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Chronic MCTD, corticosteroid, pulmonary hypertension, antidepressant pills

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General & Family Physician
Practicing since : 2000
Answered : 451 Questions
Iam in my 11th year of having mctd. Have been through all the motions, pain sicknesses and emotions. I am on 20 mg methotrexate, enapril, aspirin and omeprazole as well as the pain killers. Every winter is hard especially the last 3 years, after this winter I just want to die because of the pain, sores on hands legs and feet, swollen and aching joints, blurred vision a BIG feeling of unwellness. I have also had my gullet stretched twice and on poorly days have to have my food made as much liquid as possible. Have also had an illoprost infusion last November. To add to it all I live on my own and I am currently experiencing a lot of disturbances from kids playing on the XXXXXXX next to my house. Have also had my property vandalised on 5 occasion. Have had to involve the police and the anti social behaviour unit. I am still getting (I feel victimised). Have experienced it just today and have been house bound for the last two days. I have hardly slept, my apetite is a no go. I am a stone under weight now. I still work but now this is starting to suffer as I cannot concentrate. I am a fighter and never usually moan, but please help me any advice will be appreciate. Regards Mandy aged 45
Posted Wed, 16 May 2012 in Lupus
Answered by Dr. Jagdish 15 hours later

MCTD is a chronic disease. It sometimes flares up. If the symptoms are mild, you do not need treatment. Since you have several symptoms, you need to be on treatment. First line of treatment is with Corticosteroid. Steroids have lot of side effects if used long term. Some doctors do prefer low dose methotrexate. MCTD affects lungs, heart, skin and joints. So I agree with the current management.

I noticed that you had swallowing problems, pulmonary hypertension and it was properly managed. Most common cause of mortality in MCTD is pulmonary hypertension. And it best responds to Ilprost.

Coping with the disease is very challenging. But you coping is an organized thought process. If you organize things, you can do it. Coping involves managing symptoms with Ibuprofen etc. You need social support. Build up network. Ask your doctor who might suggest some net work groups. Church is the best place to make relations. Unusual worries should be watched. Too much worry about existing and future problems makes you depressed.

I notice you are depressed and some antidepressant pills might help elevate your mood and help to cope up with the disease.

Disclaimer: The Expert’s advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.

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