I'm learning

You may call me slow sometimes but I am learning. Some medications when you start taking them  have a relatively quick impact on you. You take a tylenol and your fever usually goes down and pain subsides within an hour. Antibiotics often make you feel better with in 24-48  hours.

Rheumatoid medications are different. They can take months, as in 3-6 months.

When I was diagnosed with RA last fall, I was immediately put on prednisone and plaquenile and we quickly learned I was allergic to both. I was then switched to oral Methotrexate (MTX). The dose was upped to the maximum in January. I started to feel a little  better, I thought. But not better enough so I was switched to injection MTX in April.

I have felt some improvement but could not be completely sure. My back pain was making it difficult to 'feel better' because I was always in pain from something.

After I had my back treatment at the end of June, I thought my back was better but immediately got a double ear infection and was too sick to care about body aches and pains as I lay on the couch and watched Lifetime movies and bad reality TV.

Since I was put on antibiotics for two weeks, I had to go off my MTX. Its been three weeks since my last treatment.

Over the past week I have been feeling more and more tired with more and more aches and pains. Yesterday I was ready for a nap at 9am and my wrists were killing me.

Last night I started doing a little research to find out from Dr Google how soon after finishing antibiotics is it safe to restart MTX. After reading a lot of answers online I realized two things:

1. I was feeling awful because my RA has been acting up because I haven't been taking my MTX.
2. Methotrexate was working to help my RA.

Tonight I will go back on MTX and hope I start feeling better soon. I hope it doesn't take months to feel the effects again.

My rheumatologist told me if you have been on MTX for ye ars and go off it fo a few weeks for antibiotics, its not that big a deal because your blood levels are high enough. But since I have only been on it since April,  I would probably feel the lack of it. She was right.

I am learning, slowly. I will suck it up, wear my wrist splint, and take my pain meds.

Okay I learned a few things

I have had this stupid evil cold since Friday afternoon, June 28. It came to me courtesy of my husband. This is a normal event, one family member gets exposed to germs and brings them home to share with other family members.

My theory on colds has always been to take good care of myself and basically ignore them unless I become fairly sick. Rarely does a cold send me to bed for more than a couple of extra naps. I have never had a problem with this theory. Ignorance keeps the colds away.

This worked for decades.

Not any more.

In  the past 24 hours I have learned:
- when you start to feel sick, stop RA drugs
- when you start to feel sick, call your PCP, not after a week or 10 days as I normally would
- colds more easily turn into pneumonia when you have RA both due to the disease and due to the medication.

Today I am home in bed sick again/still whatever. If you are keeping count this is day 14. Normal colds evolve and slowly get better. Evil RA colds, stick around and get worse. My sore throat is gone but my cough is not and my ears are clogged.

I am on antibiotics that I started yesterday morning and if I don't feel better by Saturday I am supposed to go to the walk in clinic. Next Tuesday I see my new rheumatologist and will probably learn more about the common cold with rheumatoid.

The only good side to all this is that the scale seems to be going in the right direction even though I have been eating ice cream every day.

Antibiotic resistance

When was the last time you were prescribed antibiotics? And took them? The entire course of them? And what ailment did you have? I think the last time I was prescribed antibiotics was a few years ago after some surgery. I very rarely take them.

I hear more and more complaints from friends and family that they were sick for a couple of weeks, went to their doctor finally, and were told they would have to wait it out with over the counter medications, fluids and rest. They were not given antibiotics as they had expected and were frustrated.

This is a good thing. One of the biggest medical problems we have these days is resistance to antibiotics and the emergence of 'super germs' which cannot be treated with antibiotics. Too often prescriptions for antibiotics have been given without signs of infection and often prescriptions are not being taken for their entire course - the patient feels better but is not completely recovered and still has the germs in their body which now have the potential to become antibiotic resistant.

On Monday, I was a moron (to use the term loosely) and managed to cut the palm of my hand with pruners. Yes it bled a lot. Yes it was deep. Yes I panicked. No it wasn't very big. But as it was on my lymphedema arm, I called my doctor's office which sent me to the minor ER (who knew there is a minor ER but there is) in case it needed stitches. It needed a pressure bandage, no stitches, no steri strips. I felt somewhat like an idiot that I even went to get medical attention in the first place but was concerned about my lymphedema arm which is not supposed to have any punctures or pressures, never mind incisions from pruners, to prevent lymphedema which can become a permanent problem.

They also gave me a prescription for antibiotics and told me that at the least sign of infection to fill the prescription and take the entire course of them. I toyed with the idea of taking them to prevent infection but rejected that thought on the grounds that I really don't want to take any more medications at this point. I hadn't expected to get antibiotics at all.

I do think that patients go to the doctor and expect to get antibiotics for almost anything these days. Doctors are heeding the call of reducing prescriptions to prevent the emergence of more super drugs but patients do not always understand.

As patients we need to understand the bigger picture. Antibiotics are good but should not be taken unless they will help. And if you take them you need to take the entire dose.