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What next?

I don't know where to go next with my treatment.  I was on Enbrel, and it didn't seem to do enough.  So now I'm on Rituximab, but it wears off to soon.  The first round seemed to stop working by five months.  Now I'm just at the 4 1/2 month mark of the second round and I'm feeling pain again.

 

Last month, my Doc increased my Methotrexate from 15mg to 20mg in hopes that it would stave off the pain that I was getting on weekends.  But instead I find that I'm feeling exhausted and fuzzy, and I think the MTX is to blame.  I have an appointment on Friday, and hope that I can get some ideas on a better path to take.