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Finally diagnosed..........

SaltdogSaltdog Posts: 30
edited 1. Aug 2015, 12:54 in Living with Arthritis archive
Well, I had yet another appointment with the rheumatologist yesterday and he's finally admitted that my varying symptoms are related. Finally!!! Last time I saw him he was convinced my foot pain was in no way related to my shoulder pain.

He's diagnosed me with Psoriatic Arthritis even though I have no recollection of ever having psoriasis. I'll take his word for it though. Funnily enough, he's given me a choice of medication and given me leaflets for both telling me to think about it before letting my GP know which one I'd prefer. I've been offered Sulphasalazine or Methotrexate. I've looked in to both and am leaning towards the lesser evil seeming side effects of the Sulphasalazine. I'm willing to listen to advice or people's experiences of both though.



  • barbara12barbara12 Posts: 20,868
    edited 30. Nov -1, 00:00
    Hello Kev
    Finally ..sometimes this is all we want..some answers..sorry I cant help with the meds but lots of people take the same on here...I am still waiting for them to make there minds up about me..I have had 2 things diagnosied or is it 3 :? I lose count but they cant agree ..good luck with the meds and I hope they bring lots of releif..
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    In the not-so-wonderful world of arthritis a diagnosis is always better than no diagnosis. To be honest, the particular 'flavour' doesn't matter compared with no diagnosis as the meds are virtually the same.

    Meth and sulph are the most common starting meds. I've no experience of sulph but I've taken meth, very successfully, for about 15 years now.

    I have RA. My impression (and it's only an impression) from reading on here is that meth is more usually offered for RA and sulph for PsA. I could be completely wrong about that and I know others have said they were offered a choice. I guess it's one of those situations where choice isn't particularly envious. Tweedledum or Tweedledee. Maybe people tend to be happier with their meds if they feel they've had some say in them.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • DebraKellyDebraKelly Posts: 398
    edited 30. Nov -1, 00:00
    I have been on Meth for years. (I have RA)
    It is an amazing drug and has always worked for me.

    You will get side effects with both drugs, but these should stop has your body adjusts to taking them.

    Sulpha didn't do anything for me at all, but we are all different.

    If you start on a serious drug like Meth or Sulpa, I would suggest starting a medical diary, that way you can track how you are feeling each week.
    The GP will find this very useful.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    I have PsA with very little in the way of psoriasis. I take both sulph and meth and I think these are the meds that keep my skin relatively clear. I have a friend who has PsA and his is wonderfully controlled by just four sulph per day, no skin trouble and no joint damage - I hope you'll be in his gang!

    As sulph is a DMARD you would be wise to arrange for a 'flu jab this autumn. DMARDs suppress our immune systems (to reduce disease activity) so we are more prone to infections. I am an assiduous hand-washer and steer clear of those with coughs, colds, bugs etc. I have enough on my plate without being properly ill too! I remember that when I began the tablets (it's a phased increase over four weeks) I reacted by bruising very easily. That eased after a while but I still bruise at the slightest knock. Others have headaches, some nausea but side effects are not guaranteed. I had to have fortnightly bloods for some time after I began the tablets.

    Good luck, I hope sulph proves to be the one for you. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • slomoslomo Posts: 180
    edited 30. Nov -1, 00:00
    Hi Kev,

    Do I say Congatulations on the diagnosis or is that just being silly?!
    Seriously, though, it's good to know what you're up against. My rheumatologist was keen to find out which label to give me so we could get on with treating it. I'm on methotrexate and fingers crossed it's going ok but as you might remember, I've only been diagnosed 3wks ago so very early days yet. I'm still getting weekly blood tests and have a review appt with my GP on Monday.
    My GP phoned me with the diagnosis and I was trying to write down what he was saying as I seem to get a better grasp of things when I can see them written down. Anyway before my brain could get into gear, my mouth suddenly asked for a copy of the notes. My poor GP almost squeaked that it was 10pages long, but when I went to collect my prescription I found that he had indeed printed the whole lot out for me! The things is, it's our notes and we're entitled to see them.
    I found it helpful to sit quietly and have a good look at them. The blood test results take a bit to understand but my x-ray and scan results were in plain English. Also, (pause while I wonder if you're the same health board as me. You've been to ARI so you could be) the last pages of the notes give details in plain English about who is responsible for what, so I should never be caught between the GP and the rheumatologist with each saying the other is responsible for dealing with something 'cos I've a copy of who's responsible for what! Could be handy to have.

    hope you can getting started on a course of treatment soon and that it works well for you.
  • SaltdogSaltdog Posts: 30
    edited 30. Nov -1, 00:00
    Thank you all for the lovely responses. It's great to know a place where I can come and find advice and support. I don't know anyone else personally who has any type of r thirties so this is invaluable to me.

    I'm currently on holiday so I've got some time to think through which option I'm going to go for. I don't suppose it's a case of the best option. More like the least bad. At the end of the day, there's no guarantee my first choice will work. As my wife and I still enjoy entertaining and eating out I'm liking the idea that I can still have a wee wine with Sulph. If I have to take meth and give up drinking it's not the end of the world though.

    I'm afraid I have no option to keep away from bugs DD as I have two young children who love to share everything. Not sure about the flu jab. I've never had flu and have heard bad stories about the jab. I'll take the advice if my doctor though.

    Slomo, although I have used ARI and have indeed been involved with that particular health board, that's only because my local one isn't able to cope with the more complicated conditions and treatments so send us there on occasion.

    Thanks again folks. It's good to know the support is out there.

  • tkachevtkachev Posts: 8,332
    edited 30. Nov -1, 00:00
    I started on sulfa and it was my first RA related medication and it worked brilliantly for 3 months then my symptoms gradually returned. I'm still on it over 10 years later and not sure if it does me any good as I've often had spells without it and haven't noticed much difference. The rheummy seems happy for me to continue on it.

    I hated mtx because of the nausea. The dose was regularly increased as it wasn't working well enough. But everyone is different and it is considered to be a success in fighting arthritis symptoms. I've heard medical staff say it is best to get onto mtx without delay.

    It was the next medication that really worked for me-Humira- but I was only given this after MTX failed to make a noticeable improvement.

    I have RA and osteo.

    Never be bullied into silence.
    Never allow yourself to be made a victim.
    Accept no ones definition of your life

    Define yourself........

    Harvey Fierstein
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    Saltdog wrote:
    As my wife and I still enjoy entertaining and eating out I'm liking the idea that I can still have a wee wine with Sulph. If I have to take meth and give up drinking it's not the end of the world though.

    I think the USA is more stringent than we are re meth and alcohol. Certainly one should give it up while getting established on meth to be sure the liver's coping well but, after that, many of us enjoy the odd glass. Here's what Arthritis Research UK say about it:

    You should only drink alcohol in small amounts. It's recommended that you keep well within national guidelines (2–3 units per day for women and 3–4 units per day for men). In some cases your doctor may advise even less (e.g. no more than 4 units per week). This is because methotrexate and alcohol can interact and may damage your liver. You should discuss this with your doctor.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Kev, you are more than welcome to the support, we've all been there, done that, have asked similar questions and understand how confusing it can all be.

    I have lost count of the years that I have had the 'flu jab but it must be nigh on thirty (I began pre-arthritis days thanks to chronic asthma). Problems with it? None. 'Flu? Never.

    I was a private tutor for dyslexics for many years and had a steady stream of junior germ factories, of varying ages, plodding through my front door. I rejected one pupil who threw up on the doorstep, but everyone else rapidly adjusted to the squirt of hand gel on arrival, after every sneeze and cough and visit to my lavatory. Their parents also learned to ring me to say 'He's off school so probably no lesson this week?' Yup. My husband has become an assiduous handwasher (he still works and mixes with far more people than myself) and so far so good.

    The problem we face is that, due to the suppression of our immune system, we don't produce symptoms until something has gotten a proper hold, this is why we have to be so careful. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
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