Medications

I was DX with rheumatoid arthritis about a year ago when I was refered to a Rheumatologist by my family doc for pain I was having in my hands, wrists and feet in the mornings lasting for a few hours. It had been getting worse over the past two years and some of my fingers were beginning to deform. I also have OA in both knees. Also, I am a 49 year old male with many years of abuse on my knees resulting in the OA.

For the past year I have been on 400 mg of Celebrex, 400mg of plaquenil and 10/1000 mg of hydrocodone at night so I can sleep. Even with the hydrocodone I only get about 4 hours of sleep before the pain in my knees start in and wakes me up. He had me try a higher dose of the hydrocodone (2 of the 7.5/325 mg) plus I started splitting my Celebrex and was taking 200 mg at night, no change so I went back to the lower dosage of Hydrocodone.

Any suggestions out there on what else I might want to discuss with my Rheumatologist that may be a better solution, I can't go on like this and I don't want any more narcotics.

Thanks,

Jon

[NewLeaf]

Methotrexate is a good first line drug for RA it is taken once a week and takes about 6 weeks to really feel a difference. Fot the OA, that's a different ball game. Have you tried any of the asprin creams? Sounds old fashioned but can work well. My RA doctor also showed me how to make a topical cream using diclofeniac which is too hard on the stomach and it works better but you need a prescription for the diclofeniac, soak about 24 pills (15mg) in just enough water to cover them and soften them overnight then mix the soft pills in a mini blender with your favorite cream. No joke, it is a good topical pain reliever without having to take addictive hydrocodone.  

If the methotrexate doesnt help the RA you may have to add one of the newer TNF inhibitor drugs which work well too but are very costly.

Hope you feel better soon.

[erijon]

I did have a prescription for methotrexate and diclofeniac along with the Celebrex, we tried all three but found the Celebrex worked better so I stuck with that. I have some diclofeniac left and maybe I'll give the cream idea a try. Anything has got to be better than living like this everyday.

Thanks,

Jon

[NewLeaf]

Methotrexate works completely differently than celebrex ar antinflamatories. It works inside your cells and makes certain"gates" smaller so the cells that like to cause inflamation (inflammation) cannot get into the joint areas. That's a really basic description but it does take about 6 weeks or so for the methotrexate to really be noticed. Also, if you are a big guy maybe the dosage was too small, usually doctors start out at 8.5 mg and if it is not effective enough can go up as high as 25 mg per week. I have had RA for over 25 years and managing this disease can be tricky sometimes.

Good luck, Oh, just checked the mg on the diclofeniac and they are 50mg pills, not 15. The cream gets better after is sits as a cream for a few days (less grainy) and you really do need to use a mini blender to get it really fine with the cream. I just lather it on during the clean up tho. ;-) cause it is kinda messy. My husband puts it on my whole back, shoulders and any other place that is buggin me and in about 15 minutes I am feeling so much better. It also lasts quite a long time and helps me get to sleep.