So as I mentioned in my last blog, I had a check up with my consultant this week. I first saw her in August 2012 when I was diagnosed with arthritis, click here to read the post about my first meeting with my consultant. The plan was to get started on medication and to come back in three months to see how I was doing... Well five months later I finally got my appointment!
My expectations of how the appointment would go were nothing like what
actually happened! After being told by my rheumatology nurse that I was
improving nicely and therefore didn't need to see her anymore or have my blood
tested as regularly, I expected for the consultant to match this notion. Even
though in the back of my mind I felt like I was going downhill again and a lot
of my pain had returned, since the nurse was happy with my progress, I assumed
that I was just having a bit of a blip because of the snow and cold weather.
In actual fact, after being examined by my consultant, she told me that
since I still have so much swelling and pain in my joints, this is an
indication that my medication (Methotrexate) is not working properly. I was slightly confused
by this, as a few weeks ago I felt almost back to normal, but it turns out that
my steroids were masking the fact that my medication wasn't working. When I was
reducing my steroids, my medication should have stepped in its place, but
instead I have just got progressively worse.
The consultant also asked if I had any rashes on my body. I told her about a
small rash that had started on my elbow and had appeared up my right forearm
over the past week, but it was only minor and I didn’t have it anywhere else.
(It turns out that I also had it on my other elbow, but couldn’t see it) My consultant believes that this is the start of psoriasis, and therefore I probably have Psoriatic arthritis.
About 1 in 10 people with psoriasis develops psoriatic arthritis and in most cases, the arthritis develops after the psoriasis. However, in a small number of cases the arthritis develops first, sometimes months or even years before the psoriasis develops. Trust me to be the minority!
This also highlights the fact that my medication isn't working because if it was, it would have stopped the psorasis from a developing. In a way, this is a good thing because it means I can have a firmer diagnosis of the type of rheumatoid arthritis and get the most accurate treatment, but at the same time I'd rather have nice skin. Although, at least I only have very small patches of it at the moment.
So the new plan is I have had my dose of Methotrexate increased to 8 pills, and will continue with this dose for the time being. I will have to go back to see my rheumatologist nurse in 6 weeks to see how I'm doing. If it looks like I'm still not getting better than this means that I am just not absorbing enough of the Methotrexate for it to work and therefore I will have to start injecting myself with it.
So I'm hoping that the increased dose gets to work ASAP!