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Medical Forum / Diseases and Disorders / Arthritis / November 2005

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Re: I Have Ankylosing Spondylitis

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Ray - 28 Nov 2005 00:35 GMT
First, Vioxx does nothing to slow down AS.  You need a disease
modifying drug such as Arava, Enbrel or Humera.  

Celebrex is still available, have you tried it?  However,  I can no
longer take Celebrex due to stomach problem, but Enbrel has
decreases inflammation and problems better that Celebrex
(even though Enbrel is not an NSAID like Vioxx is).

It was sort of funny last week when I went to a Medical University
about a weird throat problem.  A student doctor came in first and
could not understand how I could possibly have any form of RA
or AS because I did not show any of the text book signs - the
Enbrel had all the indications under control.

Ray
======================================================
I have AS and nothing works for me since they took Vioxx off the
market.  I am cervically fused from C-3 to C-6 for ten years now.  I
have Adhesive Capsulitis so bad the manipulation didn't work.  First of
all should I get surgery for the AC? My other question is nothing works
for me because I have to much bone rubbing on bone.  I know my ribs are
fusing as are part of my thoracic and lumbar sections of my back.  What
can be done about bone on bone or am I faced with severe pain the rest
of my life.  I'm on Social Sec. Disability and only 48.  Any help would
be appreciated.  Thanks.
thelongestday320@aol.com - 28 Nov 2005 01:31 GMT
Ray,

Thanks a lot.  But why then does my Rheumy not have me on anything to
stem the disease? After all I was on Enbrel and Humira and did a stint
with Asulfasizdine which I never saw any difference with at the time.
I have been doctoring with him for almost 16 years and feel he has done
right with me.  He suggested Methotrexate combined with remicade but I
have apprehensions about those meds.  Perhaps I will start the enbrel
again.  Isn't an anti inflam. enough to stem the disease?  Thank God
for message boards.  Thank you kindly.

TLD
Harvey R. Stone - 28 Nov 2005 14:18 GMT
> Ray,
>
[quoted text clipped - 4 lines]
> right with me.  He suggested Methotrexate combined with remicade but I
> have apprehensions about those meds.

Your doctor see reasons to put you on Methx and Remicade.    That is as
strong a combo as a person can take to slow the progression of inflam.arth.
The doctor has done his job almost but did not explain well enough the
reason you need to take them because you have apprehensions.   I think it
would be truefull to say that we all have them but the need to control what
we have must win out.   When you can no longer drive a car,,,, like
firechief,,,,(who needs to be talking to you about AS) ,,,, you will wish
you had taken them.
    Sometimes AS is very slow to do what it does to a person  giving you
time to learn to live with the changes.    We just try to keep you from
saying,,,, I wish I had of,,,, but we all make choices and live with them.

Harv

Perhaps I will start the enbrel
> again.  Isn't an anti inflam. enough to stem the disease?  Thank God
> for message boards.  Thank you kindly.
>
> TLD
Charrlygrl1 - 28 Nov 2005 16:56 GMT
TLD,
No, an NSAID is NOT ENOUGH to stem AS.
I am on Enbrel, methotrexate, sulfasalazine, prednisone and a few
others for pain and sleep. Even with all of this I still do have pain,
but have so far avoided any fusions.
I try to look at it this way: the side effects from the drugs usually
go away when the drug is discontinued....the damage of AS does not go
away.
Somehow, I thought I responded to this yesterday?
It seems that most of the TNF inhibitors (Enbrel, Humira, Remicade)
work better in combination with methotrexate. I was on MTX early on for
about 2.5 months, then my rheumatologist took me off of it. Two
rheumatologists later, my doc tells me that I wasn't on it long enough
(minimum of three months) and put me back on it. It does seem to be
helping me now, whereas it did not seem to help the first time. Again,
I wasn't on it long enough....and as it  turns out, I wasn't on a high
enough dosage the first time around.
I don't know enough about the surgery to comment on that part.
Good luck to you, TLD,
Charlene
thelongestday320@aol.com - 29 Nov 2005 01:34 GMT
Thanks Charrlygrl1
thelongestday320@aol.com - 29 Nov 2005 01:33 GMT
Thanks Harv.  Good advice indeed.  Since I got through the day to day
pain and stiffness the past years I never gave it to much thought. The
last 6 months to a year has wreaked havoc on me.  The pain is constant.
Take care.
Norman - 29 Nov 2005 03:52 GMT
Sorry for not responding earlier with my eight cents (inflation). I'm
usually running (or limping) around so much that I'm liable to come in
and see myself going out the other door.

I also have AS. I was lucky in that they found it before any fusing, and
started me on stretching for range-of-motion, NSAIDS, etc.

One thing I have found out, for myself and from reading here and
elsewhere, is that no two people respond quite the same way to either
medicines or to treatment. Also, If you're not satisfied with how your
doctor responds to your questions and concerns, look for another doctor.
Some doctors are very good, but not for some patients. I have changed
doctors several times (in several specialties) for my self and my
father. We now have very good doctors who work with us and make sure we
understand the problems and treatments and who LISTEN to what we say.

There are many aspects of medicine which can't be defined by hard and
fast rules, so doctors make educated guesses, bases on training,
education and experience, and then adapt as needed. They also have to
take into account any medicines and treatments started by another doctor
for other reasons. I've had a few times when a doctor tole me that he
would prefer to use one medicine, but it was contra-indicated by another
problem. I also make sure that my doctors talk with one another
concerning my treatments. It's easier on me, quicker and much more
accurate than if I had to ferry messages up and back.

The other thing is to read up as much as you can and ASK YOU DOCTOR to
explain anything you're not sure of.

The best doctors are the ones who treat it as a team effort with you
being an important member of the team.
 
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