Tag Archives: methotrexate

Reality Bites


For the most part, I work really hard at being little miss mary sunshine.  Sometimes it takes more work than others.  Sometimes it is pretty much cake.  This early morning I’m sitting in the chilly (62 in the house) morning house… the only sounds this morning are the dog chewing her dry food and burping and the not so rhythmic click of my fingers on the keys of my keyboard.

I’ve been having stomach pains.  The symptoms have seemed to be (to the Dr too) generally related to a gallbladder problem.  Dr poked and prodded and sent me for an ultrasound.  It took a week to get the pre-approval from the insurance (want to be sure the chick without any “women’s” plumbing after that total hysterectomy isn’t just trying to see the baby) and the test was done yesterday.

The lady that did the ultrasound hit some spots that felt like very deep bruises and there were a couple times that I would dearly have loved to hit her.  But I didn’t. She sent me on my way telling me that the Dr would have the results by the afternoon.  And they did.

PA called me with someone’s interpretation of the results.  I also got the test results that were on My Chart (I really like that feature of Cleveland Clinic) and read through their interpretation.  The PA assured me that my Gallbladder is not inflamed, infected and that I don’t have gallstones.  I should keep taking the industrial strength Zantac, stay on a low fat diet (cause there’s nothing wrong so it is a given that I should stay on a bland diet) and follow up with my regular PCP in… oh… about 5 weeks now.

Funny… when I read the results of the test, it showed some accumulation of gallbladder sludge and what seems to be hepatic liver changes.  Technically… it showed “increased hepatic echogenicity”… which seems to be (thank you reliable medical websites) frequently connected to high alcohol consumption (which… I don’t even get a glass of wine at the fancy dinners that work throws when we are on the road, even for the toast… I toast with ‘Coke-a-regular’ or ‘Coke-a-normal’ depending on the country so it isn’t that) or… (insert Daht-daht-da-dahhhhhhhhh) use of methotrexate.

So, I sent of a message to my rheumy to have her look and take everything into account and now I’m waiting to hear from her.

I don’t wait well.

Last night I had an ever so small panic attack.  I took a long hot bath to try to convince myself that it’s all okay… and now I wait.

I’m not sure how to feel… but scared seems to be winning out this morning.

There has to be some kind of irony in the fact that I went because of the pain… and they found the sludge that is probably causing the pain… and I’m looking at maybe now catching MTX side effects reasonably early before there is too much damage… and what there is is likely reversible (no scarring yet).

And… the adventure continues…


Updated: September 24, 2014
Author: Figment of Fitness
Keep your dreams alive

Methotrexate… a rant…

Okay, so I gave you fair warning.  This is a rant.  I try not to let it eat at me and fester, but there are just some things that are so irritating that I have to let lose.  THIS is one of them.

Methotrexate has always been kind of a sore spot with me (not to… you know… make bad jokes about stomach shots and stuff).  For a while I had a hard time finding a store that had sufficient available Methotrexate (liquid) to fill my prescription.  It isn’t a profitable drug.  Passe.  So the makers don’t always manufacture sufficient.  Or there is a mass recall (this has happened more than makes me comfortable).  Add to that, my DOCTORS have suggested that I would be better off using the “with preservative” kind and have written my scripts as such.

Most pharmacies don’t have a problem filling what is written.  Most… If they have it.  I’ve had trouble with one chain in more than one city… in more than one state… in more than one TIME zone… when it comes to this drug.

In Texas it was ‘suggested” (okay… they told me flat out) that they don’t carry my medication as it is written.  I need to go BACK to my doctor and MAKE her write my script either as pills (which make me really REALLY sick) or as the injectables that they DO carry because the company they happen to chose to use doesn’t carry the with preservative vials.  So… I said that they wouldn’t be my pharmacy, I trust my doctor and it is HER job to write what she wants me to take… not theirs to prescribe what they want to sell me.

Now I find myself insured with a company and the pharmacy that I HAVE to use for maintenance drugs (which, despite the fact that I take MTX every week and have for three or four years now, apparently this isn’t… ) is… yep yep yep… the one that doesn’t like my MTX script.

Skip forward to yesterday.

Dr called in my refill.  One month supply, 4 shiny little vials (except the doctor thinks she’s calling in two moth supply… blood test to blood test) came from the pharmacy.  Bear and I got into a lengthy text message conversation about the meds.  He said the bottles didn’t look like what I’ve been taking.  They didn’t.  They say preservative free on the vials, so I got a one month supply, half of which I would be throwing out, and the vials are bigger and a different shape than what I use.  OH… and they are twice the dose I use.  The ones I take are 25mg/ml the ones they filled are 50mg/ml.

Now, I’m not a pharmacist or anything, but I’m good enough at math (it was one of the dual minors on my undergrad degree) to know that 50 is kind of a bigger number than 25.

I called the pharmacy.  They don’t carry my script and TECHNICALLY the doctor didn’t say it HAD to be with preservative.  They GUESS (they guess???) they can TRY to get what I take to fill my script NEXT month, MAYBE, but only if the doctor SPECIFICALLY says they HAVE to.  Otherwise they will give me what they like to sell not what I take.

What do I do with the drugs I won’t take?

Toss them they guess, they can’t do anything with them.  WE left the store.

The guy on the phone laughed at me.  He thought it was hilarious that I was calling him about this.

I called the insurance company.  The part of the company that handles the prescriptions.  The part of the INSURANCE company DIRECTLY AFFILIATED with the pharmacy (which is why I HAVE to use them for maintenance drugs) because I was concerned with being laughed at and being told that there is NOTHING they can do until they get a different prescription.

And I had questions about why (maybe the doctor changed what dose she wants me to take even though I’ve been mostly controlled and even though when I was there she verified my dosage) it was 50mg rather than 25mg.

The insurance company showed that 25mg had been billed in Feb and (GHASP) yeseterday.  25… 25… yeah… the right dose.

I was also informed that MTX is apparently not considered a maintenance drug, so I can get THAT filled anywhere I like.  So I’m going back to where I can get what I take without argument or stress.

I don’t understand why they think it is okay to mess up my meds.  And I know it isn’t personal.  They mess up meds for lots of people or it wouldn’t be such a joke.

My MTX… taking twice the strength might make me feel crappier than usual for a day, but it probably wouldn’t do any real lasting damage.  But other people take other meds.  They RELY on pharmacies filling the scripts RIGHT.  They might not realize the dose is doubled.  What then?  Not everyone has a George Bailey looking out for them.  Not everyone triple checks the labels every time (okay, MOST times).  What happens with them.

he he he… ooopsy?

shake my head… you are dealing with LIVES… it’s really not that funny.


Cold Front Friday

So… it was 91 degrees Fahrenheit yesterday. That’s about 33 Celsius if anyone  reads this who lives in a place where that is more common (as in ANYWHERE but in the US… ). About 9 last night a cold front went through.  Windy and … Continue reading

Not Quite So Far Into Remission

So, here I sit.  Austensibly, I’m working.  Scripts are running.  I’m keeping an eye on what is running.  I’m getting ready for a move of the current enviornment to the almost latest and not exactly greatest technology that will get us by until a year or so from now.  Knock on wood.
I smell like Tiger Balm.
I’m thinking… contemplating… the fact that I’m probably going to be adjusting my MTX back up from .8 to 1 cc starting next injection.  I’ve been feeling my fingers and toes starting to ache and be stiff (okay, okay, technically “starting” might be a bit of a stretch) more and more.  I’ve been wearing Tiger Balm under my fingerless gloves… I don’t see any extra lumps and bumps.. but I’m feeling like I’m using my fingers and toes more gingerly than I have been of late.  So… I think going back up a little on the meds (as the doctor suggested I might) is my next step.  Probably should call the doctor and let her in on it… but… it is what it is.
I’m kind of sad thinking that I’m not doing any better than I am right now.  I’m going to put myself through some less than exciting loops and jumps tomorrow at soccer practice.  I will probably regret it after Saturday’s game but it’s all wonderful fun and that is a good trade off.
I’m viewing the resent events with mixed feelings.  I have liked the idea of not having to take as much of the chemo poison every week, but I like not aching even more.  So, we adjust. I guess I won’t be finding my hair growing back any time soon.  So, I keep a few bobby pins so I can use them (one at at time) to hold my thimble sized bun… and my BUffs… and I keep thinking… and keep dealing with the brain fog/chemo brain.
The adventure… continues…