Date: 04.09.2013
From: Tracey O'Donnell
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Subject: Bloods getting worse
Hi, I started methotrexate almost 4 weeks ago. My bloods since then have got much worse crp 115, esr 126 and haemoglobin 10.9. Is there anything I can do to get my esr and crp down. They are not sure if my hb is dropping bcos of methotrexate anyone else had this?
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Date: 04.09.2013
From: rhona
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Subject: Re: Bloods getting worse
Hi Tracey, Your inflammation markers are very high. My crp was 200 last year and I know how bad I felt. Have they not offered you a steroid injection to help until the mtx starts to work? The esr and crp will not come down until you get the arthritis under control. I would ask for something else while you are waiting on it working. The hb can be lower in people with ra etc. I am usually between 9.1-10.6. I hope you feel better soon. x
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Date: 04.09.2013
From: Tracey
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Subject: Re: Bloods getting worse
Thanks Rhonda, I had a kenalog inj bout 4 weeks ago when I was diagnosed with psoriatic arthritis it didn't help any. I am going tomorrow for a joint injection either to ankle or knee will probably opt for ankle I'm hoping that helps a bit. Do u know how often the joint injections can be given?
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Date: 04.09.2013
From: rhona
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Subject: Re: Bloods getting worse
It really depends. Some don't like to give more that 3 into a joint in a year. When I was really bad I was having around one a month and when I counted them up I had 13 over the year. I sometimes think it depends on who gives the injection as to how effective it is. Good luck.
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Date: 04.09.2013
From: Tracey
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Subject: Re: Bloods getting worse
Thankyou, did u just get relief in that 1 joint or did it help anywhere else?
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Date: 04.09.2013
From: Colin W
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Subject: Re: Bloods getting worse
hi Tracey , totaly agree with rhona , ask for steriod injection to help until the MTX kicks in , think they may need to give you another Disease-modifying antirheumatic drugs (DMARDs) , most of us have two or three of them , myself on MTX + sulfasalazine & golimumab
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Date: 04.09.2013
From: rhona
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Subject: Re: Bloods getting worse
It usually has a bit of an effect all over but mainly in the joint that was injected.
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Date: 04.09.2013
From: Eve
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Subject: Re: Bloods getting worse
Steroid injections are good. I've had a number of general ones in the bum and also had both hips and both shoulders done, they make a bit difference. I think the frequency depends on the need. Ideally you shouldn't have too many but if you are suffering and that will help then it's a balance. I've had quite a few this year already and due for more.
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Date: 05.09.2013
From: tracey
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Subject: Re: Bloods getting worse
Thanks eve I just need some relief I had im one in bum but didnt help! Just deciding if I shud get my ankle or knee done today! My shods and hips also very sore! How long does it usually help for? X
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Date: 05.09.2013
From: Tracey
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Subject: Re: Bloods getting worse
Thanks Colin and Rhona they did mention at my app bout adding in a tnf got this today then app with nurse specialist on monday! Due my 4th dose of mtx today so hopefully its starting to build up in my system! Just not easy coping with this pain and my 2 kids age 5 and 3.
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Date: 05.09.2013
From: rhiannon
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Subject: Re: Bloods getting worse
Hi Tracey, I've only ever read the posts here, never posted til today. I'm in pretty much the same situation as you, I have psoriatic arthritis and I'm 6 weeks in to arava (leflunomide), my RC gave me a steroid shot in my bum to help while I was on the loading dose of arava. I'm also still taking my pain meds at the mo, 600mg ibuprofen x3 per day and cocodamol at night to help me sleep with the pain. So far at monitoring clinic there has been no change in my inflammation markers, next appointment is Monday so I'm hoping for some change though I don't actually feel any improvement. I guess it's a case of practicing patience, easier said than done though.
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Date: 05.09.2013
From: Louise
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Subject: Re: Bloods getting worse
With a hb of 10.9 you are anaemic and when you are anaemic your ESR can give a falsely high reading (though your reading is very high)You need to be treated for your anaemia (treatment would depend on why you are anaemic) as well as your arthritis. Hope the MTX kicks in soon.
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Date: 05.09.2013
From: rhona
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Subject: Re: Bloods getting worse
That is true Louise but I have just read an article from the "Iron Disorders Institute" it states that iron supplements can actually be dangerous when we have a disease and I have taken a paragraph from it, as I haven't learned how to copy and paste the full page lol. It states that when the body senses a potential threat iron gets shuttled to ferritin to be contained so the harmful invaders cannot get to iron. Just enough iron is made available to master red cells but no surplus is left to nourish the harmful pathogens. My blood is very low but when I take iron I seem to feel the arthritis worse. I don't know if anyone else has noticed that happen.
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Date: 05.09.2013
From: tracey
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Subject: Re: Bloods getting worse
Thats interesting I am seeing my gp in morning abput my hb. Will be a bit wary of starting anything if that is the case. Got knee done today, no relief yet to go back nrxt thu to get ankle or shoulder done x
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Date: 05.09.2013
From: rhona
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Subject: Re: Bloods getting worse
Try and rest your knee as much as you can over the next 48 hours Tracey as that is supposed to make the injection more effective. x
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Date: 06.09.2013
From: Louise
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Subject: Re: Bloods getting worse
Tracey may not have iron deficiency anaemia, there are many types that come with different treatments.
The blood results should indicate the cause of the anaemia or if not further blood tests should be taken to determine the cause. Hope you had a good appointment with your GP.
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Date: 06.09.2013
From: tracey
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Subject: Re: Bloods getting worse
Hi, my gp is leaving it up to rheumotology to decide what treatment I should have. I have app there on monday afternoon. To change diclofenac to 600mg ibuprofen 3-4 times daily and see if that helps pain any better. The hb drop cud be caused by the mtx. My knee I think (dont want to tempt fate lol) is starting to feel a bit less stiffer. Gp gave me another 8 week line from work!
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