My two best friends – Meth and Acid

Methotrexate. The very mention of this drug makes me feel nauseous. For me, it is not so much the taste of it, but rather knowledge of what it can do to your body that causes me to become so apprehensive towards this medication. Perhaps it is my body’s way of telling me that this medication shouldn’t be ingested in the first place. Of course, I would rather not be taking this medication in the first place if it were not due to my set of unfortunate circumstances.

Alas, it is this medication that has helped control my inflammatory factors  (through varying degrees of sucess) these last few years. When a flare up happens it happens – even when you are taking your prescribed medication religiously. Methotrexate is one of those drugs in modern medicine that can be a bit of a double edged sword. It is well known for it’s use in chemotherapy in combating cancer cells, and yet it finds itself in the use of treating rheumatoid arthritis albeit at a different dose. Take this too often or at a high enough dose and you may find yourself in hospital….if you are lucky. My lecturers at university has never ceased to impress upon undergraduates the dosing regimen for methotrexate is usually ONCE A WEEK followed by its partner in crime, folic acid 24-48 hours later. Very rarely if ever is methotrexate taken on a daily basis.

One of it’s side effects (and I suppose it’s intended effect in some cases) is it’s ability to suppress your body’s immune system. That is to say it makes your immune system a little less active. Great for preventing flare ups and slowing the disease progression, but absolutely rubbish throughout the winter months as you struggle to not catch a cold! Needless to say, I have a love-hate relationship with methotrexate. And don’t even get me started on the mouth ulcers that come with taking this medication!! Not being able to enjoy eating the bountiful food of this earth is enough to send one into a blinding rage of frustration!

Because of methotrexate’s ability to suppress your immune system patient’s like me have to undergo a blood test every 4 weeks to monitor our blood levels. It can be scary and annoying for some people who don’t like getting stabbed with a needle on a regular basis. Not only that but to watch yourself bleed to fill the necessary vials that are to be sent off to the labs to be analysed. Taking methotrexate is a pain. There is no way to avoid the blood tests as they are necessary to monitor not only rheumatoid factors but also signs of methotrexate doing it’s job too well.

So how do I cope with all this?

The simple answer: stay healthy. Be that through diet, exercise, and not doing silly things that would put your health at risk. Seriously doing this will solve the vast majority of life’s health problems (You can thank me later).

The answers that you were probably looking for:

Disclaimer: Please double check with your doctor or pharmacist over the suitability of some of the recommendations that are mentioned in this blog. Everybody’s circumstances are different and what may work for one person may not necessarily be the best option for another.

For the blood tests I can’t avoid. Though saying that, I had unintentionally missed my last blood test appointment. It is important to stay on top of your blood levels so that your doctor can adjust your treatment accordingly should something flag up. Just have to be brave, and bleed for the sake of your life.

For the mouth ulcers, Bonjela is your best friend. Or alternatively you can use something like Orajel. They both do the same job. Both acts to numb the ulcer so that you can carry on with day to day activities with little pain and interruptions. The downside to this is that you may find multiple applications of this product is required throughout the day.

Some people have complained of diarrhoea whilst on methotrexate too. I have experienced this during the early days of my treatment, but now it would appear my body has adapted around that and is no longer an issue. If you aren’t one for waiting then I would suggest taking something like Immodium as a short term measure. This is a typical anti-diarrhoeal medication that you can buy over the counter and it essentially slows the passage of food through your bowels.

One of the doctors at my doctor surgery had suggested that from time to time I may take an extra tablet of folic acid to help reduce the side effects. I have yet to take her up on this advice as my side effects have not been so bad that warranted such action.

To be honest, the vast majority of side effects from methotrexate are bearable. The few times where you would be concerned is when the results from your blood tests are abnormal.

I am fortunate enough that I am only on two medication to manage my rheumatoid arthritis currently. I know patients that are taking a few extra and also at higher doses. Which goes back to the short answer I gave earlier: STAY HEALTHY!!