Methotrexate is Working!

I took my girl to see the rheumatologist yesterday for a follow-up appointment. I am very happy to report we are seeing results from the weekly methotrexate injections! Originally, the rheum told me her sed rate was 41 and has only dropped a few points since she started. Yesterday, she told me her sed rate was actually 59 when she started and has dropped to 35. The inflammation is still high in her body, but it is making its way back down! 

She has full range of motion in her big toe and again and, while she still has some morning stiffness and is limping a bit still throughout the day, the swelling is going down in her ankle. The only joint that is of some concern to the rheumatologist is her left knee (the knee that has been drained twice; the one that was swollen when she started walking when she was 18 months old). It is very swollen with lots of fluid sitting on top:

The rheum wanted to increase her methotrexate dosage to 0.6mg, but is concerned how Mia is responding so far to the injections. She had some side effects (that are too be expected): she is very tired, gets nauseous a lot, has thrown up, and complains of stomach pain. So, she wants to keep her at the current dosage (10mls/0.4mg) and continue the daily 12mls of Indocin. She had Mia repeat the urine test because of the white and red blood cells found in it and because of how frequently Mia has to go to the bathroom - she is going all the time during the day and even wakes up during the night now to go to the bathroom. She's never done that before. We should get the urinalysis test back soon.

So, for now we stick with what we've been doing and go back to see the rheumatologist on January 10, 2013. Mia will have more blood work done between now and then to check her inflammation, liver and kidneys, etc.  Her rheum said to me if the fluid does not go down in her knee between now and then and if her sed rate is still high, she will want to start her on biologic medicine like Humira or Enbrel in addition to Methotrexate. 

We asked Mia if she is able to tell a difference since she started the new treatment and she said, "Yes, I don't feel the pain as much anymore like I did." By the end of the appointment, Mia was showing the rheumatologist how she can do center splits and right splits (they are learning them in dance right now). The doctor was very impressed and even wrote it down in her chart that Mia can do the splits! :)

Tonight is our fifth shot with Mia, and our first time doing it by ourselves with no nurse at the house. We've finally got a good system down - I am the one who gives her the shot and my husband is the "Encourager/Hand-Squeezer/Hugger." We make a good team!