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When did you know it was time to start a biologic?

Hello everyone. I just met with my new rheumatologist for the first time today after my family physician diagnosed me with Ankylosing Spondylitis about 2 months ago. I only met with him for about 15 minutes and was a little surprised when he quickly brought up starting me on Enbrel (after also mentioning that he hasn’t reviewed my X-rays). Now, I wouldn’t say I live with a 10/10 for pain everyday (not that I think I should have to) but I just don’t know if starting a biologic right off the bat is something I want to do, but this is new territory for me and I’m not sure how to navigate any of this. There are a fair number of days that I feel pretty good. I’m also absolutely terrified of having to give myself a shot every week- so there’s that. So now my question is, when did YOU know it was right for you to start a biologic? Was there a moment in your disease where you were like “this is the last straw and I want these expensive, lifelong meds that might not be a good fit for me”. Thanks for listening and for any wisdom from the been there done that crew

  1. Hi. I'm amazed your rheumy seems to be so flippant. My rheumatologist had to present my case to the health board in order to get me on biologics, and I had ultrasound, X-ray and MRI which were scrutinised before approval. My pain levels were high (8/9) for weeks as were my inflammation markers and I was told it was the only thing that could help (which it has a little but not been on them long) as I'm restricted as to what meds I can take. I've broken a few bones and the pain is nothing compared to AS in full flow (I have osteoporosis).
    If it doesn't feel right then don't just accept it, it's an expensive alternative if paracetamol will sort your pain 😂
    I would probably go back to the doc and get their opinion, there are obviously online communities but you'll find so many differences between people and how they are affected by the wonderful disease that you may end up with more questions than answers.
    I wish you well, whatever you choose to do, but don't fear the injection it's done in a flash

    1. I knew it the minute I heard there was something I could use to help me walk down the street without gasping for pain. I had put off seeing the doctor for 2-3 years so I was ready, I siad lets go.

      1. I started biologics after I had tried all the nsaids and was not getting the AS flairs under control. Honestly the biologics saved me. Historically I was having a flair once a month and after starting biologics maybe once a year.

        1. I read the article. It's very informative. Thank you so much Cody🙂

        2. I'm glad to hear that it was helpful! You're most welcome. 😀 - Cody (Team Member)


      2. Great question. Here's my experience - obv not medical advice.


        I didn't even know about biologics for years!
        My rheumatologist thought I was doing well enough and kept me on NSAIDs between 2013-2017.
        Those last 2, 3 years were hell, I had one SI joint inflamed at all times, nearly the entire spine inflamed and by the end even my chest bone (at the front where the ribs attach) was so painful. My neck hurt, my heels hurt, i couldn't sit in a restaurant chair for more than half an hour before the pain became unbearable.


        It took upwards of 15 minutes to get out of bed in the mornings, so stiff and every movement hurt. Struggled to brush my teeth and get ready for work. Then, going down the staircase was a real challenge and required a special technique 😆
        Same with getting in my car to go to work, you have to kind of fall in butt first, looking away from the interior.


        Had about a 200 meter / yards walk to work which required 2, 3 breaks. Walking was very painful basically. 25 years old by the end of this.


        I'll leave it at that, but yeah it was really bad. Years were wasted. Looking back, I wish I complained more to my rheumatologist and started biologics at least 2 years sooner. So don't let it get to that point.
        You don't gain anything by enduring pain, it just ruins your life. So don't let it get to that point.


        1. thank you for that. My drs have not suggested weekly injections yet. they want to try the cortisteroid (?) injection first. I too was wondering what would be better. Does the injection calm down the inflammation or only block the pain. Do the biologics calm down the inflammation and slow down the pain? I prefer the latter but I am so new to all of this

        2. That's my question and feelings too

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