.  She cannot take Enbrel as Medicare does not cover it.  Any suggestions, thoughts, or advice is greatly appreciated.  I feel so helpless seeing her in such pain.  Thanks.

Lynda

I am surprised that her Medicare coverage does not allow Enbrel. I know the Medicare formulary varies from state to state but thought that the specialty drugs were covered. I know several Medicare participants that do get Remicade paid for. I get Remicade for Ankylosing Spondylitis which is a type of arthritis. I was to the point of needing a wheelchair to get around. Once I started the Remicade my condition improved greatly. The Remicade has really helped relieve the inflammation in my joints thereby lessening the need for pain medications.

There is also a non-narcotic pain killer that helps with joint pain. It is called Tramadol. Has she tried that? It might be worth asking for a small script if it is not contraindicated with other meds. That way she could see if she can tolerate it. I hope she can find relief soon....

She said her insurance will not cover Enbrel because it is self-administered, but they will cover Remicade since it is administered by a doctor. Crazy, huh? I'm not sure about Humira. Maybe I should do a little more research on her coverages and make sure that's correct. She has a doctor's appointment tomorrow, so I will have her talk to her doc about Tramadol. Thanks for the suggestion. We need all the help we can get.