Synovial Syntax

Treatment history

Treatment started September 2008 with a whacking depot steroid injection which provided great relief from joint pain for about 5 weeks. Methotrexate (a cyctotoxic antimetabolite) was added once bloods and chest cleared for OK. I reached 15mg as a weekly dose before spending 3 weeks having a nausea and vomiting crisis. It was dropped back to 10mg while I removed gluten from my diet. It has increased in stages again to 15mg but I’m feeling well rough on that. After enduring it for a couple of months, that’s now back down to 12.5mg, which gives just a day of nausea and about a 1:4 chance of upchucking the next day.

The aminosalicylate Sulphasalazine was added in Febrary, rising swiftly to 1.5g per day. Everything I secrete was on the yellow colour spectrum and I had to fight hard against the mood lowering effects and nausea. I stopped taking this on consultant recommendation in July 2009.

I passed my assessement as per NICE guidelines for anti-TNF in July 2009, and commence taking 40mg every 2/52 in Septmember 2009, as soon as someone signs me off as proficient at doing the jabs. Looks very easy, have itchy fingers as they sit waiting in the fridge…

And oh boy, does Humira work for me! I’ve had a nearly ten doses by Jan 2010, and am on the whole up and fighting fit. Lucky, lucky, lucky.

Less lucky during late winter/spring 2010 as I’m felled for lengthy periods of times by new bugs at boy’s new school. Can’t take Humira/Methotrexate so often, and flare, better once summer comes in and I acclimatise to their mini-bug culture.

Get stable again on Humira in April and seem so well we try reducing MTX, but up I flare. Have to stay on 15mg, is fine, no real side effects.

Co-codamol is mostly effective against most pain so far in that it allows me to get to sleep and care for the kids, but never removes the pain entirely. Voltarol against inflammation doesn’t seem to make any difference, but I take it in case things are worse without it. I think it contributes to the nausea. Tramadol was excellent during the worst of the TMJ times, but the hangovers, oh my. Still, I also occassionally took a tot of the hard stuff in the depths of the night to tip me away from being stuck in pain. But not much, not often.

Tramadol in hefty doses also needed during shoulder injury in Spring 2010. Was sure I’d be addicted by time I stopped, but apart from a couple of days headache, coming off it is easy and a pleasure of increased clarity of mind.

Switched to injectable MTX January 2011, nausea begone! Success!


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