Missing a second week of MTX?

Starburst

Good morning,

I'm having a rough ole ride at the moment. I've had terrible mouth ulcers which led to me eating mushy food for a week, so I missed one week's dose of MTX. I know that's ok to do because the rheum nurse has told me it's fine. The original ulcers are now healed but a couple more have appeared as has a cold, sore throat and a nasty cough. There are no drs or nurses in my rheum clinic today and my GP said he doesn't know if I should skip another dose or not! Any advice on what I can do next? I'm loathe to inject on sunday because my immune system is so low but I'm also in a flare too and aware that repeatedly missing doses is not good.

I know you guys can't give medical advice but I'm a bit lost and wondered if someone could suggest someone who might be able to?

Thank you!

stickywicket

Mm, not an easy decision. I've dropped my meth (tablets) for weeks before an op but I wasn't in a flare at the time. I don't think there's a problem with dropping them then taking them up again as I've done it. (I was once on a med where you couldn't.) I think it's probably just a matter of which will be worse for you, the ulcers or the joints. My gut feeling would be to leave the meth for another week if you feel able to. A rubbishy choice to have to make. Sorry.

dreamdaisy

Ah, I've been there and happily dropped it for another week. Things are obviously not right with you at the moment Starburst, you poor thing, and if I were in your shoes I would give my body a chance to heal, flare or no flare. I agree with sticky, it is a very hard choice and only you can make it. I wish you well. DD

Colin1

Hey Starburst thats not an easy one and i have been there on more than one occation. when you start MTX they tell you it takes time to get into your system and work, perhaps 12 weeks. So it must still be in your sytem now, But hey i'm no doc. Its awful when your torn between whats best, if it where me i would miss out The MTX again and contact the Rheumy nurse on Monday.
Colin

theresa4

Hi
Ive had to drop mine for 4 weeks once when I had a nasty chest infection, I often miss a week due to one illness or another and sometimes that stretches to 2 (usually 1 a month) true my RA gets much worse when I havent had it for 2 or more weeks but its not worth getting worse. Personally I would leave it another week and speak to your rheumy nurse monday to discuss the problem and what you need to do in future.

Good luck and I hope you feel better soon

Theresa x

phoenixoxo

Hi Starburst,

Sorry you're having such a tough time. I'm a bit surprised at your GP's (non-)reaction to this. I'm on immunosuppressive treatment too and my doc has always encouraged me to contact the surgery if I develop a sore throat, as it may well indicate an infection that requires close monitoring. I don't need to speak with him about it, but I organise a district nurse visit for blood tests asap and in the meantime I keep off the meds.

If you're still feeling uncertain, perhaps there's an out-of-hours service available? If not, I'm with the others: take Sunday off and give the nurse a ring on Monday.

Hope you feel better soon,
Phoebe

ritwren

Hi there Starburst, I'm so sorry to hear you're having such a rough time of it. Have you been on the MTX for long? For the sake of 1 day I'd forgo tomorrows dose and ring the rhumy nurse first thing on monday. If she says to go ahead, you can change your giving day to mondays instead of sundays and you won't miss a dose this week at all.
There has been talk about GP's taking over the majority of care for people with Arthur due to the rising numbers of patients waiting on appointments and follow up's. My Consultant was telling me about it the other week when I went to visit. What's happened with you is a good example of what can happen if this is the case. Either lack of experience or lack of knowledge means they cannot make a decision. :roll:
I hope your flare and your poor mouth ease soon for you. Do let us know how you get on.
Rita.

Starburst

Sorry I didn't reply sooner. I'd taken to my sick bed *cue lots of complaining* but thankfully it has done the trick and I am feeling much sparkier today if not still a little snotty. I'm waiting to hear back from my rheumy nurse but I'm pretty sure I'll take my weekly dose today.

As for the GP, well he did look very young and he is new to the surgery so I could partially forgive him. Our surgery has a designated GP who apparently deals with all the MTX patients but she only works part-time. I am seeing her tomorrow and I will bring it up to ensure I'm not left wondering again.

I have thought long and hard about asking to have the MTX dose reduced but 20mg (or whatever it is in injected terms) is the only dose that has given me a semi-decent quality of life. I've tried other drugs too but this is the best. So, I will solider on and try not to complain too much!

Thank you for your wise words and for taking the time to reply. I'm now in stress mode as I have an important uni deadline next week and I'm a bit behind but I will be back soon! xx (Incidentally, if you see me on here, please tell me off and send me back to the books!)

barbara12

Hi Starburst
Sorry I cant offer any advice, but I just want to wish you well, and hope your mouth clears up very soon.xx

stickywicket

You sound as if you're now coming out the other side of this particular nasty episode, Starburst, and I do hope so.

Now, get back to your books, Oh Snotty One

phoenixoxo

Hi Starburst,

That's great, you're feeling a bit better; and that's a very good idea to chat with the MTX doc to make sure you're not left in the lurch again.

Best of luck with the uni deadline!
Phoebe