Bloom, it sounds like your docs are on the right track, getting a biopsy and a CT scan, but I'm afraid you aren't getting enough treatment and they sound too hesitant and tentative about what it will be. I agree with Pete that, even though they will be deciding on an immunosuppressant soon, you should already be on a lot more than 20mg. prednisone, considering your symptoms and that they think it is WG. 60mg. would be typical to get you through the period of no additional meds, and continuing with the start of treatment they decide on. Then it can be gradually reduced over time as you show improvement. Coughing up blood is serious, and I don't think that methotrexate is often considered strong enough for that situation. I would expect CTX or RTX, to start with, and maybe a change to MTX later. CTX worked very well on my lung issues. RTX is preferred these days but may take a little longer to work. One or both may be used in treatment. I'm no doctor but am going on all the many cases I've read about on this forum. Do consider the lists of recommended specialists here: VF Medical Consultants , either to see in person or to have your docs consult with. Also look at this list: http://www.vasculitispan.org/united-states for lists of docs by state recommended by patients even if not known by the VF as experts. If you are not in the US, you may navigate to other pages listing docs elsewhere. Best of luck to you, and let us know what your docs decide.
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