Medical Forum / Diseases and Disorders / Arthritis / August 2006
A quiz to challenge your arthritis expertise (also graded on wittiness)
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chuck - 02 Aug 2006 07:24 GMT I've has RA since '98 in my late twenty's. Male, no family history. Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. Can't take sulfasalizine because of sulfa allergy. Couldn't tolerate any but enbrel and it stopped working after about a year (others caused elevated ALT/AST, lupis-like syndrome, infusion reaction, ect.). Afraid to try any new DMARDs because invariably I get sicker. Chickened out on gold shots last month. Taking 3-5 prednisone for ~ 1.5 years, plaquenil the whole time, and naprosyn to vioxx back to naprosyn. Now have osteoporosis from prednisone and gastritis from naprosyn and maybe the fosamax. Even have trouble taking vicodin because the tylenol seems to elevate the ALT, so I take straight oxycodone 5mg usually 2-3 per day. And so no regular tylenol either. Luckily my joint deformity has been minimal; my problem is severe fatigue and pain with constant C-reactive protein lab values of 2-21 (yes I thought the 21 was a mistake too, but it was repeated). Hot PIP's, MCP's, feet, knees, elbows, and oooh!!! those shoulders that wake me up every night. Rhuem nodules on both feet, one achilles tendon, and both elbows.
So here's the quiz:
I'm now 37, taking plaquenil, 3-5mg prednisone, oxycodone, and as many naprosyns as I can get away with without having GI symptoms. What do you all forecast will be my future over the next 5-10 years?
A. you're screwed, update the will. B. quit bitching, at least you're still walking around, albeit slowly with those orthopaedic inserts. C. you are sentenced to a continual steady decline as you've seen thus far, nothing will work-- you've got bad Kharma. D. I don't care! My hands hurt too much to hit any key but the space bar and that damn voice-activated software costs 200 dollars.
Thanks for playing. I would appreciate knowing what an experienced group like this thinks.
bosco62a - 02 Aug 2006 08:55 GMT > I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. You might have a problem with Hidden Food Allergies. Hidden Food Allergies can trigger asthma, eczema, psoriasis, migraines, hayfever, ADD, joint pain, chronic fatigue, and other health problems. These food reactions can occur up to 72 hours after a food is eaten. Many people don't recognize this because ther problem food is "hidden" in other food. For example, I am sensitive to corn. Corn additives are in most processed foods, in the form of High Fructose Corn Syrup, Corn Starch, distilled vinegar, MSG, etc. Since I had a delayed reaction, i could not connect my health problems to food. I also had a sensitivity to dairy products. You may be sensitive to several foods. Medical testing for Immediate food sensitivities are pretty good, but testing for delayed food sensitivities are very unreliable. You may need to do some detective work to find your problem foods. The foods thast you crave the most may be your problem foods.
You may be able to find some books about this at the library. Try "Dr. Braly's Food Allergy and Nutrition Revolution" or "Food Allergies and Food intolerance" by Dr. Jonathan Brostoff. You can also find an alternative doctor at www.acam.org and talk to them on the phone for a few minutes. This is not a cure. It doesn't work for everybody, but it works for most people.
bosco62a
chuck - 03 Aug 2006 05:14 GMT Thanks for playing! I do appreciate the comments and suggestions.
NOW! -- the grades . . .
Nann: B :for timely response, helpful suggestions and empathy.
Rose: B :for two great suggestions (cyclosporine and rituxan), but cyclosporine's immunological effects scare the hell out of me considering my problems with Kineret and Humira; and rituxan just seems too new to take a chance on (I'm a chicken).
Johnie: B+ :for being to the point and honest. Laughing at the cruelty, ain't it the truth.
Jean: A :because you articulate an understanding the "shoulder thing".
Harv: B :for realism, but not as witty as Johnie.
Bosco: you were DQ'd for a double posting.
Again, thanks for your ideas and encouragement. It is hard to expect the wife to understand this torture we are hit with and always be understanding . . . so, you've all made me feel better. I hope my report card made you laugh.
Thanks
Don't know that I'll be a regular here, but I'll try and stop by.
bosco62a - 02 Aug 2006 08:55 GMT > I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. You might have a problem with Hidden Food Allergies. Hidden Food Allergies can trigger asthma, eczema, psoriasis, migraines, hayfever, ADD, joint pain, chronic fatigue, and other health problems. These food reactions can occur up to 72 hours after a food is eaten. Many people don't recognize this because ther problem food is "hidden" in other food. For example, I am sensitive to corn. Corn additives are in most processed foods, in the form of High Fructose Corn Syrup, Corn Starch, distilled vinegar, MSG, etc. Since I had a delayed reaction, i could not connect my health problems to food. I also had a sensitivity to dairy products. You may be sensitive to several foods. Medical testing for Immediate food sensitivities are pretty good, but testing for delayed food sensitivities are very unreliable. You may need to do some detective work to find your problem foods. The foods thast you crave the most may be your problem foods.
You may be able to find some books about this at the library. Try "Dr. Braly's Food Allergy and Nutrition Revolution" or "Food Allergies and Food intolerance" by Dr. Jonathan Brostoff. You can also find an alternative doctor at www.acam.org and talk to them on the phone for a few minutes. This is not a cure. It doesn't work for everybody, but it works for most people.
bosco62a
bosco62a - 02 Aug 2006 08:55 GMT > I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. You might have a problem with Hidden Food Allergies. Hidden Food Allergies can trigger asthma, eczema, psoriasis, migraines, hayfever, ADD, joint pain, chronic fatigue, and other health problems. These food reactions can occur up to 72 hours after a food is eaten. Many people don't recognize this because ther problem food is "hidden" in other food. For example, I am sensitive to corn. Corn additives are in most processed foods, in the form of High Fructose Corn Syrup, Corn Starch, distilled vinegar, MSG, etc. Since I had a delayed reaction, i could not connect my health problems to food. I also had a sensitivity to dairy products. You may be sensitive to several foods. Medical testing for Immediate food sensitivities are pretty good, but testing for delayed food sensitivities are very unreliable. You may need to do some detective work to find your problem foods. The foods thast you crave the most may be your problem foods.
You may be able to find some books about this at the library. Try "Dr. Braly's Food Allergy and Nutrition Revolution" or "Food Allergies and Food intolerance" by Dr. Jonathan Brostoff. You can also find an alternative doctor at www.acam.org and talk to them on the phone for a few minutes. This is not a cure. It doesn't work for everybody, but it works for most people.
bosco62a
Harvey R. Stone - 02 Aug 2006 11:36 GMT > I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. Hi guy,,,,, I am sorry to say,,,, C. I can truthfully say that my only experience with RA this bad is reading every now and then about a person that nothing really works for. I got RA in my late 30's and am now 67 and do pretty well. There are new DMARDs and I would try everyone of them unless I got a reaction to them like the one you had with Enbrel. I do want to welcome you to ASA and ask you to take part here where people have a good idea what your day is like. Harv
Jean - 02 Aug 2006 14:04 GMT Chuck,
I don't have a crystal ball so I don't know what your life will be like in the next 5 - 10 years, but I have a feeling whatever it is, you'll still have your sense of humor. Laughing at this crap we deal with is SO important. Oh, we all have our 'oh poor me' days and other days when crying/bitching/stomping feet is the only thing that works, but most of us carry on by keeping that humor intact.
I can identify with the shoulder issue. Me too. Not much has helped yet but I'm only a few years into the shoulder problems so am still working my way through the myriad of meds.
I'm sure others will be along shortly to give you more insight than I can. Keep smiling!!
Jean
> I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. johnie - 02 Aug 2006 14:40 GMT chuck, welcome aboard. And the answer is E. will spend the next ten years wondering if gold might have been the ticket...>g< keep laughing at the cruelty of the world chuck cause there really is a lot of beauty left no matter how deep the hole is your peering out of.
johnie
> I've has RA since '98 in my late twenty's. Male, no family history. > Tried and failed MTX, enbrel, remicade, kineret, humira, and arava. [quoted text clipped - 30 lines] > Thanks for playing. I would appreciate knowing what an experienced > group like this thinks. RoseB - 02 Aug 2006 17:09 GMT MY choice is also E) None of the above.
There are always new meds coming down the pipeline and so there is always hope that the next one will be your miracle drug. Even now you still have some choices. I notice that you do not mention taking cyclosporine, an antibiotic that is sometimes tried for RA. That may be one avenue to explore. Another may be rituxan.
In RA as in everything else attitude is everything, and I think you have a good one. Basically my advice is keep thinking positively, spend your days with meaningful people, share meaningful experiences, and get the most out of life despite the pain.
I spent the first 15 years of my JRA with unrelenting pain, and it was not until I tried gold, that I achieved a (partial) remission.By that time, I had had three major joint replacements, and significant joint damage elsewhere. Although that lasted two years, it was the beginning of my trying other drugs that worked even more effectively. Penicillamine was one of the best ones, and I took that for several years. Then came the biologics, and the two that I tried worked well. My point is that you never know what is ahead because at this point there are many new drugs in clinical trial.
Keep your positive attitude, your sense of humour, and your joi de vivre. Then whatever else comes, you will be prepared to handle it. Rose @}>->-- Being educated means that rather than fearing the unknown, one seeks to understand it. RB
Please remove "Ima" to reply.
Nann Bell - 03 Aug 2006 04:59 GMT > There are always new meds coming down the pipeline and so there is > always hope that the next one will be your miracle drug. Even now you > still have some choices. I notice that you do not mention taking > cyclosporine, an antibiotic that is sometimes tried for RA. That may > be one avenue to explore. Another may be rituxan. wise words, but I ll point out that cyclosporin is an immuno-suppressant. In fact it was the breakthrough in immuno-suppressant therapy that made today's high number of transplants feasible.
There is also an antibiotic out there that has helped some people, but I'm blocking on the name right now. You can learn more at www.roadback.org Never did anything for my PA, unfortunately.
> Keep your positive attitude, your sense of humour, and your joi de > vivre. Then whatever else comes, you will be prepared to handle it. And Rose has shown us that as well as anyone ever can. :)
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
RoseB - 03 Aug 2006 07:09 GMT >ll point out that cyclosporin is an immuno-suppressant. In fact it was the >breakthrough in immuno-suppressant therapy that made today's high number of >transplants feasible. Ok that is not the one I meant, but rather the one you referred to later in your post, the abx protocol advocated by the Roadback foundation. Is it minocycline? Like you, I was not certain of the name.I should have looked it up.
Sorry for giving wrong information. I guess that puts me down a mark. :( Rose @}>->-- Being educated means that rather than fearing the unknown, one seeks to understand it. RB
Please remove "Ima" to reply.
Nann Bell - 03 Aug 2006 04:44 GMT E. Don't give up hope yet. Even now there are options you haven't tried - In DMARDs there are Orencia and Rituxan (sp?). You seriously need to be taking milk thistle extract to help out your liver - it's available in the vitamins/supplements section of just about any store. I buy mine at WalMart.
And what has your doctor put you on for the gastritis? Many folks here have to take stomach meds in order to tolerate their other meds.
Meanwhile, have you been evaluated for possible fibromyalgia and/or any sleep issues? Your fatigue could be from just the RA, but it is also possible that one or both of the above has entered the picture and is contributing to the fatigue. It'd be worth checking out - anything that helps some is a step in the right direction.
BTW, my dad was on gold shots in the late 60s/early 70s. They didn't make him all well, but they did help some and he had no side effects from them. IIRC, we have someone here on the group who found gold worked better for her than any of the newer DMARDs, so give it a shot.
I feel for you and know you are going through hell. My first horrendous PA flare was in the days before aggressive early treatment. I'm still amazed that I made it through that first year, it was that horrible. Hang in there - your miracle is out there.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
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