Methotrexate Is Back on the Menu

Methotrexate Is Back on the Menu

🌼 Date: Tuesday, May 19, 2026

⚡ Energy: Cautiously hopeful with a side of snap, crackle, pop

❤️‍🩹 Status: Cleared to restart the miracle drug

😇 Outlook: Praying for relief, because this body is loud

Today I got two emails I have been waiting for.

One from my radiation oncologist.

One from my rheumatologist.

And both of them basically said the same beautiful thing:

My skin has been cleared from its “radiation reaction,” and I can start taking Methotrexate again.

Cue the tiny celebration.

Not a full parade.

My joints are not ready for choreography.

But maybe a little seated jazz hands.

I had to stop taking Methotrexate the week before I started chemotherapy back in December, and let me tell you, my body noticed.

Methotrexate has been one of my long-term medications for psoriatic arthritis, and I have been on it, in one form or another, for at least 25 years.

So when they took it away, my body was like, Excuse me? Who approved this?

Now, before anyone hears the word “arthritis” and thinks, “Oh, sore joints, I get that,” let me explain.

This is not your ordinary arthritis.

This is not “my knee hurts when it rains” arthritis.

This is not “I slept weird and now my hand is cranky” arthritis.

Psoriatic arthritis, or PsA, is a chronic inflammatory disease that happens in some people who have psoriasis. It is autoimmune, which means the body’s defense system gets confused and starts attacking healthy joints and skin like it is defending the kingdom from invaders.

Very dramatic.

Very rude.

Very on-brand for my body.

PsA can cause pain and inflammation where tendons and ligaments attach to bone, like the Achilles heel or the bottom of the foot. It can cause stiff, swollen, throbbing joints, especially in the fingers and toes. It can affect the lower back and neck. It can come with red, scaly, itchy skin patches. It can mess with fingernails and toenails, making them thick, pitted, or just generally rude.

And then there is the fun little symptom where an entire finger or toe swells up like a sausage.

When I was diagnosed, it was all five toes on my left foot.

Not one toe.

Not a cute little “hmm, that looks swollen” situation.

All five.

My left foot looked like it had been inflated for a parade.

So yes.

Psoriatic arthritis and I go way back.

Unfortunately.

When I was first diagnosed, I started on Methotrexate. Over the years, I have also tried several biologics that are used for both psoriasis and arthritis. Those were weekly shots I had to give myself.

Because apparently my life needed more needles.

I did that for a while, but now I take a pill, and I like that much better.

A pill feels a little less like I am running a tiny medical clinic from my kitchen.

Methotrexate is interesting because its classification depends heavily on how it is being used and the dose someone is taking.

When Methotrexate is used for cancer, it acts as an antimetabolite chemotherapy drug. At higher doses, it works by interfering with how cells use folate, which can stop rapidly dividing cancer cells from making DNA and multiplying.

So yes, technically, Methotrexate can be a chemo drug.

But when it is used in much smaller doses for conditions like rheumatoid arthritis, psoriasis, psoriatic arthritis, or Crohn’s disease, it is used differently.

At those lower doses, it acts more like an immunosuppressant or a DMARD, which stands for Disease-Modifying Anti-Rheumatic Drug.

Fancy name.

Big job.

In that smaller-dose world, the goal is not to kill rapidly dividing cancer cells. The goal is to calm down the immune system and reduce inflammation.

Basically, it tells my immune system to stop acting like a drunk security guard tackling innocent people at a wedding.

And for me, it has been one of the few things that gave my body even a little bit of relief.

So now I want you to paint this picture in your mind.

Take Tina, who has lived with psoriatic arthritis for decades.

Take away the medication that helps keep some of that inflammation under control.

Do that cold turkey.

Then start chemotherapy.

Then add Granix shots every day for a week after each infusion to help boost white blood cells.

Then add the severe bone pain those shots can cause.

Then layer that on top of the joint pain I already live with.

Then sprinkle in chemo fatigue, nausea, baldness, surgery recovery, radiation, neuropathy, skin reactions, and my general commitment to being medically ridiculous.

Not a pretty picture.

More like a Picasso painted during a flare-up.

The Granix bone pain was no joke.

It felt like my bones were being remodeled from the inside by a crew with no permit and zero concern for customer satisfaction.

And while that was happening, my psoriatic arthritis was over in the corner, unsupervised, saying, Oh, Methotrexate is gone? Wonderful. I live here now.

It has been a lot.

And I know I say that a lot, but honestly, “a lot” is doing some Olympic-level lifting on this journey.

Cancer treatment did not happen in a vacuum.

It did not pause all my other health issues politely and say, “You deal with breast cancer first, and we’ll circle back later.”

Nope.

Psoriatic arthritis stayed.

Joint pain stayed.

Inflammation stayed.

The old body problems did not pack a bag and leave just because cancer showed up with a clipboard and a treatment plan.

They all moved in together like terrible roommates.

And now I am learning that some of the lasting side effects from chemo can include sore joints, stiffness, and that lovely snap, crackle, pop sound every time I stand up.

So that is exciting.

Apparently my future may include me sounding like a bowl of Rice Krispies with medical debt.

I am not exactly looking forward to that part.

I already had joint pain.

I already had stiffness.

I already had days where my body felt like it was assembled incorrectly by someone who lost the instructions.

I did not need chemo to add a bonus track.

But here we are.

Clear of cancer, but still very much dealing with the aftermath.

That is the part people do not always understand.

Being clear is amazing.

It is huge.

It is everything.

But it does not mean my body instantly returns to factory settings.

There is no magical reset button.

No little tech support person appears and says, “Congratulations, Tina. We have removed the cancer and restored all previous mobility, hair, energy, immune function, nerve sensation, and emotional stability.”

Wouldn’t that be nice?

Instead, it is more like:

Cancer is clear.

Radiation reaction is improving.

Neuropathy is still being a jerk.

Your chest feels shrink-wrapped.

Your feet are numb.

Your immune system is rebuilding.

Your joints are angry.

And now we can finally restart the medication you had to stop months ago.

Progress?

Yes.

Simple?

Absolutely not.

But today’s news is still good news.

Really good news.

Because starting Methotrexate again feels like getting one of my tools back.

Not a magic wand.

Not a cure-all.

Not an instant fix.

But a tool.

And after months of feeling like my body has been fighting a war with one hand tied behind its back, I will take every tool I can get.

I am hopeful it will bring some relief.

Maybe not overnight.

Maybe not dramatically.

Maybe not enough for me to leap out of a chair like a spring chicken, which is rude because I have always wanted to be a spring chicken at least once.

But maybe it will help quiet some of the inflammation.

Maybe it will help my joints calm down.

Maybe it will help me feel a little more like I am living in a body instead of a haunted house with bad plumbing and angry hinges.

And right now, a little relief would be a big deal.

Because this body is tired.

This body has been cut open, rebuilt with temporary bags, poisoned, radiated, burned, peeled, swollen, stretched, numbed, tingled, and forced into more hospital gowns than anyone should ever have to experience.

This body has earned a break.

Or at least a medication that tells the immune system to sit down and use its inside voice.

So yes, I am celebrating this one.

My skin is cleared enough.

The radiation reaction has calmed down enough.

The doctors have agreed.

And Methotrexate is back on the menu.

That may not sound exciting to everyone, but to me?

It is hope in pill form.

It is a step toward getting some control back.

It is a tiny little light at the end of a very swollen, stiff, snap-crackle-popping tunnel.

And if it helps even a little, I will be grateful.

Annoyed that I needed it?

Sure.

Tired of needing medications at all?

Absolutely.

Still going to take it?

Yes, ma’am.

Because I have places to go, things to do, a body to drag back into working order, and a life I am trying very hard to rebuild.

So pray for me.

Pray for the joints.

Pray for the toes.

Pray for the feet that already have neuropathy and really do not need psoriatic arthritis adding backup vocals.

Pray for the hands.

Pray for the snap, crackle, pop situation.

And pray that Methotrexate comes back into my system like a tiny bouncer and tells inflammation:

You don’t have to go home, but you can’t stay here.

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💗 Tina –
One Badass Day at a Time