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Date: 26.08.2017
From: Talban

Subject: MTX / consultants / a glass of wine

Hello all,

Diagnosed with with PsA not so long ago and currently in week 7 of my MTX - so v early stages but it has been a grim few months with various inflammations, pain, steroid injections etc, and a cocktail of drugs to get through the day.

In addition to MTX (and FA) weekly, I am on steroid tablets daily (a decline dose each week), dicloflex (typically twice a day) and co-dydramol as and when required, with a stomach-lining tablet each morning to complete the set.

It was a bit of a shock to hear the diagnosis, even if not a complete surprise given the googling of the various painful symptoms I had narrowed down what it was likely to be.

A few main issues that I would welcome views / comments on:

1) MTX - I'd say limited impact so far but have another six weeks to go before the drug will be properly reviewed. Should I be hopeful that it will actually start to mark a difference and 1) I'll feel a bit better and 2) the BT results will reflect this (or vice versa).

2) Pretty much as stressful as the condition has been the very regular trips to the hospital for the appointments and blood tests. This has not been helped by a consultant completely lacking in empathy and consistently late - not just in terms of appointment terms but even rocking up to the first appointment of the day 20-40 mins day on multiple occasions. I've started a new role recently and it is tricky balancing 1-2 hours at the hospital for what should be a 15 min appointment with demands of the new job. What options do I have re the consultant? Can I swap them? My files notes are also a complete mess (according to another consultant I saw when usual one was running stupidly late).

3) Alcohol - I have been given mixed advice from medical professions on what is allowed to be drunk forever me whilst on MTX - nothing, less than 5 units or the usual weekly allowance for an adult. I'd love to know what the right answer is before I tip my booze cupboard down the sink.

Thanks so much in advance. It's a brave new world I find myself in, if not a particularly enjoyable one.
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Date: 06.09.2017
From: lucy

Subject: Re: MTX / consultants / a glass of wine

Hi Talban, I hope someone can come on and help with some of your questions but in the meantime I will give my opinion. They do say MTX can take a while to start working and some people feel it really helps, to be honest I don't know that it helped me too much regarding pain although it maybe has stopped deformity in my hands (I have RA) I often had a drink (usually a few glasses of wine) but like yourself I was never sure how much but fortunately my blood tests for liver have always been ok. I wouldn't take a lot of alcohol in the early stages as you want to see how your liver is tolerating it and if all is ok then a few glasses a week shouldn't cause any problems (your blood results for the liver will tell) A lot of people on MTX won't touch alcohol but i've been fine with it. Best wishes
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Date: 06.09.2017
From: lucy

Subject: Re: MTX / consultants / a glass of wine

Meant to say...I wouldn't take alcohol on day of MTX and remember the folic acid a few days later
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Date: 07.09.2017
From: John

Subject: Re: MTX / consultants / a glass of wine

Hi Talban
If I could answer one particular aspect of your query. When I was on MTX tablets, I was in some serious pain and couldn't get any relief from it. Pretty much the day I was chanced to MTX injections the pain more than halved.
If you can get changed to them, it would hopefully help you too. Even though you administer them yourself, it's very easy and totally pain free in my case. I don't like needles but you don't even have to look. Just put it up to your stomach or thigh, look away and press the button.
Good luck
John
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