Re: Re: When you're not in remission?

[Guest guest]

Jennie,

Your doctor should read the American College of Rheumatology¹s criteria for

determining if you are in remission:

ACR Classification Criteria for Determining Clinical Remission in Rheumatoid

Arthritis

5 or more of the following present at least two consecutive months:

a. Morning stiffness < 15 minutes

b. No fatigue

c. No joint pain

d. No joint tenderness or pain on motion

e. No soft tissue swelling in joints or tendon sheaths

f. ESR (Westergren methold) < 30 mm/hour for a female or 20 mm/hour for

a male

Exclusions: Clinical manifestations of active vasculitis, pericarditis,

pleuritis or myositis, and unexplained recent weight loss or fever

attributable to rheumatoid arthritis will prohibit a designation of complete

clinical remission.

Reference: Pinals RS, et.al.: Arthritis Rheum 24:1308, 1981.

http://www.hopkins-arthritis.som.jhmi.edu/edu/acr/acr.html#remis_rheum

> My doctor says I'm in remission, with the exception of the joints

> next to my achilles tendon. I laugh because I don't think a drug

> induced remission is really remission. I am for a good portion of

> the time, symptomless. I don't have visible swelling or redness, I

> can get up and function well right away, I don't have to limp

> around. I still have some mornings with some stiffness for 1/2 hour

> or less. If I over do it, you can bet I will be in pain; and it is

> very easy to over do it. I still have a lot of fatigue and would

> benefit from taking a nap every day if I could manage the time for

> it.

>

> Before I was in " remission " I was stiff every morning for 2-4 hours

> and in some sort of pain most of the time, and had visible swelling.

> It is possible for medication to get your RA more under control than

> yours is right now. A lot of people experience some benefit from MTX

> but not complete " drug induced remission " as I call it. There are

> some who do though, and that is one of the reasons that insurance

> companies require that we all try MTX or plaquinil before the really

> expensive biological drugs.

>

> I don't think the medication will get rid of everything we experience

> with RA, but it should do two things: 1) make us functional so we can

> live our daily lives (even though we can't always do what we used to

> be able to do) and 2) keep us from having joint destruction that

> leads to disability. You need to let your rheumy know how the MTX is

> doing for you, so he/she can decide if you need to stick with it or

> try something else.

>

> Jennie