I had my med management appt at the rheumy the other day and I had done my research.  I was ready for an aggressive approach advocated by research for people recently diagnosed, only Dr. B was having none of that.  She wanted to do the monomodal approach using the old standby Methotrexate.  I asked which was more effective, MTX or one of the new biologics?  She answered, “well, of course the biologics are, but they are only for people with moderate to severe disease states and for whom MTX did not work or stopped working.”  I said, “you mean, the insurance won’t let you?” She answered, “yes, they have to try the cheap and tried and true drugs first.”  So, there you have it.  Blue Cross/Blue Shield has predetermined my treatment because MTX is cheap and has a generic form and the biologics are new and cutting edge and don’t have generic forms and so I have to wait until I am pretty bad off to get one of them.  I am trying to stay super positive though, and so I am going with gratitude that I am not bad off enough to rate a biologic yet and may never be if MTX puts me into remission and keeps me there.

Dr. B told me that MTX does not have a lot of side effects, the Internet told a different story, so holding my 4 pills plus a folic acid pill in my hand last night I did have pause thinking of the most noxious of side effects like nausea, dizziness, hair loss, stomach pain, extreme fatigue, and so on, that I could experience.  I was alone and I wondered what would happen if I had some awful reaction or got really sick.  But, I was tired, and so I swallowed them and went to bed.

Well, guess what?  I slept like a nice rock.  I remembered to take my nighttime 800 Motrin, so I awoke with less foot pain and even my hands were not too stiff.  I had diarrhea almost immediately after waking, but that was it.  The rest of the day was, frankly– the best day of this past week.  I felt pretty good all day long. So, I feel pretty victorious, like I kicked butt or something.  I am not sure what this means:  I got a bad batch, I’m a badass, I am not affected by this drug like other people are, it’s going to work great, it’s not going to work great, who knows… but I am thankful that I did not have bad side effects today.  I only take it once a week, so I won’t take another dose until next weekend, and Dr. B says I won’t really notice improvements until after like 6 weeks, so it’s a slow drug.  I hope the side effects don’t take that long to show up.

I’m off to bed now.  Everything I read says I need my rest.  I’m feeling positive and hopeful tonight. 🙂