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Rheumatoid Arthritis

Decisions Decisions

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Short version of my relationship with Rheumatoid Arthritis: diagnosed in Dec 2011 after 3 months of being unable to use my left arm and having extreme difficulty walking, amongst other things. Immediately started on Methotrexate, added Humira in June 2012. Stayed on both drugs and aside from the crappy side effects, I was doing quite well. June 2013, I got very ill with an infection. My rheumatologist and PCP had me go off Humira and Methotrexate to try to let my immune system fight the infection (I also have Type 1 Diabetes, so my immune system is virtually nonexistent except when it wants to attack itself). Eventually I was treated with the right antibiotics and steroids but remained off of my RA meds. Surprisingly, I felt good. My rheumatologist warned me that my RA might come back with a vengeance but we both agreed that I could stay off my meds so that I would have a better chance of not getting sick over the winter and during flu season.

During my months off of my RA meds, I spent a lot of time visiting specialists to try to find out why I was so sick. One visit in particular stuck with me. I visited an oncologist (for hopefully the first and last time) and as we went through my medical history and list of medications, he paused, and asked me if my rheumatologist knew I had Type 1 Diabetes. I said of course and asked why. He said that, in his opinion, I shouldn’t be on a biologic because my immune system was so compromised. He confirmed what I had read on my own and what I was always concerned about- that my chances of getting lymphoma definitely increased with having an RA diagnosis but that they significantly increased being on Humira. I felt relieved that I was currently off the biologic and my plan was to never go back on it.

Fast forward to January of this year. My RA came back and with a venegenance. Both of my elbows are screaming in pain, my hands and wrists are constantly aching , fingers swollen..you get the point. Ibuprohen, Naproxen, compression gloves, rest, heat, ice..nothing seems to make a difference.

I saw my rheumatologist this morning and he recommended that I immediately start back on the Methotrexate and Humira. His reason being that they worked so well for me before and that we really needed to treat my RA aggressively, as it had come back strong.

All day, I have wrestled with the decision of whether to go back on my meds or not. I’m hurting, so much. My wrists and hands hurt when I shampoo my hair. They ache while I drive and the thought of having to slice up a vegetable makes me wonder if my kids really need them after all (yes, I know they do). A quick fix would be great. I know that taking the Humira injection will be horrible..ice cold and so painful. But I will feel better, possibly after the first dose. And then there’s the Methotrexate. With this one I won’t notice things getting better for about 2 months. The side effects will be awful- I’ll have intense nausea for 2 days after taking it, my hair will fall out, I’ll get mouth sores, and I’ll be more tired than I am now, if that’s even possible.

I can’t go on with this much pain and inflammation, especially since it will most likely get much worse. I have to do something. But what do I do? Is it possible to start myself back on both meds with the goal of eventually staying on as low of a dose of Methotrexate as possible? Or do I try to make it only on Methotrexate and suffer for the next two months, if not longer?

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