Thanks Grammy. I tried methotrexate but had to quit due to side effects and ended up back where I was before I took it. I have confidence in my rheumatologist and now he wants me to try Actemra, right now trying to get extreme back pain issues under control with a steroid injection on Monday. Also seeing endocrinologist in June for adrenal insufficiency which rheumatologist thinks I have. All of it is making me rather miserable but hopefully I will get some help soon.