Pain

[Guest guest]

Sherrie,

If you are in that much pain and your PCP/Rheumy/anyone with an MD

cannot see you, please consider the following:

You have a right to be as pain free as possible.

On days that the pain is really bad and you cannot even move, please

consider an emergency room visit (if possible...) to a teaching

hospital. The ER docs at these teaching hospitals see a wide variety

of patients all the time and have the ability to prescribe pain

relief that your PCP/rheumy may not even think about. Teaching

hospitals also have the advantage of having interns that are fresh

out of school. This results in off-the-wall ideas for treatment

that become regular treatment modalities down the road (i.e., " I

read somewhere that this works... " to which an attending will

say, " Make it work for this patient, please " ).

My thoughts and prayers are with you as you struggle with this

problem. As winter progresses, pain seems to be an inevitable

thing. It doesn't have to be....be safe this year.

Love and gentle hugs,

Cait

[Guest guest]

Hi,

I am Gloria and I am 49. I would talk to my rheumy about stronger pain meds. The enbrel will help after a while, but I think that you need a stronger pain med to get you through the bad days. I also take paxil for depression since being diagnosed.

I am on humira injections 1x per week. I have had such an allergy problem (not to the humira) that I have had to go to an even stronger pain med to get me through the rough days. I take 10mg hydrocodone 4x daily and I take 2 at a time. I also take a low mg. morphine for the really bad flares.

I hope that this helps. Call your rheumy and make an appt. to just discuss all of your options. Make sure to tell the doc about the pain, and that the meds are not helping.

Hugs from OK. Gloria>> I am 43y/o with Ra, on Enbrel and still in pain. I take Ultram and> Neurotin, but my joints still ache. I am very active and outgoing, but> the pain makes me depressed! Please let me know either a better pain> medication idea or other recommendations for my situation.> Thank you!>

[Guest guest]

Being on an anti depressant is a good idea always. Try low dose prednisone, ibuprofen or a bit of darvocet to help you sleep at night, prednisone during the day. Start at 1mg for a week and then add a milligram a week until you feel improvement. Eat a healthy diet with lean protein lots of veggies and fruit. Hugs, Deborah

On 4/20/07, girly_girlteacher <paulajo0613@...> wrote:

I am 43y/o with Ra, on Enbrel and still in pain. I take Ultram andNeurotin, but my joints still ache. I am very active and outgoing, butthe pain makes me depressed! Please let me know either a better painmedication idea or other recommendations for my situation.

Thank you!

[Guest guest]

Hi girly , How long have you been DXed with RA & been on embrol ? I'm 42 been DXed since 04 on remicaid once emborl for going on 6 months now Ultram for years Topamax for years allso and Loratab for bad times allso predisone two others haveing to stop MTX since the RA had effected my lungs . and I am still in a lot of pain allso so the only thing I can remember helping me much more I can no longer get the best being Bextra , the other being Motrin 800 mg tabs x2 @ a time . but still it was not a great deal of releif . If you are not on a plan for maintince meds to keep the pain from gettig bad before trying to claim it down then bad

again repeating a viousious cycle over and over you may wat to talk with your dr aboult this ? It is how they keep it bearable for me but my neroologist is the one who does it for me . If you wish to talk try my email if I don't see it in the group . ----- Original Message ----From: girly_girlteacher <paulajo0613@...>Rheumatoid Arthritis Sent: Friday, April 20, 2007 8:29:30 PMSubject: Pain

I am 43y/o with Ra, on Enbrel and still in pain. I take Ultram and

Neurotin, but my joints still ache. I am very active and outgoing, but

the pain makes me depressed! Please let me know either a better pain

medication idea or other recommendations for my situation.

Thank you!

8:00? 8:25? 8:40? Find a flick in no time with the Search movie showtime shortcut.

[Guest guest]

Pain

Pain (any pain -- emotional, physical, mental) has a message. Theinformation it has about our life can be remarkably specific, but itusually falls into one of two categories:"We would be more alive if we did more of this," and, "Life would bemore lovely if we did less of that."Once we get the pain's message, and follow its advice, the pain goesaway.~ Mc, Life 101

[Guest guest]

I don’t recognize anything you are

taking that I consider to be a real RA medication. With RA or a related

type of inflammatory arthritis it is important to get prompt and aggressive

treatment so you reduce the risk of permanent joint damage. You really

should be seen by a board-certified rheumatologist because few other doctors

are really qualified to diagnose or treat RA. In fact, I wonder about

some who are actually board-certified so if you aren’t being helped I

suggest a second opinion.

There are over 100 kinds of inflammatory

arthritis, and RA is the most common. However, with spine involvement I

do wonder about possible Ankylosing Spondylitis that is treated similarly to RA

but with some differences. It is also possible to have more than one kind

of arthritis.

The most common starting medication for RA

or related problems is Methotrexate, but Plaquenil and/or Sulfasalazine are

sometimes used for milder symptoms. Along with Methotrexate it is

important to take Folic Acid to maintain the needed vitamin and to combat some

of the side effects of Methotrexate. Arava is similar in effectiveness to

Methotrexate but generally more expensive. The next step up is a biologic

but these are a lot more expensive and most insurance will not cover them

unless the less expensive treatments have been shown to be ineffective for

you. All cases seem to be different so you and your doctor will have to

cooperate to find out what will work for you.

Another medication that usually works

pretty quickly on the symptoms of RA is Prednisone (a corticosteroid but not

like the anabolic steroids athletes use). It does a little to slow joint

damage but it is less effective than many other RA medications. Also it

has some bad side effects, especially if used in high concentrations for long

times. What we call a ”Pred Pack” might be useful. It

starts at a moderate dose and uses decreasing doses each day for a week or

two. If it helps initially and then as the dosage decreases the pain

comes back this is a strong indication that you do indeed have an inflammatory

problem that could be RA (or hundreds of other things.) It may help with

diagnosis and also help to evaluate the severity of your disease. I

started with 40 mg Prednisone daily to allow me to hobble to the bathroom and as

I started real RA medicines I cut down on the Prednisone. It took me

about a year to get completely off it but now I’m pretty well controlled

with Methotrexate and Remicade (a biologic).

I hope you get effective treatment for

your problems. God bless.

From: Rheumatoid Arthritis [mailto:Rheumatoid Arthritis ] On Behalf Of hazel

Sent: Wednesday, March 19, 2008

2:05 AM

Rheumatoid Arthritis

Subject:

[sPAM] pain

Hi im 38, Ive had back problems all my life but only

reciently been

diagnosed with RA.

I had an x-ray to conferm.

I take Devils Claw i also have Voltaren 3 times a day it's a gel as im

illergic to brofen.

The doctor has also given me Dihydrocodine x2 every 6hours so im a bit

spaced out but the pain is still there.

I have RA in my spine & pelvis it's very painful i can hardly walk or

dress myself most of the time.

Im all new to this RA, is there anyone that can give me advice i hate

being spaced out as i have a 9 year old daughter who's my Angel she

helps me in so many ways with getting dressed etc... she should have a

medal.

Hazel.T

[Guest guest]

>

> I don't recognize anything you are taking that I consider to be a

real RA

> medication. With RA or a related type of inflammatory arthritis it

is

> important to get prompt and aggressive treatment so you reduce the

risk of

> permanent joint damage. You really should be seen by a board-

certified

> rheumatologist because few other doctors are really qualified to

diagnose or

> treat RA. In fact, I wonder about some who are actually board-

certified so

> if you aren't being helped I suggest a second opinion.

>

>

>

> There are over 100 kinds of inflammatory arthritis, and RA is the

most

> common. However, with spine involvement I do wonder about possible

> Ankylosing Spondylitis that is treated similarly to RA but with some

> differences. It is also possible to have more than one kind of

arthritis.

>

>

>

> The most common starting medication for RA or related problems is

> Methotrexate, but Plaquenil and/or Sulfasalazine are sometimes used

for

> milder symptoms. Along with Methotrexate it is important to take

Folic Acid

> to maintain the needed vitamin and to combat some of the side

effects of

> Methotrexate. Arava is similar in effectiveness to Methotrexate but

> generally more expensive. The next step up is a biologic but these

are a

> lot more expensive and most insurance will not cover them unless

the less

> expensive treatments have been shown to be ineffective for you.

All cases

> seem to be different so you and your doctor will have to cooperate

to find

> out what will work for you.

>

>

>

> Another medication that usually works pretty quickly on the

symptoms of RA

> is Prednisone (a corticosteroid but not like the anabolic steroids

athletes

> use). It does a little to slow joint damage but it is less

effective than

> many other RA medications. Also it has some bad side effects,

especially if

> used in high concentrations for long times. What we call a " Pred

Pack "

> might be useful. It starts at a moderate dose and uses decreasing

doses

> each day for a week or two. If it helps initially and then as the

dosage

> decreases the pain comes back this is a strong indication that you

do indeed

> have an inflammatory problem that could be RA (or hundreds of other

things.)

> It may help with diagnosis and also help to evaluate the severity

of your

> disease. I started with 40 mg Prednisone daily to allow me to

hobble to the

> bathroom and as I started real RA medicines I cut down on the

Prednisone.

> It took me about a year to get completely off it but now I'm pretty

well

> controlled with Methotrexate and Remicade (a biologic).

>

>

>

> I hope you get effective treatment for your problems. God bless.

>

>

>

> _____

>

> From: Rheumatoid Arthritis

> [mailto:Rheumatoid Arthritis ] On Behalf Of hazel

> Sent: Wednesday, March 19, 2008 2:05 AM

> Rheumatoid Arthritis

> Subject: [sPAM] pain

>

>

>

> Hi im 38, Ive had back problems all my life but only reciently been

> diagnosed with RA.

> I had an x-ray to conferm.

> I take Devils Claw i also have Voltaren 3 times a day it's a gel as

im

> illergic to brofen.

> The doctor has also given me Dihydrocodine x2 every 6hours so im a

bit

> spaced out but the pain is still there.

> I have RA in my spine & pelvis it's very painful i can hardly walk

or

> dress myself most of the time.

> Im all new to this RA, is there anyone that can give me advice i

hate

> being spaced out as i have a 9 year old daughter who's my Angel she

> helps me in so many ways with getting dressed etc... she should

have a

> medal.

> Hazel.T

>

Hi, ive been to see the doctor & im now taking Misofenac Arthrotec

diclofenac/misoprostol, the doctor is going to look at my medical &

xray resaults as in new to the surgery.

Is there any major problems with this medcuation?

Hazel

[Guest guest]

Dear Hazel- It sounds like you have anklynspondilitis which is RA of the spine. I know someone who has this disease but because he did not use an aggressive proactive approach is in a wheelchair and diabetic. RA of the spine and hip is the most debilitating because it is the entire weight bearing area and the spine is essential to movement. You are on pain medication only. You need to be on something that will impede or interfere with the inflammatory process. This requires a biologic. A biologic will interfere with the inflammation cascade by targeting a certain cell that it can attach itself to called a TNF receptor. It biologically interferes with the RA process itself. Your white blood cells are attacking your hip and back joints. This has caused erosion in those bones and it very very serious. I dont know how bad the erosion is but having RA might make the damage even worse. I would see a specialist in Rheumatology if you have not already. A bone scan will help. Taking a bone builder like actonel might also help. Go to www.arthritisfoundation.org for support groups and referrals in your area. They are huge on education of your condition. If the erosion is very severe then being on something to stop the RA from doing further damage is essential and possible joint replacement is a consideration. Unfortunately RA is a very aggressive disease and very destructive. Only with proactive and serious treatment can you begin to build your quality of life back to a place where you can live with less pain. You should also realize that having a bad back all your life may have been RA all along. Many times as with many people, doctors pass this off as a back only problem when the root is an auto immune disease such as RA. See a Rheumatologist straight away and get on some truly effective medications. Get a bone scan in addition to X-rays. yours, Deborah. RA since 1994.

On Wed, Mar 19, 2008 at 6:05 AM, hazel <hazel.todd@...> wrote:

Hi im 38, Ive had back problems all my life but only reciently been diagnosed with RA.I had an x-ray to conferm.I take Devils Claw i also have Voltaren 3 times a day it's a gel as im illergic to brofen.

The doctor has also given me Dihydrocodine x2 every 6hours so im a bit spaced out but the pain is still there.I have RA in my spine & pelvis it's very painful i can hardly walk or dress myself most of the time.

Im all new to this RA, is there anyone that can give me advice i hate being spaced out as i have a 9 year old daughter who's my Angel she helps me in so many ways with getting dressed etc... she should have a

medal.Hazel.T

[Guest guest]

Yes Hazel , you need a Rheumatologist right away , without the proper meds it will cause all kinds of problems with your body . As RAs favorite place to attack your body is in your SI joints so your pelvis maybe the area , RA doesn't favor the spine form what I'm told but as Deborah said Anklynspondilitis causes all kinds of serious issues such as spinal disc fusing together . So this is something that doesn't need to be treated by just a family Dr or General Dr . it's way more serious than that . ----- Original Message ----From: Deborah Bargad <dbargad@...>Rheumatoid Arthritis Sent: Friday, March 28, 2008 3:33:19 PMSubject: Re: pain

Dear Hazel- It sounds like you have anklynspondilitis which is RA of the spine. I know someone who has this disease but because he did not use an aggressive proactive approach is in a wheelchair and diabetic. RA of the spine and hip is the most debilitating because it is the entire weight bearing area and the spine is essential to movement. You are on pain medication only. You need to be on something that will impede or interfere with the inflammatory process. This requires a biologic. A biologic will interfere with the inflammation cascade by targeting a certain cell that it can attach itself to called a TNF receptor. It biologically interferes with the RA process itself. Your white blood cells are attacking your hip and back joints. This has caused erosion in those bones and it very very serious. I dont know how bad the erosion is but having RA might make the damage

even worse. I would see a specialist in Rheumatology if you have not already. A bone scan will help. Taking a bone builder like actonel might also help. Go to www.arthritisfounda tion.org for support groups and referrals in your area. They are huge on education of your condition. If the erosion is very severe then being on something to stop the RA from doing further damage is essential and possible joint replacement is a consideration. Unfortunately RA is a very aggressive disease and very destructive. Only with proactive and serious treatment can you begin to build your quality of life back to a place where you can live with less pain. You should also realize that having a bad back all your life may have been RA all along. Many times as with many people, doctors pass this off as a back only problem when the root is

an auto immune disease such as RA. See a Rheumatologist straight away and get on some truly effective medications. Get a bone scan in addition to X-rays. yours, Deborah. RA since 1994.

On Wed, Mar 19, 2008 at 6:05 AM, hazel <hazel.todd (DOT) com> wrote:

Hi im 38, Ive had back problems all my life but only reciently been diagnosed with RA.I had an x-ray to conferm.I take Devils Claw i also have Voltaren 3 times a day it's a gel as im illergic to brofen.

The doctor has also given me Dihydrocodine x2 every 6hours so im a bit spaced out but the pain is still there.I have RA in my spine & pelvis it's very painful i can hardly walk or dress myself most of the time.

Im all new to this RA, is there anyone that can give me advice i hate being spaced out as i have a 9 year old daughter who's my Angel she helps me in so many ways with getting dressed etc... she should have a

medal.Hazel.T

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