Methotrexate

VSSDot

Hello, Can anyone give me some help and advice? My OH is in the early stages of getting a definate diagnosis for some form of inflammatory arthritis - it's not confirmed yet as Rheumatoid, but that's the most likely label. He's been to the hospital clinic (and they were amazing), ad he was advised to start immediatley on Methotrexate.

He's very reluctant to take anything that going to supress his immune system - we're livestock farmers and the nature of the job involves quite a lot of contact with cow ****, soccasionally sick animals, handling live vaccines and generally working in what would by most be classed as a dirty environment. At the moment, he feels that if anything is going to stop him from doing stuff, he'd rather it was because it was painful than something that "might" make him ill.

Can anyone give me any advice? Is taking methotraxate going to make him really susceptible to bugs? Or are they medics just covering their backs?

dreamdaisy

Oh dear, this is a tricky one. Auto-immune inflammatory arthritis is caused by an over-active immune system reacting to no-one knows what and attacking the body. To reduce diesase activity, and to halt direct damage to joints and possibly organs, the immune system has to be suppressed which does leave one more susceptible to infections etc. Of course not taking the meds is an option but if you google rheumatoid damage the images that pop up are not reassuring.

There are around three hundred auto-immune inflammatory conditions, I was born with one (eczema) and developed another (asthma) when I was seven so for me taking the meds is no big deal but your joint situations are very different. I cannot see that as long as you are both assiduous with hand hygeine and take sensible precautions like the rest of us by avoiding unhealthy people why things wouldn't be OK: we have had other farmers on here in the past but very few people post nowadays, they get what they need and we never hear more. DD

stickywicket

I can see his dilemma but, as someone who was diagnosed with RA before modern DMARDS, I wouldn't hesitate to take the meds, take all necessary precautions and hope for the best.

As DD says, our immune systems need dampening down because they are overactive. That's why we have these autoimmune problems. we have become allergic to ourselves.

I was without modern DMARDS (only the old gold injections) and, twenty years in, my RA, which had started in my hands then moved on into ankles, feet and shoulders, had done so much damage that OA had also set in and I needed new knee joints.

My life became much better once I was started on methotrexate.

I take reasonable precautions. I use all the alcohol gels in hospitals and docs' surgeries where germs are rife and I keep antibac gel handy for other occasions. My family know not to visit if they have streaming colds. I get my flu jab in early every year and, before my husband retired and qualified in his own right, he was given one too for my protection.

My experience of farmers is that they can be a bit gung ho over germs. A friend's Dad was astonished in 1970 when we visited with our baby and the latter's bottle steriliser. I think Frank would have just wiped down a cow's teat and attached my 3 month old

Have a word with the rheumatologist next time you go there. I'm sure you won't be the first farmers to ask about sensible precautions. And good luck

stickywicket

P.S. Live vaccines? Ask about this too but live vaccines are a nono for us. Could you do them instead?

BettyMac

Hi VSSDot

I understand the dilemma. It’s not an easy thing to think ones way through.
The modern way to treat RA is to hit it hard, early, because it’s known that will prevent more damage in the long run.

Sorry if this sounds tough - but if it’s confirmed to be RA, then without the meds your husband may find that his ability to actually be a farmer is compromised.

When the joints are painful and being slowly damaged - and when the body is being wracked by inflammation, causing exhaustion and possible damage to organs - normal life is impossible.

I’m on a couple of Immuno-suppressants.
Yes, I’m more prone to infections if I’m not careful - but I feel I have good quality of life again.
Had I been given these meds ten years ago, I wouldn’t have had to retire prematurely.
When I was just on methotrexate on it’s own, I didn’t find too many problems with infections though, in theory, it does increase the risk.

I know dealing with livestock is a mucky business but there must be ways of reducing the risk of infections.

A relative’s partner is on the same meds as me. He’s a farmer too and although mainly arable, he does have a small number of cows, calves and pigs. I shall make some enquiries and come back to you if there’s anything relevant to report.

I also wonder if the NFU might have some advice to share?

Good luck with it all!
Your husband is lucky to have you in his corner.

MsP

Hello I am nearly 4 weeks into methotrexate & having disturbed sleep at night & feeling a bit low so just wondering if these could be side effects? Before my sleep was disturbed by pain but now it’s different & sometimes I wake with a start from a vivid dream or even feel delirious. I’ve been diagnosed with IA & unsure at this stage whether my improvement is still an effect of the steroid jab. I’m now up to 15mg but wondering if I might be able to drop back down to 10mg. Anyway, as long as I can get enough sleep everything is improving and I try not to complain.

dreamdaisy

Vivd dreams? Check. Disturbed sleep? Check. Waking tired and unrefreshed? Check. IA? I can't remember what that is.

In my case it's 23 years of arthritis (a few years of just psoriatic then osteoarthritis was diagnosed in 2011 so woo-hoo, I've donenthe double) and pain breakthrough. I attribute the dreams to the codeine part of my cocodamol tablets, which are required from time to time: dreams usually involve me doing things I have been unable to do for years and the pain breaks through as I no longer move naturally in my sleep, but the weirdy ones come after more cocdamol than usual. I also had the weirdies when when I was taking oral steroids. Steroid jabs did nothing to ease symptoms, neither does my meth or humira, they merely control disease activity and obvs. do nothing for the OA.

Life continues despite arthritis and there can be many reasons behind disturbed sleep. Stress is the most obvious, living with a chronic condition is bad enough but then factor in the demands of family, work, finances . . . . . I don't recall your current issue being listed as a meth side-effect but its been years since I read the leaflet. DD

stickywicket

Hello MsP. All meds and diseases affect us slightly differently. I've been on methotrexate for 20 years now and don't recall any particularly vivid dreams.

Please don't think of reducing the meth without checking it all out with your rheumatology helpline. You need the disease to be under control one way or another.

Other things can, potentially, cause vivid dreams. If you're taking strong pain relief, that can. High dose steroids once did it for me.

Have a word with a medical professional if it's bothering you.