Tag: methotrexate

Monday, July 19th, 2010

Misdiagnosed with Rheumatoid Arthritis (RA): My Lyme Disease Story

As some of you may have heard, I just recently found that I was misdiagnosed with rheumatoid arthritis (RA). I have Lyme Disease.

Anyone who has followed this blog probably knows that I thought that I had Rheumatoid Arthritis (RA) for over 9 years. I have always had some doubt about what was going on with my body and the effectiveness of the treatments the doctors were prescribing. But I trusted my doctors more than I trusted my instincts. My story is a cautionary tale for anyone who has been diagnosed with an autoimmune disease.

Let me start by saying that we live in rural Rhode Island. We have a small 3/4 acre wooded lot. All sorts of wild life can be found in our yard at any given time and there is no shortage of deer that visit our property. We moved out here to raise our family in a quiet, serene place with good schools and friendly neighbors. Unfortunately, with the good comes the bad, and the deer carry ticks that carry Lyme Disease.

Each member of my family at one time or another has had Lyme Disease. It is not uncommon to be outside for only a few moments and pick up one of the poppy seed-sized ticks. For the most part we have all either tested positive with Lyme Disease or the tick if we were able to keep it tested positive with the disease.

9 years ago I had been bitten by a tick. At the time, I was tending to my newborn son, and had two older boys to watch over as well. In prior exposures to the disease, I had felt “flu like symptoms” and that was my cue to get tested. I don’t know if it was adjusting to three boys and 2 jobs or if I was just too busy to notice, but I really don’t remember any “flu like symptoms”.

It started with my ankle. It hurt and was swollen so I went to the urgent care center where they X-rayed it and told me they could find nothing wrong with me. The doctor prescribed an anti-inflammatory and gave me and air-cast. We were going with the assumption that I must have sprained my ankle even though I couldn’t remember doing anything out of the ordinary.

The swelling did eventually go down on my ankle but shortly after my knee on the opposite side started swelling. Ice, rest, and ibuprofen seemed to help with the swelling in my knee. Then, my wrist on my left hand began to swell. My husband and I were discussing the weird joint issues I had had over the previous few months when he suggested that I go get a Lyme test. I thought that it couldn’t hurt, so off I went back to urgent care for a Lyme test. The Lyme test came back positive and the doctor gave me zythromax.

Unfortunately I did not get better after taking the antibiotics, so I went back to the same doctor who gave me another course of the same antibiotic. When after finishing the second course of medication and I was not improving, the doctor said to me that this was beyond his level of expertise and I needed to see either an infectious disease specialist or a rheumatologist. He felt that I should start with a rheumatologist because if it was Lyme or something joint related a rheumatologist would be the best choice. He gave me the name of a rheumatologist and sent me on my way.

The rheumatologist seemed nice; he listened to my story and took a medical history. It may be my perception of what happened next, but it seemed to me that the minute he heard that my mother had rheumatoid arthritis (RA) his mind was made up. He told me that more than likely it was RA. He examined me and put me on prednisone immediately. When I asked about the Lyme he said that it was very unlikely that I had Lyme and that he was fairly certain it was RA. He told me the steroids should get the inflammation under control and ordered some blood work.

The blood work came back and showed that I was positive for RA. What I did not know then that I know now is that an active infection like Lyme Disease can affect the test results for RA.  He gave me a prescription for methotrexate, talked to me about Enbrel, and sent me home with a handful of pamphlets.

To be completely honest, I never felt comfortable with the diagnosis, but I somehow talked myself out of trusting my instincts by comparing his knowledge on the subject with mine. His practice was a teaching practice with Brown Medical School and I felt like he should know more than me on the subject. I really trusted that he knew what he was talking about. I have beat myself up for not going with my gut many times over the years on this topic.

Over the next several years I just seemed to get worse. Every time I brought up the fact that I was not really improving he would tell  me that the first several years with the disease are the worse, when the most damage occurs and that we needed to increase the medication. For a while he really had me scared. He would say things like “We don’t want to see you in a wheelchair, do we?”. After way too long I decided to find a new rheumatologist.

I took my time looking for a new doctor. One I went to yelled at me when I told him why I was looking for a new rheumy. Turns out he was friends with the one I left. I finally decided on a rheumatologist who I was told was well versed in Lyme disease.  She had plenty of posters on the walls of the office with picture of both damaged joints and Lyme disease bulls-eyes. I discussed my story with her and she felt I had rheumatoid arthritis as well. She decided to add Plaquenil to the cocktail and that did seem to improve how I felt. The disease seemed to ebb and flow with the increased mtx and plaquenil combination. There was never a time when I didn’t feel sick.

Over the years I have had some symptoms that no doctor has been able to  explain. I have had extreme sensitivity to light and sound. It’s like having a migraine without the headache. I have ear pressure so it feels like I am in an airplane all the time. I have also had other more traditional RA symptoms (i.e.  joint swelling, pain, fatigue)

Last summer everything came to head when Kevin had a bout of the swine flu and I had to go off the methotrexate. I had to take antiviral medication for 3 weeks, and immediately following that I got bronchitis and was on antibiotics for two weeks, followed by 3 more weeks of antiviral medication because Nathan got H1N1, and finally 6 weeks of antibiotics because I got bit by another tick. I tested positive for an active Lyme infection and stayed off the mtx for another 6 weeks. After 14 weeks off methotrexate I felt surprisingly good.

The doctor told me to start back on the methotrexate, and being the dutiful patient I did what I was told. After 2 doses of the methotrexate I felt like I was back in Lyme hell. I went to the doctor and I told her I was not going to take any more mtx. She order more tests, including a new Lyme test. A few days later my primary care doctor’s office called to tell me that I tested positive for Lyme and I needed to start antibiotics. I was surprised that I had not heard from the doctor that ordered the test, so I called my rheumatologist office to find out what was going on.

She told me I did not have Lyme disease. She said that it was a cross reactive protein and ordered more tests. I again brought up the long ago Lyme test that started this RA nightmare and the look on her face scared me.  She looked frightened. She claimed that there was nothing from the previous doctor that mentioned Lyme disease. ( I know now that this was untrue because when I requested copies of my medical records from her office the previous rheumatologist did sent his notes on the Lyme and that he felt it was a false positive.) Over the next several weeks as I felt worse she ordered more and more tests, she managed to rule out quite a few different ailments and still could not explain the Lyme results. Finally, I got tired of being poked and went to see my primary care physician and asked her to put me on antibiotics. She agreed that there was no harm in trying antibiotics and if I felt better than it must be Lyme.

After 2 weeks on the antibiotics I started to feel normal again. After 3 weeks I felt better than I had in years.  The inflammation was almost gone. I walked with a spring in my step. I felt really really good. One day I was going about my daily routine and I stopped myself in mid-stride because it was as if I had been in the situation before. It was the most beautiful deja vu that I have ever experienced. As it occurred to me what I was reliving I began to cry. I felt the way that I did BEFORE. Before the rheumatoid arthritis diagnosis. It was as if time had melted away and that I was the old me, the healthy me. That moment will stay with me forever.

In that moment everything changed for me. I decided that I was going to investigate Lyme disease. I wanted to find out if this had happened to anyone else. What I found was that everyday people are diagnosed with chronic autoimmune diseases that really have Lyme disease because of the ignorance of some of the medical community about what Lyme Disease is and what it can do.

I took my time and thoroughly investigated several doctors. I knew after doing my research that I needed to find a Lyme Literate MD (LLMD). I got references and asked questions about each one. I decided that I wanted the opinion of someone who was respected in dealing with Lyme not only by his colleagues, but also by his patients. After quite a lot of research I found the doctor I felt comfortable with. It took me 2 1/2 hours to get to his office but I didn’t  mind the drive if it meant that I would get some answers. I figured if he told me that I did not have Lyme disease, I would believe him, and I would move on from there. I needed to know once and for all if I had Lyme disease or something else.

I spent 90 minutes with this doctor discussing the past nine years of my life. Every tick bite, every treatment, everything. When all was said and done, he said to me that it was no surprise that I did not feel better after the original doctor put me on a Z pack for 5 days and then repeated the process; it would not have done anything to fight Lyme Disease.  He felt very strongly that after I described all of my symptoms and heard all my treatments that I have Lyme Disease and never had Rheumatoid Arthritis.

I left the LLMD’s office overwhelmed. I could not hold back the tears. 9 years. 9 years that could have been so different. 2 of my children don’t even know what I was like before all this happened. I am angry and sad. I want as many people as possible to know my story because it could be there’s as well. I am not the first person to be diagnosed with Rheumatoid Arthritis that has Lyme disease and I am certain not to be the last.

My new doctor offered no guarantees. He told me that this is going to be a long, hard battle. The very last thing you want to do to treat Lyme disease is to weaken the immune system. We have a lot of work to do. I was prepared for that.

Today I have something now that I did not have 10 days ago.

Hope.

My final thought to anyone that ever had any doubt about whether or not they had been “cured” from Lyme disease,  or had concerns about their current autoimmune disease diagnosis is to trust yourself, trust your instincts, and if it feels wrong it probably is.

As a side note, as of this writing I have been on antibiotic therapy for ten days. The results are that at least half the inflammation if gone from my joints. I don’t need any more proof than that.

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Thursday, April 1st, 2010

Rheumatoid Arthritis: Survival Mode

These past several months have been an exercise in survival.  I am feeling better than I have in months, but I still have a way to go before I am at a place where rheumatoid arthritis is not in every other thought.  I have come to a place of survival.

All this down time has made me wonder how many of us are living with this disease and how many of us are in survival mode?

What is survival mode? For me it is getting through another day.  Surviving the day with rheumatoid arthritis.  Not exactly my idea of fun, but I am getting by. I wonder what survival means to everyone else with this disease.  While survival is better than giving up it is not where I want to be.

I am an optimist so I believe that this is just a temporary setback on my journey to living well with RA.  The idea that this survival mode is a permanent situation is not something that I am willing to entertain ever.  I have too much fight left in me to settle for half way.

I am grateful to be out of bed. Two months ago I was flat on my back all day long.  I am grateful that I am able to tackle small tasks on a daily basis so that I feel that I have accomplished something.  But this is not where I want to be.  I know that I have a ways to go and that this will probably take longer that I originally anticipated, but I am in this for the long haul and I am determined to find a new way to live with this disease without adding toxic chemicals to my body.

Here is what I have been doing so far and it seems to be having an impact on my overall wellness.

  • I am monitoring my diet and have eliminated dairy from my diet. I have found out the hard way that if I do ingest something that has dairy in it I will swell. I have been adding and subtracting different foods from my diet to see what is having an impact on inflammation. So far dairy has had the biggest impact.
  • I have been taking Flaxseed Oil (I can’t do fish oil supplements) and Vitamin D daily.
  • I have found that mediation helps me sleep better and makes mornings a little more manageable.
  • I am starting to be able to exercise ( I am using this term loosely because the rate of speed that I walk would hardly be called exercise, but it is movement and more than my body has seen in months.)
  • I am careful about what I eat and have lost over 25 pounds since January 1, 2010.
  • I spend time every day visualizing what it looks like to be free of stiffness and pain.

So far I am improving and I hope to be back to my old self soon.

In all honesty I have felt this bad on methotrexate.  I have had the same levels of pain, inflammation, and stiffness while on mtx so I have been pleasantly surprised at my progress and so far happy with my decision to look for an alternative solution to mtx.  It has made me wonder on more than one occasion how well the mtx was really working for me.

So for me, tomorrow is a new day with new hope for less pain and inflammation and life mode not just survival mode.

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Thursday, January 21st, 2010

Rheumatoid Arthritis: What Six Months of Sickness Has Taught Me.

The past 6 months have been somewhat like a bad dream.  I never could never have imagined being sick for this long with so many different ailments.  I can’t help but wonder if all the years on methotrexate had such an effect on my immune system that everything kind of shut down for a while. With all this down time I have had the opportunity to learn somethings about myself.  I thought I would share some of what all this sickness has taught me.

  • Trust your instincts. When two of my doctors had conflicting opinions on whether or not I had a second or continuing Lyme infection I should have trusted my instincts.  I could have saved myself valuable time and pain and not have subjected myself to way too many diagnostic tests had I just trusted my gut.  I know my body better than anyone else and I knew that I still had Lyme Disease. I shouldn’t have allowed my rheumatologist to talk me into more tests to prove that her opinion was right when I knew deep down inside all I really needed was another treatment of antibiotics.  When I finally got the antibiotics was when the symptoms went away and I started to feel better.  Lesson learned. Again. I hope this time it sticks.

  • Lyme Disease is something to take very seriously. I have had Lyme Disease in the past.  I thought that I knew and understood what this disease could do.  I could not have been more wrong.  I have never in my entire life felt more physically ill than I did with Lyme Disease.  I can’t say whether or not the Rheumatoid Arthritis (RA) had an effect on the severity of the Lyme Disease but I know that the treatments for the RA had an effect on how well my body was able to handle Lyme Disease.

  • I need to nourish my body and my soul. I have always been the one who puts everyone’s needs before mine.  It wasn’t a conscience decision, but none the less other things took priority in my life. Now every day I am slowing down and taking time to do things that nourish my soul.  Things that bring me joy nourish my self. I find that I have more patience and energy for other things after making my self a priority. Before I put anything into my body I am asking myself will it nourish me or fill me.  They are two very different ideas. I have tried to eat responsibly in the past, but I haven’t always looked at what I am putting into my body as nourishment as opposed to something that will fill me up.
  • Don’t be afraid to ask for help. Being an independent person and a bit of a control freak I frequently would rather do something myself than ask for help.  Part of me just didn’t want RA to get the best of me.  I felt like it was a bit of a battle of wills.  I wasn’t going to let RA take over my life completely, I could do most things myself and I hated to ask anyone for help.  Being as sick as I have been, I have had no choice but to ask for help.  There were days when getting out of bed to go to the bathroom was an ordeal.  An extremely painful ordeal.  It was simply impossible not to ask for help with some of the most basic of needs.  I discovered that the world did not end and it was okay if things were not done “my way”.
  • A clean is nice but really not all that important. I used to care very much about how clean my house was.  I felt that how my house looked was a reflection on me and how I cared for my family.  I know that sounds a little nutty but that is how I felt.  I really felt like I could not physically do a great many things anymore but I could take care of my family and a clean house was part of that.  Of course now looking back I can see how crazy that whole idea sounds.  My house currently is picked up. No one is going to trip over anything in my house, but it is a far cry from clean and I really don’t care.  I could spend the next few hours cleaning, or I could spend the next few hours playing with Kevin or reading a good book.  Now I choose something that will fill me up instead of depleting my resources.

  • Connecting with other people that know and understand what it’s like to have RA is important. Knowing that I am not alone in the day to day challenges that this disease brings has helped me in so many ways.  There is comfort in knowing that there are people out there that completely understand what I am going through.  I am very grateful to all the new friends that I have found here and for their kindness and support.
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Monday, September 28th, 2009

Rheumatoid Arthritis (RA): Which Treatment Option is Best?

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Over the past several months I have received comments that I think need to be addressed in a much longer format than a comment response.  The comments are related to treatment options for rheumatoid arthritis and which treatment is best.

We are fortunate enough to have many options available to us today to manage our rheumatoid arthritis (RA).   Traditional medicine offers everything from NSAIDs (Non Steroidal Anti-Inflammatory Drug) like Advil and  DMARD s(Disease Modifying Antirheumatic Drugs) such as Plaquenil, Arava, Methotrexate, Gold, and Cyclosporine to biologics like Remicade, Enbrel and Humira. There is a growing trend toward alternative medicine as a  solution to  deal with this disease.  Each option has its benefits, risks and side effects.

NSAIDs are a class of drug that are used primarily to treat inflammation and mild to moderate pain.  These medications vary in potency and  include the brand names Advil, Motrin, Naproxen, Anaprox and Celebrex.  Between 10% to 50% of patients are unable to tolerate NSAIDs because of their side effects. These side effects include upset stomach, stomach pain, and diarrhea.  About 15% of people on long term NSAID treatment develop ulcers of the stomach and/or the duodenum.

DMARDs cover a variety of different of drugs.  Anti-malarial drugs such as Plaquenil (Hydroxycloroquine) are considered a DMARD and were initially used to treat malaria. It was discovered to help  arthritis when patients noticed an improvement in their arthritis symptoms while taking plaquenil for malaria.  Plaquenil effects the immune system but doctors do not know how it works for rheumatoid arthritis. Arava (leflunomide) interferes with genes in developing immune cells. When taking Arava, liver monitoring for toxicity is required.  You should not take this drug if you are planning to get pregnant or are currently pregnant because of birth defects. The most common side effects for patients taking Arava are rash, nausea, hair loss, liver enzyme elevation and anemia. Methotrexate is a chemotherapy drug that initially was used to treat acute leukemia.  Methotrexate (MTX) has become the gold standard for treatment of rheumatoid arthritis (RA).  Methotrexate interferes with the growth of cells in the bone marrow.  The most common side effects from methotrexate include stomach upset, hair loss, diarrhea, and  mouth sores.  Folic acid is given while taking this medication to reduce the side effects.  Liver function monitoring is necessary to watch for toxicity. Methotrexate should also not be taken if you are pregnant or planning to get pregnant. Injectable Gold has been shown to improve symptoms of rheumatoid arthritis however toxicity is common and constant monitoring in necessary.  Side effects include rash, diarrhea, conjunctivitis and marrow suppression. Cyclosporine is a medication that is used primarily for the prevention of rejection of transplanted organs.  It is effective for the treatment of rheumatoid arthritis because it stops an overactive immune system from attacking the joints. Side effects can be severe and include hypertension, kidney problems, headache, nausea and diarrhea.

Biologic response modifiers (biologics) are the latest treatment option for rheumatoid arthritis pain and inflammation.  They work by blocking the tumor necrosis factors(TNF) components of the immune system.  People with RA have too much TNF in their bodies and it overwhelms the immune systems response to inflammation. Biologics such as Enbrel, Remicade and Humira are genetically engineered proteins that binds to and deactivates the TNF molecules before they can do damage.  The risks in taking this class of drug include serious infection including sepsis and tuberculosis, nervous system diseases such as multiple scholosis, allergic reactions, lymphoma and congestive heart failure.  Because these drugs are fairly new their long term side effects are not known.

There has been much debate on the effectiveness of complimentary and alternative treatments options for rheumatoid arthritis.  These treatments include GLA (Gamma Linolenic Acid), DHA (Docosahexaenoic Acid, Tai Chi, herbal supplements and acupuncture. There are many more complimentary and alternative treatment options that will be discussed in future posts.

GLA (Gamma-linolenic Acid) is an essential fatty acid found primarily in plant oils. It is found in borage  oil and black currant seed. In preliminary testing it has shown to reduce morning stiffness and swelling however studies have been small to date and additional research would provide more information. DHA (Docosahexaenoic Acid) is an omega 3 fatty acid found in cold water fish. Several studies have shown that DHA reduces inflammation but not the progression of the disease. The movements of Tai Chi improve strength, flexibility and balance. There is no indication that Tai Chi effects the progression of rheumatoid arthritis. Acupuncture in thought to stimulate the release of chemicals called endorphins that block pain. Acupuncture is very effective in treating chronic pain like that in rheumatoid arthritis. The list of supplements as an alternative solution to conventional medicine for the treatment of rheumatoid arthritis include vitamin E, MSM, copper, manganese, vitamin C, selenium, zinc, bromelain, ginger, turmeric and boswellia.  These alternatives have proven to help in inflammation and in some cases joint damage.

The benefits of using conventional medicine for the treatment of rheumatoid arthritis are that knowledgeable doctors using this method are readily available and the medications work for many people. These medications have significantly improved the lives of many with rheumatoid arthritis. The downside to this treatment option is the side effects can vary from mild to severe and some long term effects are not even known.

The benefits to choosing an alternative medical solution for the treatment of rheumatoid arthritis is that the side effects to these treatment are few and are less damaging to the body.  The disadvantage to complimentary and alternative treatments are that finding a qualified medical professional that can help guide you through all the options available can be a challenge and there is debate on whether or not they can help with joint damage.

Ultimately the choice for a treatment option is a personal one.  What matters is what works for you. Everyone has their own body chemistry.  What works for one person may not work for another. The advantage that we have today is that we have options, many options, and if something is not working for us we can try in another direction until we find our own solution. It is not up to me or anyone else to decide what is best for you and your body.  Trust yourself to figure out what is best for you.

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Friday, July 17th, 2009

Methotrexate for Rheumatoid Arthritis: Long Term Use Considered Safe

The results of a recent study published in the Annals of the Rheumatic Diseases indicate that the drug methotrexate (MTX) appears to be safe for long term treatment of rheumatoid arthritis.  This conclusion was based on data collected from 88 studies that involved patients treated with methotrexate for at least 2 years.mtx 001

Methotrexate is classified as a disease-modifying anti-rheumatic drug also known as a DMARD.  Methotrexate had been used to treat psoriasis and cancer prior to its approval by the U.S. Food & Drug Administration in 1988 to treat rheumatoid arthritis. It is also used to treat other autoimmune diseases including ankylosing spondylitis, psoriatic arthriis, lupus and vasculitis. It can take from 6 to 12 weeks to feel the full effect of this medication.  Taken once weekly via either 2.5 mg tablets or self injection,  methotrexate blocks certain enzymes that affects the production of folic acid which is necessary for growing cells. Therefore it is necessary to take folic acid suppliments while on methotrexate.

It is important to avoid drinking alcohol while using this medication because of the increased risk of liver damage.  Methotrexate can cause abnormal liver function so it is necessary to have blood work monitoring done every 8 weeks. The 88 studies concluded that 13% of people taking methotrexate experienced elevated liver enzymes however only 3.7% had to stop using the drug due to liver toxicity. Other side effects include nausea, vomiting ( may be based on the dosage), mouth sores, rash, diarrhea, blood count abnormalities,  persistent dry cough, unexplained shortness of breath, cirrhosis of the liver ( rarely), gradual hair loss, and sensitivity to sunlight.  Some over the counter and prescription medications may increase the toxicity of methotrexate so it is important to check with your doctor or pharmacist before taking any additional medication. Methotrexate can cause birth defects and can cause complications during pregnancy.  It should not be taken if you plan on starting a family.

Patients in the study experienced side effects but usually mild. Methotrexate rates of discontinuation were less than gold, sulfasalazine and penicillamine but more than plaquenil in this study.

Of the 88 studies only 2 assessed the relationship between methotrexate and cardiovascular disease. One study concluded that there was no increased risk of cardiovascular disease, the other suggested that there may be a reduced risk.  There was no increased risk of infections linked to methotrexate.

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Saturday, April 18th, 2009

Vitamin D and Rheumatoid Arthritis

sunshineThe warmer weather is on its way and it is the perfect opportunity to get outside and grab some rays.

The best source of vitamin D in sunshine.  In just 15 to 20 minutes per day outside in the sun your body will absorb all the vitamin D it needs for the day.  But beware some RA medications like methotrexate make you more sensitive to the sun.  And steroids interfere with absorption of vitamin D.  The best time to get the maximum benefit is when the sun is directly overhead.  It is not necessary to get all 15 minutes at the same time .  You can split up the exposure to 5 minutes, 3 times per day to get the same benefit.

The human body manufactures vitamin D when exposed to the sun.  It also can be found in certain products such as milk fortified with vitamin D. It is also found in fish, eggs and cod liver oil. Vitamin D is essential for promoting calcium absorption  for healthy bones.  Vitamin D has been shown to reduce inflammation and regulate immune function.  

The recommended daily value of vitamin D for both women and men under 50 years old is 200 IU ( international units ), 400 IU for those 51 to 70 and 600UI for 71 and older.
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Friday, March 27th, 2009

What Rheumatoid Arthritis Has Taught Me: Lesson #2 Patience

RA has forced me to learn to be patient.  I have had to be patient with my medication and with my body. Patience in doctor’s offices, waiting for test results, and for prescriptions to be filled has been a difficult lesson. I wish I could say that I readily accepted the fact that my life was changing and that I would need to become a patient person to deal with all that lay ahead.  That was not the case.  I spent a lot of time just being aggravated that things took me so long to finish, or that the meds I am on were taking forever to start to work.

Some lessons come easy and some don’t.  Becoming a patient person has not been easy for me.  RA has given me no choice. It took almost 2 months before the methotrexate started giving me some relief from the pain and stiffness. The very last thing I wanted to hear from my rheumatologist was to be patient and that many RA medications can take from several weeks to several months to take the full effect.  I wanted to take a pill and be better.  Wasn’t that why I was going to the doctor in the first place?  I wanted him to make me better NOW not 2 months from now.  I don’t know why I was so dense about the whole process.  I have watched my mother for years deal with these issues.  I guess I thought I would be different.

I spent a lot of time feeling frustrated because I could not control the basics in my life.  I could no longer just finish a project in what I felt was a timely fashion.  Each project needed to be done gradually so that I would not over do things and be out of commission for several days recovering. At some point I had to accept that my body has limitations now.  I have to do things differently and that means I have to be patient. Things take longer now.  Because repetitive motions can be painful, I can do some and then I need to rest a bit.  Because staying in one postition too long can be painful, I need to sit for a while and then get up and move around.

I have chosen to be patient now and accept that my life is going on a slower path than I had planned.  I do not want to waste any more energy on something that is completely futile.  I think that somewhere along the way I had to give up trying to control things and just trust that there is a reason for all things and with patience I will understand what that is.

I think that Brian Adams put it beautifully…

“Learn the art of patience. Apply discipline to your thoughts when they become anxious over the outcome of a goal. Impatience breeds anxiety, fear, discouragement and failure. Patience creates confidence, decisiveness, and a rational outlook, which eventually leads to success.” -Brian Adams

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  • Jo-Ann Colburn: Kelly, I will email you the name and address of my...
  • kelly siesel: could you tell me the name of your Lyme dr? I have...
  • Jo-Ann Colburn: Unfortunately the Lyme tests are not that accurate...
  • Pam: Congratulations on feeling normal (even if was onl...
  • Lene: Wow! Just.... wow. So happy you've left RA behi...
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