mtx and the two year old (sounds like a bad tv show!)

Hi folks,
I am back again with more questions about mtx and my son.  As I posed earlier, he has been on mtx for apporximately 2 months now .  I don't know if he is getting any better (I think I see less swelling in his fingers but his wrists look worse to me - go figure) but will have to wait till we see his rheumy next month to get a 'professional' opinion.  I do have a few more questions though....

Do you get pulled off the mtx when you are sick?  After 2 doeses he got strep throat (which he has never had) and was put on a 10 day antibiotic.  My rheumy pulled him off the mtx for one week and them let him go back on at the tail end of his antibiotic.  We were going along fine for another 3 weeks and then he got an ear infection (had tons of them when he was a baby but havent had one in about 15 months).  Again, he was put on an antibiotic and pulled off the mtx by his rheumy.  This week, we go back on the mtx.

I know the mtx will lower his immune system but do you get sick more frequently.  When you are sick do you go off the mtx?  Is all this on and off doing him any good - I wonder if it is causing him to flare because of the up and down of the mtx?

Just wondering what your experiences have been with this and if we are just destined to do a constant dance of mtx and antibiotics.

Thanks again for all your help.

Heather

Hi there- sorry to hear he is so sick! I'm on mtx and humira (and plaquenil) and every time I get sick, I get taken off humira but never get taken off of methotrexate. My doc says that it takes so long to build up in your system, that taking yourself off it for a week barely changes anything. I guess the good news is, skipping a week can't hurt that much either, but if he's constantly going on and off of it, he's probably averaging out to a lower dose than he needs. Of course, I'm 32, not 2, so there may be differences in what they do for adults! (by the way, I have never been taken off the plaquenil for any reason, including when I needed IV antibiotics).

Heather,

I am sorry to hear he is getting so sick.  The first question is he in a day care? usually kids that go to day care will get sick more often than those that doen especially those with a compromised immune system.  This happens often with my 2 year old granddaughter that has a metabolic disorder as well. 

MTX will lower the shield the bodies immune system builds in the younger people with RA; remember at that age they haven't had time to build those types of antibodies and become immune to the standard colds and bacteria as adults.  This is just my opinion and wha they have told my family for me when I was younger and my granddaughter that is NOT on MTX but has other immune system issues.

Because of my granddaughters situation we looked into assistance from the government on medicare/medicaid for a Medical daycare.. The standard daycares refused to take her because of it..  

Good luck.. 

Heather,

My rheumy does take me off the MTX when I have an infection.  I've gotten a few kidney infections and one ear infection since I've been on the MTX (I never got either before then), and both my rheumy and my PCP tell me to stay off the MTX until I get better.  This is different than what Kate said, but the same as your sons' rheumy, so I really don't know whose rheumy is correct.  But I do know that if your son is getting so many infections close together, it could be daycare like Tessa said, or it could be that he's on too high a dose of the MTX.  I would ask your rheumy about that. 

Are they giving him any other meds. for the JRA?

I know a lot of the ones we take are not prescribed for children, so I'm curious as to what treatment options you guys have.

Keep us posted.

- Kati

He is in daycare (and has been since he was 4 months old)  It is almost like he is reverting to that 'sick' daycare baby again.  We had a really healthy run with him but since he has been on the MTX, the typical daycare sicknesses are coming back.  He had tubes put in his ears at 10 months and one fell out about 4 months later.  Needless to say, it is the non-tube ear that got infected.  He seems to have cleared up but I need to bring him back to his pediatrican to be sure.  If we are going back to the constant ear infections, I think he will have to have the second tube put back in. 

He isn't on any other JRA meds - right now it is just motrin 3xday and the MTX once a week.  I was just thinking though that his fingers/toe/wrists have been swollen consistently for 8 months now.  We go to the rheumie in July and think he will probably add something else to the mix - I can't imagine it is good that he hasn't gotten any relief yet but maybe not - as you know, I am far from an expert in this area.  Learning as I go, from his dr and you guys.  Our dr did mention the biologics (sp?) but I don't know if that is a treatment option just yet (and honestly - the thought of that scares the hell out of me - he is just a little guy and I think of those as serious, big time drugs for big people!)

Thanks again for all your help and responses -

Heather (and Nathan too!)

[[hugs for heather and nathan]]

Something occurred to me - and maybe it has zero validity! - that maybe his immune system has to "re-learn" how to deal with bugs now that the mtx is in the mix?

I know that whenever I move someplace new, the first year I'm sick ALL THE TIME. After that, I'm fine. It's like each city or region has its own unique "brands" of viruses that my immune system has to learn how to deal with. Once the learning curve is done, all is well. Okay, mostly.

Carolan

Carolan, I think you have a good point because every environment is different.  Including if you just move from one house to another and or schools...!!! 

Good Point.

Hi Heather,

I got taken of MTX such a lot as my white cell count just wouldn't stay above 4, eventually I was taken off it all together.   It took a long time for it to work for me however, Etanercept was almost overnight.

Good point Carolan,

I keep writing on here how I don't feel that pregnancy was my trigger for RA however, I moved to my present home in May 2004 and had my first sign of RA in the June.

Dozey.