Q: My mother is suffering from acute rheumatoid arthritis. She is unable to move around and has a lot of pain. She has also lost about 15 kgs and took the injection, which the doctor gave for rheumatoid arthritis. It begins with letter ‘M’ but I am not sure about the name. She has a lot of side effects and other complications due to with the medicine. We need help.

A:There are a few important points to be noted. 1. She must immediately be evaluated by an experienced rheumatologist (not by any other specialist, like an orthopaedic surgeon). This is important to ensure that the diagnosis is correct. 2. If the diagnosis is correct, a detailed evaluation of the patient is essential; especially to ensure that there is no associated additional disease that is causing so much of ill health and weight loss. 3. If there is no other additional problem but she only has RA, then the method of treatment is not simply to give injections of Methotrexate but a combination of several drugs. This is essential to cut-down on the side effects of methotrexate and also to boost its good effects. This can be done only by a specialised rheumatologist expert in treating advanced cases of RA. 4. It is sad that Methotrexate - a specific drug for rheumatoid arthritis - is unnecessarily being called a cancer drug. This is big mistake! While the dose of methotrexate in cancer is 3500 mg, for rheumatoid arthritis, only 20 mg or 25 mg is given weekly. This is why in the US the name has been changed to Rheumatrexate (to remove the sigma of cancer drug!). Several thousand patients are presently on this treatment around the world for as long as up to 20 years without any side effects! But, only those who know what additional medicines are required to get rid of all the side effects can achieve this.