Hi there, I had my RA confirmed just last week. At the same appointment I was given a steroid injection to help ease my current debilitating symptoms. Three days later and I find my symptoms have improved but not completely disappeared, yet. I was given information leaflets on Sulphasalazine and Methotrexate. When I return in 3 weeks I will be started on which ever one I decide on.
I have been off work now for 7 weeks and am due to return next week. However, I find although I am desperate to get back to work and normality, I am worried that my symptoms will return and I would then have to go off on sick again which would count as another sick episode, something which HR don't take kindly to.
I am a nurse and work 12 and a half hour night shifts. Prior to this period of sick leave I was finding that half way through the shift my hands became inflamed and sore. .....this would lead to poor sleep the next day and then struggling (badly ) through the next nights shift. Got to the point I had to go off sick and now understand I have been having a bad flare. My bloods showed RF and CCP positive.
My question is, will the steroid injection keep me symptom free till I get started on the meds?
Any advice would be much appreciated. Thank you for listening!
The steroid injection will only work for so long to help with your discomfort now.my first one lasted a month.
It also takes about 12 weeks for the DMARDS to kick in.
There is no easy fix I'm afraid
It depends - pred injections last different times for different people.
Are you in the UK? RA comes under disability discrimination law so I suggest you talk to Occy Health who will help you with advice and making reasonable adjustments if you return to work in the meantime. Perhaps a staged return would help - and if it doesn't work then you shouldn't get accused of having a second sick episode. And get the union onside.
As Frances says, it isn't even possible to say the DMARD you choose will work quickly - methotrexate can take up to 6 months for example. And some people don't respond as well as others. Maybe they will give you oral steroids to cover the interim.
I was diagonised in mar 16. Doc put me on Methrotrexate right away . For six months I still feel pain until doc increase the dosage and added 5mg of steroid daily . Then everything kicked in. My symptoms improved . Now I'm only on MTX. You can't take steroid for a long term. Stay positive while you are waiting for the meds to kick in.
Er - you CAN take pred longterm, I've been on it for 8 years without any problems at all overall. The autoimmune disorder I have only responds to pred, there is no choice. Some rheumys don't like it - but beggars can't be choosers!
Thank you France for replying .........I think I was hoping for a quick fix! After some extensive reading this morning I realise that's not going to be the case 👎
Thanks for the advice Eileen, much appreciated. Phased return to work and reasonable adjustments aren't really possible in the busy ward I work in.......that's why I'm nervous of going back. I feel that I may be just coming out of this particular aggressive flair i've been experiencing for 3 and half months now! I do feel an improvement since the Kenalog injection , but I'm terrified of the extreme pain returning.
I think I'll phone my boss in the morning to see what she suggests. I'm only just beginning to realise that until I get things under control with the meds, there may well be further periods of sick leave 😓
I am on steroids for life and have been sinice 2012.I have other health problems too.I take 2 DMARDS aswell.unfortunately biologics didn't work for me and am still struggling.
Some people respond better which is great
Thanks Sia.....I always tell my patients to stay positive. .....now I need to practice what I preach!
I appreciate the length of shifts can possibly not be altered - but maybe the gap between each shift can. If you aren't well enough to work you will be no use to them or to yourself - and the NHS is hard work and it is hard to adjust. Know all about that - worked there, was married to it and both daughters and sons in law work there!
Hi I'm so glad to read you are on predisone to help. I was diagnosed with RA two years ago and my doctors are allowing me to just work with predisone between 7-10mg and it allows me to keep my RA under control, though I'm scared it's not stopping the RA progressing and so many people say that steroids are not good long term . The big but is they suit me and I can work and live life and be mostly pain free.
Did you mean your response for me? I don't have RA - and mercifully PMR doesn't damage joints so the DMARD bit isn't as important. What we do have is numerous rheumies desperate for us to take methotrexate as a "steroid sparer" - even though the evidence is very mixed and far from convincing.
They are terrified of pred - but if a low dose works and gives us our life back when nothing else does, I don't understand their arguments. They are all horrible drugs!
I was diagnosed in May last year, I take Mexotrate and Steroid tablets. Every time ai have tried to come off steroid tablets my excruciating pain comes back before I even come off them. I reduce the steroid tablets down weekly from 8 to 0 but as soon as I get to 1 a day the pain returns. I'm on 1 a day at the moment as I am due back to Consultant next week and he wants me off the steroids but the pain is killing me today and will do when I totally come off them on Thursday. In my opinion, methotrexate is doing no good at all, sulphazalazine did no good either. Steroid tablets are brilliant but they don't like you on them long term as they have many side effects. I am at my wits end after all this time so be patient as you will certainly need patience to get through this.
Hi
thank you imissed understood,but your comments helped x
When you say "8" and "1" - do you mean 8mg and 1mg or is tha the number of tablets you take?
Steroids only are generally used as "BNRIDGE THERAPY" until the DMARDS kick in, or during an acute flair. If you know you have it-- start the DMARDS NOW!!! IT will get worse, and the sooner you start the better. For me, Sufasalazine does next to notheingm, and that's on top of 25. mg of Methotrexate. I
d suggest start with methotreexate as (in the US) youi have to fail at that before moving tonto any biologics, if you need ton .
Also, 122 hours in probably getting to be too much. I couln;t even work 5 hoursnin a row any more , if i wanted to. I'MM TORED ALL THE TIME.
BE CAREFUL. TAKE CARE OF YOUR SELF NOW!!
This os a tough disease. I hate it-- but we have to love ourselfs and be good to ourselves.
All the best of luck to you.
Hi that's how I started, on my diagnosis day I was also given a steroid injection and oh my goodness all my pain disappeared the next day, they told he it would last 3 months and by that time the methotrexate should take over, i could only tolerate it for 6 weeks and sadly had to come off it as my enzymes were raised in my liver. I was off it a fortnight and the pain returned with a vengeance oh my goodness it was a bad time for me. A few weeks later the rheumatologist wanted to try me back on methotrexate I was dubious but he knows better than me I guess, before I left I had another steroid injection and again it worked a treat, that was the beginning of o Tiber and so far so good, I take 6 a week (15mg) and one 5mg folic acid each day apart from methotrexate day and it has helped me so much I just hope it continues
Thank you Barbara, i would start the methotrexate now if I could, but my next appointment isn't till another 3 weeks 🙈. I think I know deep down that 12 and 1/2 hour shifts are too long, I was struggling even before the intense pain started, it came from nowhere in the middle of a shift, no gradual build up, just....BANG !!
If I could be sure the injection would keep the symptoms at bay until I start the meds then I'd feel more confident about going back to work. ........I have a nagging feeling that's not gonna be the case? ??? Or maybe I'm just paranoid now.
I am 53 years old and NEVER had any kind of illness before (I don't even get colds! !), I am thinking maybe I'm in denial about the effects this is going to have , all I csn think of is just being painfree, back at work and carrying on as before. .......am I being naive? ? I've also read of many people 'getting their life back " .......i'm pinning all my hopes on this being the case once the meds kick in
Thank you everyone for taking the time to offer advice , it really is much appreciated
Your right Eileen about the NHS being hard work. .......that's exactly why I'm worried about going back. I hadn't thought about asking for split shifts......I will ask about that tomorrow when I speak to the boss, I think that would defo be better than working 3 shifts in a row !
Thank you!
Which speciality do you do?