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Medical Forum / Diseases and Disorders / Arthritis / May 2005methotrexate-some questions
I don't know if any of you remember, but I had elbow surgery last June and unfortunately I am still having pain in the area of the scar. I have rheumatoid arthritis and both the surgeon and my rheumatologist have said that the healing from the surgery is slower because of my rheumatoid arthritis. A cyst has developed on the elbow scar. My rheumatologist did an ultrasound and showed me as he did it where and what it is...a fluid filled cyst caused probably by the trauma of the surgery. He suggested that I could have surgery to remove it but that may or may not make my elbow better. He does not think that draining the cyst will help since the fluid would just come back. Although my rheumatoid arthritis is under control at present, he is recommending that I up my Methotrexate for 3 months (he thinks that might help shut down whatever is causing inflammation that is causing the fluid) from 4 (2.5 mg) pills a week to 6 pills a week in the hopes that this will help. He will do another ultrasound then and see if it's gotten larger, or hopefully, smaller, and we'll then look again at options. Not ideal but I certainly don't want to rush into any more surgery so this seems like the sensible way to go for now. My question is: has anyone gone up on their methotrexate dose and then later gone down without any problems? Whether this helps my elbow or not, I'm hoping that I can go back down to four pills a week when the three months is over and that my body doesn't become dependent on needing six pills a week by increasing the dose. Any input would be welcome about this. MaryB > My question is: has anyone gone up on their methotrexate dose and then > later [quoted text clipped - 4 lines] > by increasing the dose. Any input would be welcome about this. > MaryB First, MTX does not create physical dependence. As long as you taper up and down to reduce side-affects, you should be fine. However, I have a lot of experience with cysts Mary, and I think you should see a dermatologist before making a decision. It is very difficult to completely remove a cyst. I've had one on my back "removed" three times, and it keeps growing back. My current dermatologist feels that steroid injections are a much better treatment option, and so far, I would say he is right. He drained my cyst, then injected it with steroids to stop the inflammation. I think it is worth a try before you consider surgery. Walt Walt, thanks for the in-put. I will probably be going to see the elbow surgeon this week to get his in-put. My Rheumatologist did mention draining it and putting in steroid but said that the surgeon should do that. So, I'll see what the surgeon says also. I know I'm not going to rush back into surgery, that's for sure! I hadn't thought of seeing a dermatologist since the cyst began inside the surgery scar. Will have to think about that also. And, that's good to know about the methotrexate. Today's the first time of the 6 pills and so far, so good. I'm drinking lots of water today and tomorrow. MaryB > > My question is: has anyone gone up on their methotrexate dose and then > > later [quoted text clipped - 19 lines] > > Walt Mary, I had the same thought about draining and injecting the cyst as Walt did, though i don't have the personal experience Walt has. It seems to me that I've heard several people talk about treating cysts that way and may have even read some studies about it....... Sorry, I just can't say for certain where I've heard about it all, but I did have it in my head that it's a preferred way of treating cysts now. As for mtx, Walt already filled you in about adjusting doses. Also, unless you have real trouble from the side effects, don't worry too much if you need to stay at 6 pills for a while. Assuming you are taking the standard 2.5 mg pils, 6 pills is only 15mg/week. For many folks that is the lowest dose which helps their arthritis at all, so it is not at all a high dose. Sure it's best if you can take as little as possible, but 15 mg/week is not at all a worrisome dose. Best of luck with it all. IIRC, you love to knit and were hoping to get back to it more after your surgery. Has that improved any, or has this slow recovery kept you away from your needles?  SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare Nann, thanks for the reassuring information about Mexotrexate. I have made an appointment with the elbow surgeon for Friday and my Rheumatologist is going to mail me the print-outs from the ultrasound that he did for me to take to the surgeon appointment. So, I'll see if he thinks we should wait and see what the upped dose of methotrexate does or should try to drain and inject it. I have been able to get back to some limited knitting so I'm a happier camper. Knitting is so much a part of who I am that I definitely need to be doing it for "good mental health"! MaryB > Nann, thanks for the reassuring information about Mexotrexate. I have > made [quoted text clipped - 10 lines] > doing it for "good mental health"! > MaryB ((((((((((maryb))))))))) are you back to knitting?<i hope, hope, hope> how'd it go for you with your surgeon? did the upped dose of mtx help? what did your ultrasound show? does it look like draining and injection might work? in other words, and? and? and? nosy people need to know these things. ô¿ô still keeping you in my healing thoughts. kate > will help since the fluid would just come back. Although my rheumatoid > arthritis is under control at present, he is recommending that I up my [quoted text clipped - 8 lines] > >(mary) I have been on mtx for almost 14 years now. Ihave taken any where from 4 starting toup to 12 (2.5mg) tablets. I felt the best when I was on 12 mtx tabs w/ Enbrel & 5mg prednisone, but my liver thought other wise so I am down to 10 tables 25mg each week. I have stopped mtx & Enbrel & went back on then after various surgeries. I hope this helps belinda Belinda, thanks so much for sharing your personal experience with methotrexate. Even though each person's experience is different, I find it helpful to hear about others. MaryB > I have been on mtx for almost 14 years now. Ihave taken any where from 4 > starting toup to 12 (2.5mg) tablets. I felt the best when I was on 12 mtx > tabs w/ Enbrel & 5mg prednisone, but my liver thought other wise so I am > down to 10 tables 25mg each week. I have stopped mtx & Enbrel & went back on > then after various surgeries. I hope this helps > belinda >I don't know if any of you remember, but I had elbow surgery last June and > unfortunately I am still having pain in the area of the scar. I have [quoted text clipped - 26 lines] > by increasing the dose. Any input would be welcome about this. > MaryB Mary, I've been up to 28 and down to 15 and back up to 25, then down to 20 where I'm holding. ALl over the course of 7 years, sometimes in several month stages, always successfully recovering my healthy state of being when my dose got back up over 17.5. |
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