Starting MTX

[jazzjaz20]

hi all 
 i am new to this group
 i am a dermatologist from india with ps
 starting mtx we  need to check so many parmeters like liver function
 we r priscribing mtx for pateints here but myself i dint take it till now as i have much controlled disease
i am planning to take acitretin . will let you people known about the results

[jiml]

hi all 
 i am new to this group
 i am a dermatologist from india with ps
 starting mtx we  need to check so many parmeters like liver function
 we r priscribing mtx for pateints here but myself i dint take it till now as i have much controlled disease
i am planning to take acitretin . will let you people known about the results

Hi Jazzjazz and   to the forum you will find us to be a small but friendly bunch of psoriasis sufferers from around the world all dealing with the problem in different ways, and are happy to exchange views on the effectiveness of treatments...... and we accept and give support to each other.

I hope this site will give you as a dermatologist an insight into the psychological impact the disease has, I'm sure you are probably aware of most of these things but reading about them may be helpful in your chosen path.
I note that you prescribe methotrexate to others but have chosen to use Acetretin yourself  is there any reason ?  sorry for that question but I'm a methotrexate failure myself  
Jim

[pingu]

Sorry for the delay in reporting. 

It's Friday and I am reporting from sunny Rhodes.

Had my 20mg MTX with no side effects. 

This is the first holiday ever where I wasn't bothered about an improvement in my psoriasis as the MTX is working great. The old areas look like new skin and are a little paler than the rest of my skin.  As I am a hairy guy the patches on my shins are a little baldy but that will change no doubt.

I was in Africa for a few weeks before coming on holiday with my girlfriend so she hadn't seen the MTX at work. Now she says it's like a miracle and I should have had the opportunity sooner.

Tonight is Folic Acid Friday. Unfortunately still alcohol free. Would be nice to have one.  May have a shandy tomorrow. 

Sent from phone apologies for typos.

Wonderful news to hear your doing so well on MTX!  Time to celebrate go dancing or treat yourself to something you have wanted for a long time like a giraffe . You can have those there right!

How did you know I always wanted a giraffe? 

It's early days but no side effects and the skin just looks a slightly different colour. Weird after all this time. Some of the patches of new skin are a different colour others almost a very slight pink.

It's good not having to think about it now.

[jiml]

hi all 
 i am new to this group
 i am a dermatologist from india with ps
 starting mtx we  need to check so many parmeters like liver function
 we r priscribing mtx for pateints here but myself i dint take it till now as i have much controlled disease
i am planning to take acitretin . will let you people known about the results

Hi again Jazzjazz just a bit of advice you will be noticed more on the forum if your start a new thread in introductions . As your arrival has been missed by most members I think

[pingu]

I was so tired yesterday after travelling back from Rhodes, no I don't think I will get any sympathy. 

I forgot to take my folic acid on Friday and only remembered on Sunday so hopefully no harm done.

Anyway took my folic acid last night and all is well.

The new skin where my psoriasis was is slightly different, went red faster in the sun probably as its so new. 

I would now consider myself 100% clear at present based on MTX.

I haven't suffered any side effect. The down side is you are not allowed any alcohol, there have been a few days when this has been tough like on holiday but actually being free of P is great and if I only have to sacrifice alcohol then so be it.

I realise I am one of the lucky ones and I only wish I had done this a long long time ago.

I think if GP's are our principle point of contact here in the UK we need to educate ourselves. For me the last 2 years has been a lesson. Having to pop pills for my shoulders and then getting a consult and a simple xray revealing the underlying issue and then asking for a dermatology consult and being free from psoriasis withing 8 weeks. Seems my GP was happy to just carry on filling out prescriptions for anything that would get me out of his surgery even though I only actually went when I was ill and not a wasteful malingerer.

[Turnedlight]

Great to hear it's working for you! I don't get the alcohol thing though, when I was on mtx I asked my derm if I had to avoid it and he looked surprised and said no. I know breaking down alcohol puts a greater strain on your liver but my liver results never changed. I only had a glass of wine a couple of times a week.

I agree about GPs, mine let me struggle with psoriasis for many years, until I brought in a carrier bag full of creams and bath products etc she'd prescribed and dumped them on her desk for a visual clue to how nothing was working for me. It's sad to think how many people out there who don't want to make a fuss are missing out on getting treatments that work.

[jiml]

I was so tired yesterday after travelling back from Rhodes, no I don't think I will get any sympathy. 

I forgot to take my folic acid on Friday and only remembered on Sunday so hopefully no harm done.

Anyway took my folic acid last night and all is well.

The new skin where my psoriasis was is slightly different, went red faster in the sun probably as its so new. 

I would now consider myself 100% clear at present based on MTX.

I haven't suffered any side effect. The down side is you are not allowed any alcohol, there have been a few days when this has been tough like on holiday but actually being free of P is great and if I only have to sacrifice alcohol then so be it.

I realise I am one of the lucky ones and I only wish I had done this a long long time ago.

I think if GP's are our principle point of contact here in the UK we need to educate ourselves. For me the last 2 years has been a lesson. Having to pop pills for my shoulders and then getting a consult and a simple xray revealing the underlying issue and then asking for a dermatology consult and being free from psoriasis withing 8 weeks. Seems my GP was happy to just carry on filling out prescriptions for anything that would get me out of his surgery even though I only actually went when I was ill and not a wasteful malingerer.

How right you are no sympathy from me, I might have had some if you brought some warmth back from Rhodes with you
What great news though 100% clear in 8 weeks .... That's brilliant news and no side effects is even better, long may it continue ,
Yes the fresh skin will burn easier than the normal skin, that is something to be aware of for all of us thanks for the reminder  

It's a mystery to me why GPs dont refer sufferers of psoriasis earlier to dermatologists, they know it's unlikely to go away, and after a short time on creams they should refer you to a specialist.

Yes it's a small sacrifice having to give up alcohol to be clear of the disease, I think most would swap alcohol for a clear skin, anyday........
So congratulations are due to you for getting clear and a thanks for keeping us informed of your progress. I hope you will keep us up to date on how it's working as time goes on  

[pingu]

@Turnedlight I am not a dermatologist but the alcohol thing is what I was advised by my dermatologist so I have stuck with it. Simply put I did not want to jeopardise the effectiveness of the treatment, potentially being taken off it or any long term damage I may suffer from drinking while on MTX. I was advised when asked that psoriasis has a a combined detrimental effect with MTX on the liver that is greater than if you were just on MTX for arthritis hence you can be on higher doses of MTX with arthritis but still drink. OK so it's a bit of a bummer but sometimes, just sometimes it is worth following the doctors advice to the letter which is what I chose on this occasion.

All in all I do  not drink a lot but would have liked the occasional beer so the sacrifice is not that great. Also gave my mates a few laughs when I ordered a soft drink.

@jiml I appreciate the support and I may not have actually been banging on my GPs door if it wasn't for this forum helping me decode, to a degree, what is and is not available.

What have I learned

OK MTX is a personal thing, some love it, some hate it, some just don't get on with it. 

You need to tell your GP what you want, often a sufferer will know more than their GP. Whatever your malady get to specialist if it's a long term condition. Be your GPs inconvenience and make sure you get the care and treatment that best suits you and your lifestyle.

Your new skin will be more delicate than your old skin, it may appear a different colour and behave differently.

[jiml]

@Turnedlight I am not a dermatologist but the alcohol thing is what I was advised by my dermatologist so I have stuck with it. Simply put I did not want to jeopardise the effectiveness of the treatment, potentially being taken off it or any long term damage I may suffer from drinking while on MTX. I was advised when asked that psoriasis has a a combined detrimental effect with MTX on the liver that is greater than if you were just on MTX for arthritis hence you can be on higher doses of MTX with arthritis but still drink. OK so it's a bit of a bummer but sometimes, just sometimes it is worth following the doctors advice to the letter which is what I chose on this occasion.

All in all I do  not drink a lot but would have liked the occasional beer so the sacrifice is not that great. Also gave my mates a few laughs when I ordered a soft drink.

@jiml I appreciate the support and I may not have actually been banging on my GPs door if it wasn't for this forum helping me decode, to a degree, what is and is not available.

What have I learned

OK MTX is a personal thing, some love it, some hate it, some just don't get on with it. 

You need to tell your GP what you want, often a sufferer will know more than their GP. Whatever your malady get to specialist if it's a long term condition. Be your GPs inconvenience and make sure you get the care and treatment that best suits you and your lifestyle.

Your new skin will be more delicate than your old skin, it may appear a different colour and behave differently.

On reading through your post has got me thinking, mainly about the alcohol thing, when I was on it I don't remember being given the advice to stay off alcohol. Or there is a chance I might have done   ( I do enjoy a drink ) but would have made the sacrifice .... And possibly would not have felt so ill and nauseous whilst on it

A big plus for your mates when you're out is they have a driver who can't drink with them  

Also I can only echo your words and agree be a nuisance to your GP  until you get a referral. They have no idea of the impact this disease has on a person. So we must learn to tell them not just show the spots  

[pingu]

Indeed jiml, the disease itself is quite easy to live with. It doesn't cause long term harm, generally not painful although it can be. I found the biggest thing was I avoided doing things I wanted to do and have enjoyed in the past such as swimming. 

I found the biggest thing was, and more often than not my own perception, the social stigma of the disease. Psychologically it is very debilitating. It is easier for a GP to give you ten minutes of their time and have you leave with a prescription and some hope that it will alleviate the symptoms. However there are much much more effective treatments that are now available that your GP cannot prescribe. Unfortunately that's the way the medical profession works, be a pain and find something that works for you. There may be some trial and error, all of this is new to me and only the start of my journey. This time next year I may be on something else but now for the first time in 35+years I am free of psoriasis.

Would I be willing to change my treatment, most definitely, it would be really nice to have a beer but that is a small sacrifice after so many years. Now I am almost in the system, I had to move my NHS appointment to early November, but I can discuss long term treatments with a much clearer mind now. 

I will discuss alternatives to MTX etc so I can have more normal lifestyle with choices and less testing but if it is MTX or psoriasis I will take MTX for now.

It's not only being clear of psoriasis but a far far easier treatment than lotions and potions upto twice a day, every day.

MTX is probably the first port of call as I guess it is relatively cheap compared to some alternatives and there is obviously a cost consideration to the NHS.