Thread by @pharmerfour

One of the interesting cases I had today was a young woman newly diagnosed with rheumatoid arthritis.

Since diagnosis 2 weeks ago, she has had some ....experiences....

She has been prescribed methotrexate & hydroxychloroquine - dropped these off last week & has been reading about them online since, before coming back to collect them

Online, she found numerous 'facebook groups' who say a lot of scary things about methotrexate, saying that it is chemotherapy & that a holistic treatment of organic food & detoxes will help her.

Thankfully she hasn't taken their messages to heart

She described her state of mind since diagnosis as "like walking around in circles asking myself how does this happen, who can I trust, why don't I know anyone else who has this?"

We spoke for about 25 minutes, covering a lot of the following (and huge shoutout to my 4th year student Adam who stepped in to entertain her 4 kids.... She was finding it hard to concentrate with 4 little voices vying for her attention)

We spoke about her age, and how early 30s is a common age for newly diagnosed rheumatoid arthritis - it's nothing she has done (or not done) that caused this

Visible relief as we discussed this point.

We discussed the progressive nature of the condition, and how early intervention can have a significant impact on quality of life now, and retaining function throughout her life

We spoke about methotrexate, & that while incorrect use can cause significant issues, weekly dosing is safe & effective.

I explained how it helps, what side effects might occur, & 'red flags' to keep in mind

We also discussed folic acid. None had been prescribed/recommended.

I advised her to call her doctor to ask about adding it to her therapy, specifically asking when to take it in relation to the methotrexate dose.

We discussed supportive therapy from allied health. She'll need access to a group of health professionals who can advise her on nutrition, exercise, pain management, physiotherapy etc

Advised her to discuss these needs with her GP who can help her access these experts as needed

We also discussed support - from information sources & support groups

Facebook groups - despite her experience so far - can be positive. It's best to look for groups that aren't driven by negativity, who can share their experiences in a positive way

We talked about @ArthritisAust who are a great source of information & support, especially at a time when there is so much information to take in...

We talked about @ChronicPainAust and tapping in to the community of people living with chronic pain for peer discussions & support.

Still a lot of questions & a long journey ahead, but it was great to be able to answer her questions in the short term, & knowing that we will be a resource for her in the future as her condition & experience change over time.