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    Suggest treatment for rheumatoid arthritis

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Posted on Wed, 18 Mar 2015 in Lupus
Question: I am suffering from Rheumatoid Arthritis and want to have proper relief from pain.
Also I thing it starts paining again due to air conditioning.
Can you please guide me through.
doctor
Answered by Dr. Naval Mendiratta 34 minutes later
Brief Answer:
Treatment of rheumatoid arthritis

Detailed Answer:
Good evening XXXXXXX

Thank you for writing on health care magic

Well i have read through your complaints and i would like to ask you a few questions before guiding you on the further treatment.

1. Duration since you had rheumatoid Arthritis?

2. Which all joint were involved initially when it started? and what all joints pain now?

3. Do you experience swelling and early morning stiffness as well?

4. Were your Rheumatoid Factor and Anti CCp positive?

5. What about the inflammatory markers now. ESR and CRP? are they still high?

6. Any other symptoms like dry eyes/dry mouth/oral ulcers/rashes/photosenstivity /decreased sleep/ forgetfulness you have been experiencing?

7. Can u tel me the dosing of Folitrax and Defza?

If your rheumatoid arthritis is well controlled it wont cause pain even in air conditioning. Secondly i would like you to go off Defza. Long term use of steroids is going to cause you more harm than benefit. The reason i asked for other symptoms( point 6) as lot of other conditions mimic rheumatoid but may not be so. I am not sure if you are following with a rheumatologist or an orthopaedic as people over diagnose the disease at times.

Do let me know these queries

Would be happy to help you out

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Naval Mendiratta 53 minutes later
Thanks Doctor,

Please check my responses to your questions -->

1. Duration since you had rheumatoid Arthritis? : Last 2 months

2. Which all joint were involved initially when it started? and what all joints pain now? : Leg, Hand & Neck joints

3. Do you experience swelling and early morning stiffness as well? : Not swelling much. But yes definitely morning stiffness.

4. Were your Rheumatoid Factor and Anti CCP positive?: Yes

5. What about the inflammatory markers now. ESR and CRP? are they still high? : ESR was high i.e. 105. Test done 1 month back.

6. Any other symptoms like dry eyes/dry mouth/oral ulcers/rashes/photosensitivity /decreased sleep/ forgetfulness you have been experiencing? : I experienced decreased sleep, forgetfulness, photosensitivity, dry eyes

7. Can u tel me the dosing of Folitrax and Defza? : Defza 6 Mg [2 in the morning], folitrax 17.5 mg [Saturday night]
doctor
Answered by Dr. Naval Mendiratta 4 hours later
Brief Answer:
Treatment for rheumatoid Arthritis

Detailed Answer:
Good evening

Thanx for your reply.

Well since the duration has only been 2 months and you have started Folitrax, you need to give it time. Folitrax action takes around 6-8 weeks to act before the levels build up in the blood and cause it s own effect. Once the effect comes, you will feel better with your joint pains.

Secondly i would recommend you to get ANA levels tested as well if not done previously as the symptoms of dry eyes, photosenstivity do not fit with Rheumatoid Arthritis.

Thirdly, we normally use that high dose of steroids for long. You should try and taper Defza over the period of next 2 weeks before you get habitual to it and find it even harder to leave.

Fourthly, dont plan family ahead while you are on Folitrax as it can cause effects on the fetus.

So, just give time for the course of Folitrax and taper and stop Defza. Since it is an early disease you will find improvement with a single drug and soon enough..

Do let me know for more queries

Would be happy to help out

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Naval Mendiratta 14 hours later
Thank You Naval Sir,

Your information will help me definitely.
Can you please guide me for ANA levels test. I mean is it blood test? How much it will cost?

Thanks
XXXX
doctor
Answered by Dr. Naval Mendiratta 58 minutes later
Brief Answer:
Rheumatoid Arthritis

Detailed Answer:
Good evening XXXXXXX

It is a blood test to be given routinely. It should not cost more than 1000-1500. Make sure the method is right by ImmunoFluroscence ( IFA)

Do let me know the results if positive

Take care.

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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