Do You Take Methotrexate for Rheumatoid Arthritis? | Rheumatoid Arthritis Warrior

Do You Take Methotrexate for Rheumatoid Arthritis?

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What about methotrexate and RA?

I answer that question frequently. People who are not taking methotrexate want to know how it feels and how it works. People who are already taking methotrexate for Rheumatoid Arthritis ask me how I deal with side effects. I’ve spent countless hours writing replies to questions about methotrexate and RA  – everything from side effects to benefits to dangers…

From what I have read, about 90% of Rheumatoid Arthritis patients take methotrexate at some point. Methotrexate is the most prescribed disease modifying drug. And people tend to take methotrexate for a longer term than other drugs.

I have now published my answers to “frequently asked questions about methotrexate.” I hope that you find it helpful. There are currently 7 articles in these new Methotrexate & RA pages, including “13 Things to Consider Before Flushing Methothrexate.”

As I wrote recently, you are the manager of your treatment. Although it is the physician who prescribes methotrexate for Rheumatoid Arthritis (or other autoimmune disease), you are the one who has to swallow the pills. My goal is to encourage you to learn as much you can and make the best decisions possible for you. And that is one reason why this website is dedicated to bringing inspiration and encouragement to fight Rheumatoid Arthritis.

Click on the Methotrexate tag or on Methotrexate and RA on the menu:
Frequently asked questions about Methotrexate and Rheumatoid Arthritis
Is Methotrexate a Villain or Vanquisher? Methotrexate is the most commonly prescribed disease-fighting drug for Rheumatoid Arthritis. I am asked so many questions about methotrexate. Here, I have provided a basic overview of issues…

Kelly O'Neill Young

Kelly O'Neill (formerly Kelly Young) has worked over 10 years as an advocate helping patients to be better informed and have a greater voice in their healthcare. She is the author of the best-selling book Rheumatoid Arthritis Unmasked: 10 Dangers of Rheumatoid Disease. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. She is the president of the Rheumatoid Patient Foundation. Through her writing and speaking, she builds a more accurate awareness of rheumatoid disease (RD) aka rheumatoid arthritis (RA) geared toward the public and medical community; creates ways to empower patients to advocate for improved diagnosis and treatment; and brings recognition and visibility to the RA patient journey. In addition to RA Warrior, she writes periodically for newsletters, magazines, and websites. There are over 60,000 connections of her highly interactive Facebook page. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She created the hashtag: #rheum. Kelly is a mother of five, longtime home-schooler, NASA enthusiast, and NFL fan. She has lived over thirteen years with unrelenting RD. See also https:/rawarrior.com/kelly-young-press/

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128 thoughts on “Do You Take Methotrexate for Rheumatoid Arthritis?

  • June 8, 2012 at 11:25 am
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    I start MTX today. I am concerned about something – I’ve had pain (diagnosed as fibromyalgia, degenerative disk disease, etc) for years but over the past few years I’ve had tremendous amounts of fatigue. Even after I started thyroid meds, my fatigue didn’t abate. The doctor says that RA treatments may help my fatigue – Is that true? I’ve only heard of MTX making fatigue worse, not of it making fatigue better (if in fact the fatigue is related to the RA). Have you heard of people feeling LESS fatigue on certain RA drugs? MTX in particular, since that’s what I’m starting with?

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  • November 8, 2012 at 4:59 pm
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    I am 63 and pretty healthy. In the last five years I have started to get more and more tired. Finally figured out I had
    Hypothroism. That being taken care of… we addressed the neropathy in my feet. Taking Gabapenten for that.And I felt a lot better immediatly. But last year I had three serious episodes called Flares. Was bed ridden.After a dose of predisone I was much better. My episodes usually occurred after a stressful moment or argument.
    Since then I have seen an RA specialist. He was informative but vague on what may happen if I proceed with the Methtrexate.
    I have serious concerns about what my quality of life will be on this drug. Actually three drugs. I am not seeing the value over all as opposed to the RA symptoms versus the Methotrexate drug.
    I do not want to make myself sicker or open myself to more infection. I live in Alaska. It is cold and I hurt usually during the winter. I take a lot of vit D and Turimic. That helps a lot with joint pain for me. I am terrified of starting this treatment and feel very unsure of what to do.
    My family is not supportive of it. But then they do not know how awful I will feel. I guess I want some averages from the patients. All the doctors recommend it. But I need to know from the patients if they feel their quality of life improved. Susanne from Alaska

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    • November 9, 2012 at 6:37 pm
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      Hi Suzanne, sorry about all your problems, and the Alaskan winter won’t help, right? I have been diagnosed with RA last year, started prednisone (horrible), then MTX pills (very bad), went natural for 1 month, and bam …. a huge flare, swollen, bedridden. At this point I just wanted something, anything, and my GP started me on 0.8 (= 8 pills)MTX injections. It never helped my hands or feet, but brought the swelling in my knee down within 4 – 6 weeks. I had fatigue before, but severe with the flare and MTX. After 3 months my rheumy added Arava, then Sulfazalazine, Plaquenil, nothing helped. But the MTX brought the flare down a bit. I finally qualified for Humira, and started in May. And this has made all the difference. My fatigue is at a minimum, and I can wear a watch and ring again (after 1 1/2 years). I am still on weekly MTX and folic acid, and was told I will have to continue. The injections were a lifesaver. Initially, I felt so cold and tired for about 1 day, but that’s gone now. I did gain a few pounds though. We have to be proactive with this disease, and MTX is the foundation. I have also started cold liver oil. I am in Canada, so I am familiar with the harsh winters. Cozy up, keep warm and take your MTX. Good luck.

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  • November 9, 2012 at 9:00 pm
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    I’ve been on MTX for 4 weeks now, I take it on Wednesdays because I am off work wed-Fri. So far the side effects have been pretty mild. I also take folic a. and 20mg prednisone daily. My Rheumy said she would start tapering down the prednisone in 2 weeks. My hands feel better now than they have in at least 10 months. I can make a fist, something I thought I’d never do again. I feel really tired on Thursday and have slight nausea, some hair loss, but nothing that would make me stop the MTX, If how I feel now is an indicator of how the MTX will help, then I will gladly continue to take it. I still hurt, but I have been able to sleep well for several nights.

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  • November 15, 2012 at 5:10 pm
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    Ive been on Methotrexate for over a year know and in the beggining it was like a miracle it worked great with minnimum side effects. Keep in mind it does take some time for this drug to build and start working in your system.Now that ive been on it for some time now it doesnt seem to be working like it did and the side effect are getting so bad its effecting my home and work life mainly the mood swing.It has attacked my vision as well and i think this vision thing really needs to be stressed by your doctor before priscibing it.I will post back and do a update on my vision a sure hope it gets better.One other thing that i think needs to be said about methotrexate is if you get the flu wile on it stop taking it untill your better something i was never told and had to find out the hard way.I hope this helps.

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  • December 10, 2012 at 10:26 am
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    My Mom had a terrible time with Plaquenil (sp?). She was in so much pain and had severe GI problems and went into kidney failure. After a hospitalization in which she was released with unstable electrolytes due to severe diarrhea, we finally found a GI MD who gave her lomitil and pepto-bismol to be taken around the clock. After recovering from that, she started methtrexate and soon after Imitrex IM, and she has been doing really well for about two years. Now she is having severe side-effects from the Methotrexate-debilitating mouthsores, and a very low wbc. We have stopped both but now she is in so much pain and still has the mouth soars and weekness. Now what to do.

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  • December 18, 2012 at 5:21 pm
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    I’m 70 years old and a retired RN, I had no idea RA hurt so much.My first thought was why me,I’ve had enough diseases. I’m still not wanting to accepting of my disease. Itaken Chemotherapy before 41/2 yrs.ago.This doesn’t scare me and I’m thankful we have something to fight this with.

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  • December 18, 2012 at 7:24 pm
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    It helped me more than anything else I’ve read.Very thankful for Kelly.I get really tired after I mtx.I’ve only been on it for a monthI thought I was being a baby about pain.But now I know it really does hurt.Thanks.

    Reply
  • December 18, 2012 at 11:36 pm
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    Yes, Sandy it makes me tired too, the day i take it since giving up work, i try not to do anything amazingly strenuous.I feel really wacked and can’t think sharply, sort of foggy.My husband says i look pale and washed out the day i take it. I luckily don’t get nausea or any other symptoms with it. I take Folic acid and B12 every day except of course the methotreaxte day ,the B12 seems to help the anaemia that i had with the methotrexate initially.I certainly feel the benefits of it as the day before its due i am beginning to feel awkward with my joints and stiff.
    Good luck.

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  • December 26, 2012 at 8:15 pm
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    I’ve been on MTX for about 12 weeks, and now I’ve tapered off prednisone. I was curious to see if the MTX was making me feel better or the Pred. Now that I’m only on the Mtx, I realize how much the Pred was helping with the pain. My Rheumy increased my dosage to 8 tablets weekly in Dec. and will go to 10 in Jan,right now I am not so pleased. I can tie my shoes, and a few other things, but this past 2 weeks have been pretty bad. My elbows hurt all the time and I can see my fingers swelling. How long before the MTX helps??? My Doc said she’s afraid to start a biologic because i need more tests, she’s not 100% sure I don’t have MS. I have no job, no insurance and cannot afford the tests needed, so I really need this MTX to help. I am getting depressed, this constant pain and fatigue is killing me. I used to be so happy. Now RA has taken my happy away.

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    • December 29, 2012 at 10:22 am
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      Hi, I started on MTX about 2 years ago and take 10 mg a week. Before I started I couldn’t tie my shoes, hold a knife and fork and getting dressed took ages… i had a lot of joint pain too. In the beginning it took a couple of months and I slowly felt the pain go away,I had a fuzzy feeling in my finger joints and it reminded me of when I descale a kettle and it slowly disappeared, the swelling went down and now for 2 years I feel free of any signs of RA. Luckily for me I don;t have any side effects of the medication. I know the RA is still there, as my doctor says “it is under the carpet”, but with the medication I feel as if has gone away and I am able to do everything as I did before. Good luck with your treatment… my RA said it would take upto 3 months to see any improvement and that is how it was, slowly, slowly until reaching a state feeling free of any of those horrible symptoms. good luck with your treatment and I hope it helps you the way it helped me. 🙂

      Reply
  • January 4, 2013 at 5:49 am
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    Hi,
    I’m a 47yr old male & was just recently diagnoses with RA (12/17). I haven’t been able to walk since 11/5 when the initial attack occurred & was told it was gout in both knees & feet. I had a similar attack 2yrs ago that put me down for a month, but that was dismissed as gout. Now correctly diagnosed they have me on prednisone, methotrexate & folic acid pills. Still getting flare ups and hopefully adding enbrel to the mixture in a couple of weeks after some more test . I’ll keep you posted on how it works out. Being able to read the comments on your site has given me some much need hope that I’ll be able to walk again & hopefully save what’s left of my small business that’s has been neglected because of the disease. One other thing, don’t hear from a lot of guys , I know we’re a small percentage of RA patients , but come on guys speak up ! Thanks

    Reply
  • February 25, 2013 at 8:45 pm
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    Well it has been a while since I was diagnoised with RA. I made the decision not to use MTX and changed a lot of things in my life. Stress seems to really cause a flare up and then I would end up in bed. Evidently …. it releases some chemical that really interacts with RA. Started meditation and deep breathing for stress. Leaned on God a lot. Taking a lot of vit D, Omegas,and turmeric. I am not saying this is a cure but for me the side affects were not worth the risk of getting sicker or dying from Chemo. I may change my mind some day. For the moment I have been Flare free for several months. I have shared with my family and they help my life stay as stress free as possible. There is no cure for RA. there is only treatment…and one or the other seems pretty aggressive and dangerous.

    Reply
    • August 27, 2013 at 2:48 pm
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      I’ve just started with methotrexate and am still considering doig what you are doing, going natural. If you read this, can you tell me if it is still working for you?

      Reply
  • May 17, 2013 at 9:08 am
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    I developed RA shortly after my mentally ill 22 year old son burned our house down (arson…intentionally set). I guess the stress of hundreds of thousands of dollars in damages, an insurance company that didn’t want to pay, being homeless overnight having to spend $12,000.00 the first month on housing alone($200.00/night in hotel charges for the only place that would take my 2 dogs, plus my mortgage, etc. etc.) was too much for my body to take. I dragged myself to all the court hearings for my now incarcerated son, a tired shell of the person I once was. Within months I went from a pretty fit individual who could still run 10 miles after her 13 hour shift in the icu…to someone who could not even get off the toilet alone, or walk up the stairs… I begged for death, but it did not come. I had no idea how painful RA was. I had 2 grandmothers that had it, and I still had no idea. The sheer agony of the first couple of months, the massive swelling in my feet and knees, and the sensation that someone was driving nails into my legs all night was enough to convince me to do something. After all that, Methotrexate sounded pretty darned good. I now take it weekly with folic acid and Prednisone, and feel 500% better. I work Friday through Sunday, so I take it Monday right after work. This way I can sleep through the worst of the effects. I have mild nausea, mild anorexia, and it makes me tired (so taking it before bed works best for me)…but hey…I don’t have to use the handicapped bathroom stall anymore and I can make up the stairs in the home we fought so hard to put back together…so totally worth it for me. I still have some pain and stiffness. My hands are pretty weak. But overall I feel so much better. I am still working full time, it’s hard, but I fear disability far more than the effects of Methotrexate. The best thing, however; was the understanding that I gained of how debilitating this disease can be, and the empathy that I gained for my patients that have it. It has changed my practice for the better. All things happen for a reason.

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  • September 6, 2013 at 12:50 am
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    I started taking Mexotrexate last May. Very low dose and It is working. The joint pain is gone. But If I do not monitor my activities, fatigue gets me and stress really knocks me down
    with a flare up.I fought taking it and did every thing I could
    to avoid it. I am not suffering from the side affects other than being tired for a day. I suffer from serious muscle spasms and nerve pain neropathy in my feet. So far taking Gabapenten and Cymbalta are starting to give me some relief. I hate having to take the meds. But I also had no life anymore. I am feeling much better. And this site gave me hope I was not alone and that many others had symptoms as I did even thogh My doctor said was not related. You may not find the right doctor. And we have to by responsible for our health ourselves. Good luck on your journey. Your not alone.

    Reply
  • September 14, 2013 at 5:07 am
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    When is the best time of day to take Mexotrexate? I am scared to even begin my dosage after reading all the posts. Please reassure me, it’s ok.

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  • November 11, 2013 at 7:30 pm
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    Hi everyone~I just read through lots of the comments here. I am starting Methotrexate today after debating about it for 2 months. The pain in the balls of my feet has been excruciating so I decided to try it. I am also taking 1 mg of folic acid–but after reading some of he comments, should I up it to 2mg to further avoid hair loss, mouth sores etc? Any input would be appreciated!

    Reply
  • November 11, 2013 at 9:36 pm
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    I started on MTX 14 months ago, added Cimzia (biologic) 9months ago. I have to say for the most part the combination has helped with my RA symptoms. I have had to add prednisone a couple of times for severe flares, but tapered off as soon as possible. I had to stop both the meds 2 times because of infections and had to be on antibiotics. The side affects were bad in the beginning, but gradually got better. For a few months I felt so much better than before the meds, but lately the side effects are bad again, plus some new ones. I have one thumb that is basically useless right now, and joint pain in too many places, I feel like a bad flare is coming, I hope this doesn’t mean I have to change meds, I do not want to start over. Advice for someone considering MTX and/or biologics, I say go for it, even with current problems, the period that I felt really good was worth it, even if it may be over. Even now I still don’t feel as bad as I did before diagnosis and starting treatment. Just be careful around sick people, infections are bad.

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  • November 17, 2013 at 10:37 pm
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    Hi all~I’ve just started on methotrexate and am nervous to be on it. But the pain in the balls of my feet is so severe, I have no choice. Even my shoes aren’t fitting right anymore because of a slight widening of joint on side by mall toe. Reading everybody’s posts is such a help as I don’t feel so alone in this. I’m curious, what to do about the pain until or if he methotrexate takes effect. My doc says I can take Aleve but I’ve read it isn’t safe? Any input would be appreciated.

    Reply
    • November 18, 2013 at 12:13 am
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      Most doctors would agree that ibuprofen or naproxyn (Aleve) is fine with methotrexate. Most RA patients take NSAIDs with MTX. Much of the info available about MTX applies to cancer doses – here’s more on that https://www.rawarrior.com/perception-reputation-information-how-do-we-decide-about-dangerous-drugs/
      There are 30 articles here on MTX – more than you want to know now, I’m sure. Sometimes too much at once can be overwhelming, so a little at a time as you need it can be better. You might also find the RA Map (on the top menu) helpful. I hope your feet feel better soon.

      Reply
  • November 19, 2013 at 1:14 pm
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    I’m 65 I’ve had r/a for 1year now. i started with MTX for about 3 months(8mg for the last month) It didn’t work. My dr. Gave me Humira . I took 6 shots. It didn’t work. I haven’t taken anything for about 3 months now. my hands hurt pretty bad and the balls of my feet hurt and I can’t walk from the pain. I have pain in my knees. I’m loading up with over the counter pain meds. My R//A blood count is over 340 even while I was on the R/A meds. My question is, is there a chance the pain in the balls of my feet are from something else, or should I just accept the fact that it’s the R/A. aNd get more meds. I read that people go on two types of meds for good results .

    Reply
  • February 16, 2014 at 5:28 pm
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    Does anyone have anything to say about low dose naltrexone and RA
    I have been taking for two months, slight improvement , no major flares
    Degradation is evident in the elbows however. Metho scares the absolute life out of me.

    Reply
  • March 6, 2014 at 1:52 pm
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    I was on methotrexate very briefly and I broke out in hives all over my body and had to be rushed to the hospital. I think I had taken it for about 4 weeks. Another RA medicine down the drain for me.

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  • January 1, 2015 at 7:06 pm
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    I was diagnosed Nov 18, 2014. The following month my doc told me my RA is very aggressive, and that if I wasn’t treated I’d be bedridden in 5 years. That was a shock. But I’m taking methotrexate and folic acid along with prednisone. I can’t believe how much better I feel! I also do not have any side effects… so far. I hope it stays that way. My right hand has started to be deformed. I hope that’s the only thing that gets deformed. All in all, from a lot of the comments I’ve read, I’m doing muck better than a lot of people, so I count my blessings. I hope others can find what will work for them.

    Reply
  • February 6, 2016 at 3:52 pm
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    Hi, I have had rheumatoid arthritis for over 5 years now. I am 27. My rheumatologist put me on 2 tablets of plaquinill everyday, 1 tablet of folic acid everyday except for the day I take methotrexate which is 10 tablets every Friday, and 2 tablets (was 4 tablets everyday, but that gave me sharp pains in my stomach and so on) of sulphalasazine everyday. My hair is fine, but lately my menstrual cycle is all over the place and I’m on birth control, have been on it for a long time. I went on it to regulate my menstrual cycles. My cycle lasted a month on and off. Once it finally stopped I opened new pack of BC pills, n my cycle came a week early, stopped then started again n so on. Today I’m cramping 🙁 its messed up. I don’t see anything in the side affects for the sulfalazine and menstrual cycles. Any body have any idea what’s going on? I know for a fact that I’m not pregnant.

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  • May 23, 2016 at 11:59 am
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    Methotrexate caused me Cancer I’m told it’s gone now but Wow what a year – And now my RA is back big time. Got my Rhummy to switch me to Dexamethasone from Prednisone ?? As that is what they give you before your Chemo and it helped not sure if one is better than other, now getting a few side effects

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  • October 10, 2016 at 8:34 am
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    I am on Plaquenil and 16mg equals 0.6 ml methotrexate injection weekly. I still have flares quite frequently.

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  • June 7, 2017 at 1:34 pm
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    MTX scarred my lungs. When I was diagnosed with RA-Lung, my rheumy snatched me off the mtx immediately. Too late though, the damage was done. MTX DID help my RA symptoms though. I read a study recently that claims out of several hundred autopsies on RA patients done, it revealed that 80% of them had some amount of lung scarring. And MTX is the most prescribed drug for RA. HMMMMMMMM………

    Reply
  • June 11, 2017 at 8:10 pm
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    Great website; very enlightening. Until I found it, I felt isolated. My illness was dismissed as being mere malingering, even by my own brother. After 33 years of being a trial lawyer I suddenly turned into a lazy slacker? I’ve never applied for disability, and refuse to do so. I still work for a living. I physically can’t drive (my hands are shot, so I can’t steer a car). All that is is left is writing and consulting…so that’s what I do.

    Everybody I know gives me tons of ignorant advice…like eating more organic carrots or Greek yogurt would cure everything that I “thought” was wrong with me. “You need more exercise” is my favorite. As they say: is eye-rolling considered cardio?

    Pardon me for venting, but at least this group will understand my frustration. This site provides an excellent forum for those suffering with RD. Thanks!

    Reply
    • June 12, 2017 at 5:10 pm
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      Dear Brian,
      Thank you for your sarcasm. Comments like yours help me know I’m not alone. My first comment in wks due to RD, but I just had to thank you.

      Reply
  • August 24, 2019 at 3:46 pm
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    Hi All,

    Are you still on this site….only the last post seems to be in 2017?

    I’m new to this World of RA, and have my first appointment to see a Rheumotoligist, next week…

    Thanks for all your previous comments and advise, I’m Sure in time I will better understand this crappy disease…

    Ria…xx

    Reply
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