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Fear Aside, She’s Trying Methotrexate
from Tanya

Hello Ed, I LOVE YOUR WEBSITE!  My name is Tanya and I'm 34 years old.  I have two wonderful boys and have been married to the same wonderful caring man for 17 years.  I have had psoriasis for about 5 years.  I wanted to just say thank you for your support to so many of us out here.  I felt like I was alone in this world,  no one understanding me and how I felt.  When I first saw your website,  I laughed for the first time about psoriasis!  I told my husband about it and he was happy that I was laughing.  I have been down and out for a while and really needed something to lift my spirits.  

It wasn't until about 1 year ago that the psoriasis got really bad, on my arms and legs, ankles, forehead and scalp and in areas we won't mention.  I just continued to apply the creams and gels that the doctor gave me.  I wasn't real faithful on applying them every morning and night, so the condition worsened. 

It was about 6 months ago that I started feeling pain in my knees and went to see my primary doctor.  After giving me Vioxx for the pain, I found that I couldn't take it every day as it did not agree with me.  So he referred me to an arthritis doctor.  She diagnosed me with psoriatic arthritis and told me I would benefit from Methotrexate.  I put it off as the side effects really scared me.  I don't want to lose my hair, or have sores in my mouth!  Worse yet, I don't want something to happen to my liver! 

I've been in a lot of pain with my arthritis.  I just had some blood work done and my sed-rate is too high at 54 when it should be 0-15 (sed-rate measures your inflammation).  I went to my dermatologist and he has also advised me that I would benefit from Methotrexate.  I have decided to try it and see what happens.  He wants to skip the pill and go right to the injection since I'm in a lot of pain.  Well, I go to him today.  I have been out of work for about 3 weeks now and I'm hoping this makes me feel better so I can get back to work.  I couldn't drive the 30 miles it took to get to work because by the time I got there,  I was in so much pain,  I had a really hard time getting out of my car!

My father has psoriasis,  but not the arthritic type. He's totally against me taking the Methotrexate and I can understand what he's saying, you know, with the side effects and everything. But I don't know any other way to relieve the pain.

Thank you very much for reading this e-mail.  I'm sure you get a lot, so if during you busy day,  you have a chance to respond,  please do,  I would really appreciate it. Thank You, -Tanya  

*****

Ed’s Response:  Tanya:  Don't be afraid of the MTX.  Your derm will monitor you closely with blood work-ups at least every three months and probably every month for the first few. 

Boy can I identify with what you have gone through!  I made my decision to try methotrexate when I could not drive. 

My first round with MTX literally eliminated my joint pain in about 4 months.  Even a year later, when I switched to cyclosporine, the PA stayed away for almost another year.  When the joint pain started to return my blood pressure was also rising (a well-known side effect of cyclosporine) and I went back to MTX (hence the recent biopsy) and, so far, it has arrested any increase in the discomfort. 

And while I certainly advocate methotrexate for someone in your condition, I also appreciate your father’s point of view.  I would not counsel my own children towards the drug unless their cases were also disabling.  Methotrexate isn’t a drug I would take just to “look better.”  (In fact, MTX has never completely cleared my lesions — and the literature suggests it shouldn’t.  It’s as though complete clearing would be a sign of over-dosing; but that’s just my interpretation.)

Thanks for writing and your kind words! -Ed

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