Are You Scared of Injections?

I recently found another blog of a fellow psoriatic arthritis warrior.  She has recently been diagnosed and is currently on methotrexate treatment – although from what she writes it doesn’t appear to be optimal as she still needs to take NSAIDs daily for pain.  I’m not sure what country / health system she is in, but I hope that her rheumatologist manages to trial her on a biologic on her next assessment.

Her treatment reminded me of when I was first diagnosed.  It was a nightmare!  Mind you, I was diagnosed in Beijing (where I was working at the time) and the rheumatologist was a local Chinese physician.  Now those of you who have been to a local doctor in China will know that they are not renowed for their bedside manner!  Curt and abrupt are two adjectives that come to mind actually.  Those of you who have read the about me page will know that the rheumatologist put me on methotrexate as soon as I was diagnosed.  Unfortunately I already had some experience with methotrexate – and in hindsight it would have been much better if I was totally ignorant to the drug so that I wouldn’t have worried so much.  I knew of methotrexate as it was a common drug given to cancer patients.  The thought that I was taking a “cancer treatment drug” really had me worried.

Now I look back I can laugh at what the physician did and didn’t tell me.  He didn’t tell me that I shouldn’t have kids while taking methotrexate as it affects sperm.  I’m not sure why he didn’t mention this since I was only in my early thirties.  Maybe it was because I already had a son (actually 2) and being China with its’ one child policy he thought that I wouldn’t (couldn’t?) have any more?  What he did tell me though, was that methotrexate was pretty toxic for the liver, so I shouldn’t drink any alcohol while taking it, and after a year or so (once I had consumed a total of 1.5 gms of methotrexate) I would have to have a liver biopsy!Now I had seen a biopsy done once before, and was horrified at the size of the biopsy needle.  I don’t know anyone who likes injections and usually the sight of a needle will give anyone the shakes.  However the biopsy needle is like the “grand daddy” of needles.  I’m sure it is what they use in horror movies.

So you can imagine what a horrible day that was.  In one day I found out that I had arthritis, that I was going to have to take a “cancer” drug for the rest of my life, and that after a year or so I’d have a jab with a giant needle to look forward to.  Thanks Dr. Wang (queue evil stare).

For the recently diagnosed who may be on methotrexate, I don’t want to scare you!  I was wrong about methotrexate – it is a very safe drug with the only “bummer” being that you can’t drink while taking it.  Also, the biopsy is painless – they will numb the area first so you won’t feel anything.  In fact the good places will even give you some IV pethidine so you can escape into a little bubble of pleasure.

I also read that there is a lot of scientific discussion about raising the methotrexate limit to 3.5 gms before doing the biopsy.  You can read about it here and here.

Everyone responds differently to treatments.  I didn’t get much (if any) reprieve from methotrexate and had to supplement it with top shelf analgesics in order to control the pain.  However on biologics I am pain free from arthritis!  So if you are currently on one treatment and are still experiencing continuous pain, don’t stop trying different things.  There will be something that helps!

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