You might have noticed that I like to use this blog as a way of showing pictures of the kids, but I've also been using it as a way of letting people know more about RA. So here we go again. Several people have asked me lately how the RA treatment has been going and what kind of medicine I have to take. Lots of things have changed and my medicine routine is definitely detailed! I think back to this time last year and the only thing I took was a daily vitamin. Now, I have one of those old people pill holders made by the arthritis foundation. Tommy was sweet to pick that one up for me as it is easy to open! It is also larger, which is helpful for the large pills I take! So, on a daily basis I take:
Arava (aka: leflunomide) This is the newest drug to my RA regimen. This is a DMARD (disease modifying drug) that we have added until we can start the biologic medicine here soon. More on that in a minute. So far no major side effects. I noticed a bit of nausea at first, but has seemed to fade. I am on a lower dose of it, so let's hope nothing else. I have to watch liver function with this med. Hopefully we will be able to tell soon if it is helping!
Calcium and Vitamin D: I take this one regularly as I am on and off prednisone to help with inflammation. Prednisone can suck the calcium from your bones. Plus, just a good idea to take some extra calcium!
Flaxseed oil: I take one of these a day. This is good for Omega 3's and has also helped wonders with my Sjogren's syndrome. I have been able to stop taking my Restasis drops for my eyes. This helps with natural lubrication for the dryness of my eyes. Let's hope it continues to help in the fall and winter when they were so bad before! Anything to help me take less major medicine!
Isoniazid (INH): This one is really fun. This is to treat the TB...yes tuberculosis. Somewhere along the way, I have been exposed to TB. Now, let's get this straight...I am NOT contagious. It is a latent form (meaning non-active). People can carry the latent form and not be treated. But let's remember, I am on immunosuppressant medicine and have been for almost a year. I could have come in contact with someone then or maybe even during some of my travels. How often do you really have a TB skin test done? I had not had one for 7 years, but they make you take one as a precaution to starting a biologic medicine to help with the RA. Thank goodness they do! The biologic could have activated the TB had I started it. So now, I am on a 9 month regimen of INH to get rid of the TB. I should be able to start the biologic in a couple months...hopefully! No side effects with this one, but do have to watch liver function with this one as well. I do lots of blood work!
Folic acid: I take 4 of these pills a day. I take this to off-set some of the side effects of the methotrexate I am going to mention in a minute. Methotrexate works on the folic acid in your body. So by adding it back in, it is supposed to suppress some side effects. I get REALLY bad mouth sores, usually 4-5 at a time, and usually twice a month for a week at a time. I don't know if this really works, but it can't hurt to try. My new rheumatologist has some suggestions as to how we can change some things up next month to try and reduce the side effects even more. Can't wait to hear that!
And now the fun one: methotrexate. I have mentioned this one in a previous post. This is a chemo drug that is also given to RA patients to suppress the immune system. I used to be on an oral form of it at a dose of 20 mg/week. You can only take this once a week or it can cause liver toxicity. As you have noticed, I have to be careful with liver toxicity. I have now switched to the injectable version of this medicine as it is supposed to be more effective in the injectable version at the same dose as the oral. So hopefully getting more bang for your buck. Since they can't up my dose due to so much liver strain, we figured this was worth a try. The try part means I have to give myself a shot. Not just any shot, a shot into the muscle. Tommy gave me my first one, and honestly, I have found it easier to give to myself. I know when it is coming! I think it is crazy how neon yellow this medicine is.
Here is a nice image describing the different types of shots. For example, Tommy is a diabetic and he does the subcutaneous shots. We had to learn how to do the IM shots at the doctor. There is some risk of blood clots if you hit the blood vessel, so you have to be careful! The needle is long! It is probably a good inch to inch and a half long. So far, it hasn't hurt too bad. Fortunately the medicine doesn't burn going in!
So that is a rundown of my daily and weekly regimen. The pain is still pretty consistent, so we are hoping that the biologic will help tremendously when we can start that. The kids are a blessing to help take my mind off of things. My sweet husband is wonderful to help however he can. I just try to keep it all in perspective and focus on the wonderful things in our life!
