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They Won’t Give Him MTX — @#$$&!
from Ry J.

Ed: Sent you mail some time ago (P in All the Wrong Places), so I thought I would let you know what’s up. I’ve given up on doctors, really. None of them will let me buy methotrexate (MTX). Instead, I get to buy $200 an ounce steroid creams. I cannot find a doctor in the Seattle area who will just f&[email protected] write a prescription for MTX! I’m about to forge one and buy it over the net. I would do that, but I can’t figure out the dosage and MTX seems to be serious stuff. Don’t want to stop all cell division all the time! Yikes!

The P is just as bad as it always was. I’ve lost all but one fingernail to complete deformity now and my feet are really involved. It’s disgusting. I spend a lot of time with a razor blade after showers cutting the skin off my feet. The amount of skin that builds up is just disgusting.

Oh yea. My P killed my keyboard at work. One of the keys got the switching mechanism filled with flakes. Dammit.

I don’t care if people know who I am, by the way. You don’t have to edit my name [which links to Ry’s home page. -Ed] -Ry Jones


Ed’s Response: Hmmmm. I wonder why no doc will prescribe MTX for you? Before I was permitted on the regimen I had a rather expensive blood workup, plus an eye exam. (And the very first time I went through this my derm did not put me on the regimen because my liver enzymes were out of whack. An over-abundant affection for Kentucky Bourbon. Or was it English Gin? Anyway, that was me.) Aside from discovering abnormal liver function, some derms will not prescribe MTX because of a patient’s age, life style, or because of the type and extent of their psoriasis. Also, different derms establish somewhat different criteria.

MTX is one drug I would definitely not try to self-prescribe and acquire. The damage it can do could go unnoticed too long, which is why continuous blood workups throughout the course of treatment are de rigueur. Those blood tests are something else you cannot do yourself (unless you’re a medlab tech, I suppose).

Until I had a real podiatrist work on my feet, I would have thought your razor-blade technique horrific. But that’s precisely what the podiatrist did to me! (Well, almost. He used a scalpel.) He carved out the thick hunks, then donned a mason’s mask and went at my peds with a rotary sander. (For the dust mites it was manna from heaven!) When I read your e-mail it reminded me of two hunks of skin from my feet in my pencil drawer. I saved them a couple years ago on the off chance that, given enough time, they might turn into passable mandolin picks. I just checked. They’re well on their way, but I’m going to give them another year or two.

And lest there be any doubt about the truly "disgusting" nature of having corrupted toe nails, here’s a reprised pic of one of my own at its worst:

(I’d swear that after the first time I posted this picture at FlakeHQ I went days without getting any email. This time I feel compelled to confess — the toe on top is an actual photo of my actual big toe taken some time in ~1997~. I took some liberties with the toe image on the bottom. And my canine teeth are no more pointy than yours.)

I’ve visited your web site twice now, and observed your empty office twice through your webcam. You need to have a sign to put in your empty office chair. "I’m here sometimes. Really!" ;) -Ed

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