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Sierra, I don't know if you are prone to infections, but, if not, I'd go for

it. I would also choose either Enbrel or Humira, since they can be

discontinued and out of your system more quickly than Remicade should an

infection develop.

The combination of MTX plus a biologic is producing impressive results.

You won't necessarily have any problems. a, for example, has been on

Enbrel since its infancy and has no serious trouble with infections.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Talking to my doc

> Hello all,

> I am thinking about asking my doc if I can try one of the biological

> meds. You may recall that a radiologist detected erosions in my recent

> X-rays, though the rheumy felt that only one was actual. I thought I

> would only discuss the one she agreed was a real erosion. Since that

> happened since being on MTX, it could be said that the MTX failed, and

> that is what must happen before my insurance co. would pay for a

> biological.

>

> I am worried, however, about infections. MTX alone has agreed with me;

> I don't want to start having all sorts of problems with an Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no swelling, pain,

> or redness. I don't want my hands to be next. (The radiologist said he

> detected erosions throughout the hands, but the rheumy disagreed.)

>

> Thoughts?

>

> Sierra

>

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Sierra,

I have been lucky not to get a lot of infections while on Enbrel, even

though my white blood cell count was below normal for most of the time

I have been on it. The low WBC count was caused by MTX and Arava but

was very slow to come back to normal. Right now it's as low as it can

go and still be normal. I make sure to take a multi-vitamin and some

extra vitamin C, so maybe that helps.

Sue

On Monday, December 19, 2005, at 08:53 PM, snowdrift52003 wrote:

> I am worried, however, about infections. MTX alone has agreed with me;

> I don't want to start having all sorts of problems with an Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no swelling, pain,

> or redness. I don't want my hands to be next. (The radiologist said he

> detected erosions throughout the hands, but the rheumy disagreed.)

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Hello all,

I am thinking about asking my doc if I can try one of the biological

meds. You may recall that a radiologist detected erosions in my

recent X-rays, though the rheumy felt that only one was actual. I

thought I would only discuss the one she agreed was a real erosion.

Since that happened since being on MTX, it could be said that the MTX

failed, and that is what must happen before my insurance co. would

pay for a biological.

I am worried, however, about infections. MTX alone has agreed with

me; I don't want to start having all sorts of problems with an

Enbrel,

Remicade, or Humira. I am doing fairly well on the MTX, but am

concerned about erosions. The toe happened silently--no swelling,

pain, or redness. I don't want my hands to be next. (The radiologist

said he detected erosions throughout the hands, but the rheumy

disagreed.)

Thoughts?

Sierra

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I would make sure that the same radiologist read both the earlier and later x-rays and that the radiologist feels they are both of equal quality. I think there is a lot of subjective judgement in reading an x-ray so you need to eliminate as many variables as possible. If joint damage is indeed proceeding, I think adding a biologic would be beneficial. Remember, these are the opiniions of a someone who is not medically trained. God bless.

----- Original Message -----

From: snowdrift52003

Rheumatoid Arthritis

Sent: Monday, December 19, 2005 5:52 PM

Subject: Talking to my doc

Hello all,I am thinking about asking my doc if I can try one of the biological meds. You may recall that a radiologist detected erosions in my recent X-rays, though the rheumy felt that only one was actual. I thought I would only discuss the one she agreed was a real erosion. Since that happened since being on MTX, it could be said that the MTX failed, and that is what must happen before my insurance co. would pay for a biological.I am worried, however, about infections. MTX alone has agreed with me; I don't want to start having all sorts of problems with an Enbrel, Remicade, or Humira. I am doing fairly well on the MTX, but am concerned about erosions. The toe happened silently--no swelling, pain, or redness. I don't want my hands to be next. (The radiologist said he detected erosions throughout the hands, but the rheumy disagreed.)Thoughts?Sierra

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I don't know about Enbral but I do know about Humira. Remember, everyone reacts differently to diferent drug therapies. I never even took MTX until after I was taking Humira. I have never had any problems with any stomache reactions to any drugs, even birth control when I was younger. The Humira really helps me. The only side effect I ever had was I would need to be able to sleep or rest the day I took the shot. I think the hardest thing was training myself to give the self injection as I firgured there may not always be someone around that could help me with that since I received them through home delivery. I did notice when I started taking MTX that it seemed like more of my hair was falling out. but other than that my body has not had any bad reactions to any drugs, I was also on folic acid(my rheumy said that would help my body to absorb the MTX). I was never really prone to colds, flus or other common illnesses. If you are the

type of person that seems to catch colds or flus at the drop of a hat, remember that the biomeds do lower your immunity to a certain degree. I have recently been taking glucosamine & chondroitin hoping that they will help to curb the erosion in the long term of things. I can tell if I miss taking them as I think my body has gotten used to having them. Good luck. Renita Hello all,I am thinking about asking my doc if I can try one of the biological meds. You may recall that a radiologist detected erosions in my recent X-rays, though the rheumy felt that only one was actual. I thought I would only discuss the one she agreed was a real erosion. Since that happened since being on MTX, it could be said that the MTX failed, and that is what must happen before my insurance co. would pay for

a biological.I am worried, however, about infections. MTX alone has agreed with me; I don't want to start having all sorts of problems with an Enbrel, Remicade, or Humira. I am doing fairly well on the MTX, but am concerned about erosions. The toe happened silently--no swelling, pain, or redness. I don't want my hands to be next. (The radiologist said he detected erosions throughout the hands, but the rheumy disagreed.)Thoughts?Sierra __________________________________________________

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Sierra,

I've been on Enbrel since 1998 with no problems with infections. I've

had to go off of it

a few times when I've had a cold, just to be safe. I am an odd ball

that rarely gets

a cold and I'm not prone to infection. It's interesting that before

going on Enbrel I got

the average 1-2 colds a year which often times was accompanied by

bronchitis. If anything,

Enbrel has made me less prone to infection, but again I am the odd ball.

I am also taking mtx, but just a low dose of 10 mg, which was

recently upped from 7.5 since my

liver seems to be tolerating it. If you are still having erosions in

spite of mtx, the insurance

company should approve the addition of enbrel. The combination of mtx

and enbrel

have had great results.

The scary part about this disease is the fact that it can silently

damage our bones. I had

erosions in my wrist that showed up in x-ray long before I had any

pain in that wrist.

a

On Dec 19, 2005, at 8:53 PM, snowdrift52003 wrote:

> Hello all,

> I am thinking about asking my doc if I can try one of the biological

> meds. You may recall that a radiologist detected erosions in my recent

> X-rays, though the rheumy felt that only one was actual. I thought I

> would only discuss the one she agreed was a real erosion. Since that

> happened since being on MTX, it could be said that the MTX failed, and

> that is what must happen before my insurance co. would pay for a

> biological.

>

> I am worried, however, about infections. MTX alone has agreed with me;

> I don't want to start having all sorts of problems with an Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no swelling,

> pain,

> or redness. I don't want my hands to be next. (The radiologist said he

> detected erosions throughout the hands, but the rheumy disagreed.)

>

> Thoughts?

>

> Sierra

>

>

>

>

>

>

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Sierra, if you're getting erosions, you need stronger drugs. I've

been on Remicade and I have had a few sinus and bladder infections,

but just normal stuff, can't say if the Remicade contributed to it or

not. And it beats having joint damage. Go for it.

>

> Hello all,

> I am thinking about asking my doc if I can try one of the

biological

> meds. You may recall that a radiologist detected erosions in my

recent

> X-rays, though the rheumy felt that only one was actual. I thought

I

> would only discuss the one she agreed was a real erosion. Since

that

> happened since being on MTX, it could be said that the MTX failed,

and

> that is what must happen before my insurance co. would pay for a

> biological.

>

> I am worried, however, about infections. MTX alone has agreed with

me;

> I don't want to start having all sorts of problems with an Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no swelling,

pain,

> or redness. I don't want my hands to be next. (The radiologist said

he

> detected erosions throughout the hands, but the rheumy disagreed.)

>

> Thoughts?

>

> Sierra

>

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Check your insurance, mine paid for Enbrel right away, I did not

have to be on MTX or anything else first. Enbrel was my first

treatment for RA.

I also have never had a problem with infections, knock on wood!

>

> Hello all,

> I am thinking about asking my doc if I can try one of the

biological

> meds. You may recall that a radiologist detected erosions in

my

> recent X-rays, though the rheumy felt that only one was actual. I

> thought I would only discuss the one she agreed was a real

erosion.

> Since that happened since being on MTX, it could be said that

the MTX

> failed, and that is what must happen before my insurance co.

would

> pay for a biological.

>

> I am worried, however, about infections. MTX alone has agreed

with

> me; I don't want to start having all sorts of problems with an

> Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no

swelling,

> pain, or redness. I don't want my hands to be next. (The

radiologist

> said he detected erosions throughout the hands, but the

rheumy

> disagreed.)

>

> Thoughts?

>

> Sierra

>

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Hi Sierra, I wnated to address your concerns about infections. I

have been taking Humira for almost a year now. I am a substitute

teacher, so I am exposed to just about anything you can imagine. I

do catch a few more colds, and sore throats seem to plague me. But

the majority of this is do to my profession. When I am not working,

I rarely have any infections, even when my son brings them home.

Again, I do not get any skin infections or things like that, just a

slight increase in colds, but only when i'm working. Hope this

helps.

Dawn

>

> Hello all,

> I am thinking about asking my doc if I can try one of the

biological

> meds. You may recall that a radiologist detected erosions in my

> recent X-rays, though the rheumy felt that only one was actual. I

> thought I would only discuss the one she agreed was a real

erosion.

> Since that happened since being on MTX, it could be said that the

MTX

> failed, and that is what must happen before my insurance co. would

> pay for a biological.

>

> I am worried, however, about infections. MTX alone has agreed with

> me; I don't want to start having all sorts of problems with an

> Enbrel,

> Remicade, or Humira. I am doing fairly well on the MTX, but am

> concerned about erosions. The toe happened silently--no swelling,

> pain, or redness. I don't want my hands to be next. (The

radiologist

> said he detected erosions throughout the hands, but the rheumy

> disagreed.)

>

> Thoughts?

>

> Sierra

>

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Thanks so much for your reply, a. I feel quite nervous about

talking to the doctor. I'm worried she will be offended by my

bringing this up. We had a minor power stuggle when I asked for a

copy of the X-ray results--she didn't want to send it because of the

radiologist's " over reading " , but I gently insisted. I told her I

trusted her assessment, but that I'm a person who's " curious and

interested in such things. " She's always in such a hurry and our

communication has suffered because of it...I get part of a sentence

out and she's responding to that before I can get to the point! I

think it would be best if the meeting could be face to face--I'll

call tomorrow and see how long it will take to get an appointment.

My gut feeling is that it might be best for me to take a biological

med.

Sierra

>

> > Hello all,

> > I am thinking about asking my doc if I can try one of the

biological

> > meds. You may recall that a radiologist detected erosions in my

recent

> > X-rays, though the rheumy felt that only one was actual. I

thought I

> > would only discuss the one she agreed was a real erosion. Since

that

> > happened since being on MTX, it could be said that the MTX

failed, and

> > that is what must happen before my insurance co. would pay for a

> > biological.

> >

> > I am worried, however, about infections. MTX alone has agreed

with me;

> > I don't want to start having all sorts of problems with an Enbrel,

> > Remicade, or Humira. I am doing fairly well on the MTX, but am

> > concerned about erosions. The toe happened silently--no

swelling,

> > pain,

> > or redness. I don't want my hands to be next. (The radiologist

said he

> > detected erosions throughout the hands, but the rheumy disagreed.)

> >

> > Thoughts?

> >

> > Sierra

> >

> >

> >

> >

> >

> >

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The rheumy seemed to give a lot of weight to how my hands looked--not

red, barely swollen. I don't believe she asked if they hurt (they

often do).

Sierra

> >

> > Hello all,

> > I am thinking about asking my doc if I can try one of the

> biological

> > meds. You may recall that a radiologist detected erosions in my

> recent

> > X-rays, though the rheumy felt that only one was actual. I

thought

> I

> > would only discuss the one she agreed was a real erosion. Since

> that

> > happened since being on MTX, it could be said that the MTX

failed,

> and

> > that is what must happen before my insurance co. would pay for a

> > biological.

> >

> > I am worried, however, about infections. MTX alone has agreed

with

> me;

> > I don't want to start having all sorts of problems with an

Enbrel,

> > Remicade, or Humira. I am doing fairly well on the MTX, but am

> > concerned about erosions. The toe happened silently--no swelling,

> pain,

> > or redness. I don't want my hands to be next. (The radiologist

said

> he

> > detected erosions throughout the hands, but the rheumy disagreed.)

> >

> > Thoughts?

> >

> > Sierra

> >

>

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Thanks, Dawn. I work in a hospital, though I don't do direct patient

care. I would less concerned if I worked elsewhere.

Sierra

> >

> > Hello all,

> > I am thinking about asking my doc if I can try one of the

> biological

> > meds. You may recall that a radiologist detected erosions in my

> > recent X-rays, though the rheumy felt that only one was actual. I

> > thought I would only discuss the one she agreed was a real

> erosion.

> > Since that happened since being on MTX, it could be said that the

> MTX

> > failed, and that is what must happen before my insurance co.

would

> > pay for a biological.

> >

> > I am worried, however, about infections. MTX alone has agreed

with

> > me; I don't want to start having all sorts of problems with an

> > Enbrel,

> > Remicade, or Humira. I am doing fairly well on the MTX, but am

> > concerned about erosions. The toe happened silently--no swelling,

> > pain, or redness. I don't want my hands to be next. (The

> radiologist

> > said he detected erosions throughout the hands, but the rheumy

> > disagreed.)

> >

> > Thoughts?

> >

> > Sierra

> >

>

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