I’ve got a rather unusual side effect from the methotrexate – and I suggest you don’t read any further if you’re eating your dinner (or breakfast, or mid-morning snack, or whatever!)
The thing about being immunosuppressed is that your immune system is suppressed all round, so the standard queries at the monthly blood test, ‘Have you had a sore throat? Any mouth ulcers? chest infection? No? Good’ doesn’t cover all the possibilities by any means!
So my advice to you if you’re on MTX would be to see the doctor with even a piffling spot or something if the obvious remedies such as TCP are not doing the trick. This is a classic example of do as I say and not as I do – if I’d gone to the doctor with this lump on my arm on say Friday, it having started on Tuesday, I’d probably be in a lot less pain by now! Instead I decided I’d see how it did over the weekend. Well, it grew and it grew until by this morning (there’s no point going to the doc’s on Monday – everyone’s waited to see how it goes over the weekend and the queues go round the block) I felt there was more lump than penguin. The lump itself is over an inch in diameter and it sticks out quite some way, and what’s worse – the redness has now traveled half way down the top part of my arm and it HURTS LIKE HELL! OK, it’s not as bad as having a really painful joint, and it proves the methotrexate is doing its job and I’m glad about that, but it still hurts like hell.
I saw the GP nurse practitioner this morning, and jolly good she was too, once we’d established that asking about a history of breast cancer in the family was probably irrelevant to a lump on the arm. (I can see where she was coming from – she hadn’t looked at it yet and if it had been right in the arm pit then I might have been referring to that sort of lump.) One look told her what it had already told me – that it’s an infected sebaceous cyst or hair follicle. Until the infection has gone down it’s impossible to tell which, but if it’s the former then I will probably need to have it surgically removed. (Luverly!)
She was initially puzzled as to why it was there because they don’t tend to get infected and if they do it’s usually because you shave your arm pits (I don’t) or you have poor hygiene (I don’t!) Then of course she realised I was on the MTX and that explained everything!
I’m now on a whacking dose of oral antibiotics and the message is, loud and clear, don’t wait – go and see the GP! Next time I shall practice what I preach!