 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Arthritis / October 2004Driving with RA drugs
My symptoms are not bad enough to affect my driving ......really, I've no excuse!...... :o) & being newly diagnosed, I know nothing about any of the medications used to combat RA. Driving is very important/essential to me, are the current drugs used going to curtail my driving? Thanks. George. My symptoms are not bad enough to affect my driving ......really, I've no excuse!...... :o) & being newly diagnosed, I know nothing about any of the medications used to combat RA. Driving is very important/essential to me, are the current drugs used going to curtail my driving? Thanks. George. It depends on the drugs. Usually you won't be taking pain killers that would interfere with your driving unless the pain were already so bad it was interfering with your driving. NSAIDS shouldn't be a problem. DMARDS either. Except to the degree they sometimes make more frequent or more immediate potty breaks necessary. Jo Thanks everyone, that's good news, Are these the two main drugs then, NSAIDS & DMARDS? I'll go look them up, are they any good?  Signature-- George. > My symptoms are not bad enough to affect my driving ......really, > I've no excuse!...... :o) & being newly diagnosed, I know nothing [quoted text clipped - 12 lines] > > Jo George, Nsaids and dmards are two of the classes of meds that are used for RA. There are others as well, but nsaids and dmards are probably the two most common classes of meds used. Nsaids = non-steroidal anti-inflammatory drugs *a few examples of nsaids = celebrex, bextra, mobic, relafin, naprosyn, aleve, etc., etc. Dmards = disease-modifying anti-rheumatic drugs *a few examples of dmards = mtx (methotrexate), arava, enbrel, remicade, cyclosporin, plaquenil, sulphasalizine, gold, imuran, etc. The dmards are probably the most important class of drugs as far as treating your RA as these drugs halt the progression or significantly slow down the progression of the disease. The pain meds are the class of medications that you need to be most concerned with as far as your driving goes. Check out www.arthritisinsight.com for more information on the medications. Donna G Thanks Donna. ........thanks for the link too, there's a lot of good information on that site, got it bookmarked. Signature-- George. > George, > [quoted text clipped - 23 lines] > > Donna G How good are these drugs then (I'm not taking anything but Ibuprofen just now) do the painkillers work? always? I mean when/if the disease progresses will they always be able to keep us pain free? How well do the disease modifying drugs work, do they really halt or slow down progression? I mean in the real world without surveys etc. is there much feedback to this group from people that are finding relief? Regards, George. > George, > > Nsaids and dmards are two of the classes of How good are these drugs then (I'm not taking anything but Ibuprofen just now) do the painkillers work? always? I mean when/if the disease progresses will they always be able to keep us pain free? How well do the disease modifying drugs work, do they really halt or slow down progression? I mean in the real world without surveys etc. is there much feedback to this group from people that are finding relief? Regards, George. Hi George, Yes,,, there is feedback. Nothing is easy or quick when dealing with arthritis and everything does not work for everyone. All the medicine listed has been taken by many people her and they will talk about them. The secret to dealing with arthritis in today's world is to find out exactly what your problem is which usually means getting into a Rheumatologists office and start dealing with what is,,,, and not someone's easy answer. Harv Thanks Harvey, I am fairly level headed & so don't expect an easy quick answer. I reckon that treatments vary in effect as much as the disease varies in the way it attacks everyone. Having said that, I think It's good to talk about what's worked for us, what's not & what the side effects have been.....I mean that's how they test these drugs,no? The one piece of advice that I keep getting is to go see a rheumatologist, ......that I think is a good idea, I'll be compiling a list of symptoms that I've been getting over the last few years & heading back to my doctor with them. Where I live though, it will no doubt be a while before I see anyone. SignatureGeorge. > How good are these drugs then (I'm not taking anything but Ibuprofen > just now) do the painkillers work? always? I mean when/if the disease [quoted text clipped - 15 lines] > easy answer. > Harv > I am fairly level headed & so don't expect an easy quick = >answer. I reckon that treatments vary in effect as much as the disease = [quoted text clipped - 7 lines] >heading back to my doctor with them. Where I live though, it will no = >doubt be a while before I see anyone. The anti-tnf drugs have been extremely effective, but they are biologic drugs from recombinant DNA technology. Take a hard look at your insurance (if you are in the US) because the cost of these drugs runs from about $12,000 to $18,000 per year. I am on Remicade and the costs of my treatment are $4000 a pop. Has put me into medicated remission though, I had 35 swollen joints at one time. -- MZ Visit my website: http://www.mzuschlag.com How Much?!? Whoa, so much for me being level headed! :o) I'm in Canada, don't know what that means exactly I don't usually go to the doctor for anything. I do hear that US citizens come up here for drugs though so it surely can't be as bad. I guess it's too late to go get some insurance! Anyone know how good/bad BC medical is? Signature-- George. > The anti-tnf drugs have been extremely effective, but they are > biologic drugs from recombinant DNA technology. Take a hard look at [quoted text clipped - 5 lines] > Visit my website: > http://www.mzuschlag.com > > I guess it's too late to go get some insurance! > Anyone know how good/bad BC medical is? It has actually been very good to me. There is a limit based on your income of what the BC government expects you to pay for drugs that are covered under their formulary. Approved drugs are often the generic brands. For some drugs however, you can get "Special Authority" if you have failed other drugs in the same class.For example, the provincial plan will cover pariet for a ppi acid controller, but if you fail it you may be able to get special authority for prevacid or nexium- provided your doc is able to do the paperwork. For drugs like the COX-2 inhibitors- you need to have failed a certain number of NSAIDs before you can get special authority. I am on remicade, and at four vials the cost is something like 4200. (plus change) every six weeks. The government covers most of that, so that now I am only paying 52.00 and change. My actual costs vary- in January my out of pocket costs are over 1000.00 until I have passed my limit determined by my income. I alos have Blue Cross coverage through my employer and they cover most of the out of pocket expences that the province does not cover. So yes, itis a good plan. Rose Those are some scary numbers. I hear people complain all the time about BC medical .......guess I won't be one of them! :o) Thanks for the info Rose, Signature-- George. >> >> I guess it's too late to go get some insurance! [quoted text clipped - 6 lines] > plan will cover pariet for a > > Rose Those are some scary numbers. I hear people complain all the time about BC medical .......guess I won't be one of them! :o) Thanks for the info Rose, George. And the good news is that you may not need the expensive stuff, George. That is what the RD is for. What you have and what to do for it. Harv I live in BC and I think our pharmacare program is wonderful but of course has a few problems. In order to qualify for paid meds that are expensive such as enbrel or remicade you must fail the inexpensive combinations first such as mtx, gold, sulfasalazine. However once those are tried and you are approved for the expensive ones they are very affordable compared to other areas. You pay a certain amount due to your income level. After you reach that amount the cost is almost nil. I pay .20 a month right now for my enbrel. I also have blue cross which in the beginning pays for 80% of whatever the province does not pay. There are a few of my meds that they won't pay that aren't approved but that usually means there are cheaper versions ie: flonase is not covered at all. The system isn't perfect but it is darn good. Kelly Good stuff! If it goes by income level I'll be just fine! :o) Thanks. Signature-- George. >I live in BC and I think our pharmacare program is wonderful but of course > has a few problems. In order to qualify for paid meds that are expensive [quoted text clipped - 11 lines] > > Kelly > How good are these drugs then (I'm not taking anything but Ibuprofen > just now) do the painkillers work? always? I mean when/if the disease [quoted text clipped - 7 lines] > Regards, > George. Pain levels vary with each person. There are some people who take narcotics for their pain, then others, like me, who have physicians who say narcotics do nothing for RA pain, so will not prescribe them. I would think those on narcotics are at least generally functioning, where I am not. My pain is "controlled" (ha) with Motrin (2400 mg a day since 1996 or 97), and it isn't controlled much, but if I stop taking the Motrin I definitely miss it... DMARDS... I am currently back on Arava (seems to work alright). I have been on Remicade (I loved that stuff, but grew "resistant" and allergic) and Humira (it never worked for me, even injecting every week, and I was allergic to it though the RD didn't want to admit that). I take MTX (20 mg on Sundays), Sulfazine HC (2000 mg a day) and Arava (20 mg daily). It's better than it was, but not nearly as good as it had been on Remicade. Hope this is/was helpful. I'm thinking I haven't had nearly enough coffee today... Smokie Darling (Annie) Hi Annie,,,, What you have said is what I worry about. Were you taking Arava or Methx while you where on Remicade???? I take 10mg of Methx and have taken it as long as I have been using Remicade. I do not what that reaction that ends Remicade. Harv >> How good are these drugs then (I'm not taking anything but Ibuprofen >> just now) do the painkillers work? always? I mean when/if the disease [quoted text clipped - 29 lines] > > Smokie Darling (Annie) > Hi Annie,,,, What you have said is what I worry about. Were you taking > Arava or Methx while you where on Remicade???? I take 10mg of Methx and > have taken it as long as I have been using Remicade. I do not what that > reaction that ends Remicade. > Harv Harv... I was taking MTX (still am - 20mg on Sundays) while I was on Remicade. My MTX and Remicade used to be on the same day (Thursdays then). The RD isn't sure if I was infused too quickly (how that makes a difference I don't know) prior to the reaction, or if I just became allergic. We just know that I can no longer use it, and danggit, it worked so well. Now, I've got a friend here in Colorado who is on Remicade, and has been for four or five years, it isn't adversely affecting her, for which I am grateful (she's a great "whine to" buddy). So, it's possible that it's just me. My family has a tendency to sensitivity to drugs, so I could be pre-disposed, but still... In fact, most of the people in my "support group" here are on Remicade and have been for ages... I'm the only one that can't take it anymore. Smokie Darling (Annie) - whimper, whimper... do I whine well or what? ;) > I would think those on narcotics are at least generally functioning, > where I am not. My pain is "controlled" (ha) with Motrin (2400 mg a > day since 1996 or 97), and it isn't controlled much, but if I stop > taking the Motrin I definitely miss it... just a thought - when I was on ibuprofen for an NSAID, the maximum prescription dose was 3200 mg/day. Is there any reason you can't increase to that amount? I know it still won't get rid of the pain, but maybe it would dull it a tad more. I definitely think pain meds work for arthritis pain. In fact, when I didn't have prescriptions for pain meds on a regular basis, I'd horde them from other things. I always liked to have a few Tylenol 3s on hand for really bad nights whne I was desperate for sleep. SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare > > I would think those on narcotics are at least generally functioning, > > where I am not. My pain is "controlled" (ha) with Motrin (2400 mg a [quoted text clipped - 10 lines] > other things. I always liked to have a few Tylenol 3s on hand for really bad > nights whne I was desperate for sleep. My docs all say that 2400 mg is the top end, and it can NOT go higher. In fact, after I had surgery for septic arthritis in my left knee, I was given Vicuprofen (sp?) for pain, and I had to cut out one of my 800 mg Motrins so I could take it (two of them, if I needed more, I had to cut out another Motrin). Can't take Tylenol, makes me throw up (rather like aspirin for "normal" people), but my doc is "considering" Ultram since he says it's "not" a narcotic (close I hear, but not quite... whatever). I also have fibromyalgia so I take flexeril and ambien at night, still don't sleep much, but hey every little bit helps. Smokie Darling (Annie) - who posts from Google so she's always behind everyone else. >> just a thought - when I was on ibuprofen for an NSAID, the maximum >> prescription dose was 3200 mg/day. [quoted text clipped - 4 lines] > 800 mg Motrins so I could take it (two of them, if I needed more, I > had to cut out another Motrin). from medline (http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202743.html) "For arthritis: * Adults and teenagersAt first, a total of 1200 to 3200 mg a day, divided into smaller amounts that are taken three or four times a day. After your condition improves your doctor may direct you to take a lower dose." (I knew I'd taken 3200! 800 mg, 4 times/day. still, it only did so much. And there might be other reasons your docs don't want you on that dose. I but my doc is "considering" Ultram since he says > it's "not" a narcotic (close I hear, but not quite... whatever). I > also have fibromyalgia so I take flexeril and ambien at night, still > don't sleep much, but hey every little bit helps. Ultram does help with fibro pain for some people. If your doc is "considering" it, then he needs to try you on it! The only way to know if it helps is to try it! For many people it works better with tylenol, but it's certainly worth a try for you even though you can't take the Tylenol. Heck, I have PA and fibro. Folks here can tell you I had a fairly bozo RD last year. Still, he did have me on Bextra and Ultram and Tylenol and Zanaflex. Each element helps some. SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare I have OA, Gout, and Lupus and I take Bextra and Ultracet (among lots of other Rx)....the Ultracet takes the edge off the pain without making me loopy. I can take it during the day, but I mostly use it in the evening when I feel like do-do. Darvocet did zero, except have me acting like a raving drunk....much to my teenagers amusement and my husbands chagrin. However, I can tolerate ALOT of pain....so I may not be the best person for pain killer advice. Janet R "Nann Bell" <hanbellGOGATORS@earthlink.net> wrote in message | Ultram does help with fibro pain for some people. If your doc is | "considering" it, then he needs to try you on it! The only way to know if it [quoted text clipped - 3 lines] | year. Still, he did have me on Bextra and Ultram and Tylenol and Zanaflex. | Each element helps some. Thanks Annie, Sorry to hear of your hurting. I'm lucky in that I don't suffer very much, nothing that can't be quelled with ibuprofen at least. There are only sometimes that the pain gets really quite bad in my hips, then if I get up & walk around it's gone in a little while. Mostly I just get stiffeness & a sort of fuzzy kind of warm not unpleasant feeling in my fingers, my knees ache badly, my left elbow & shoulders sometimes hurt, I wake up often in the night sore enough to want to turn. Hmmm...... to read that over again it sounds worse than it actually is, to be honest though, if it stayed as it is now I'd be okay, I could live a 'normal' life just using ibuprofen. ....actually the fatigue & malaise get to me sometimes, that could go too! :o) It's likely hard to know how effective the disease modifying drugs work, I mean there's no way to tell where the disease was going to go without them? Signature-- George. > Pain levels vary with each person. There are some people who take > narcotics for their pain, then others, like me, who have physicians [quoted text clipped - 17 lines] > > Smokie Darling (Annie) Annie wrote - ~~~~Pain levels vary with each person. There are some people who take narcotics for their pain, then others, like me, who have physicians who say narcotics do nothing for RA pain, so will not prescribe them.~~~~~ Holy sh.t Annie! Give the twit my e-mail addy so I can straighten his a.s out! Narcotics can't target some pain but not others. ~~~~I would think those on narcotics are at least generally functioning, where I am not.~~~~ I would have checked out long ago without mine! ~~~~My pain is "controlled" (ha) with Motrin (2400 mg a day since 1996 or 97), and it isn't controlled much, but if I stop taking the Motrin I definitely miss it~~~~ This isn't right, Annie. Pharmacies have shelves of little pills developed just for pain. Your Dr uses a bullshit excuse because he doesn't want to deal with it. I'd like to see someone sue their Dr for malpractice for keeping them in pain when he had the ability to help. I hope you can find another RD. Go to your local Arthritis Foundation meetings and talk to other arthritis patients. You can find out which RD's are prescribing narcotics. -g- Kitty > Annie wrote - > [quoted text clipped - 4 lines] > Holy sh.t Annie! Give the twit my e-mail addy so I can straighten his > a.s out! Narcotics can't target some pain but not others. Makes me mad as hell to read about doctors like this. Mine has to twist my arm to get me to take the pain control I should, but he does. Something else that is true for me and I think is generally true, when you are in a lot of pain narcotics do not knock you out the way they would someone who was not in pain. When I had the kidney stone my then doctors first diagnostic tool was to give me a shot of a strong pain killer. Before he had someone wheel me back to radiology. Said if it had been anything less severe it would have likely knocked me out. As it was it just got me to the level of coherent and to where I could stand the tests. Jo Jo wrote - ~~~~Makes me mad as hell to read about doctors like this. Mine has to twist my arm to get me to take the pain control I should, but he does. Something else that is true for me and I think is generally true, when you are in a lot of pain narcotics do not knock you out the way they would someone who was not in pain. When I had the kidney stone my then doctors first diagnostic tool was to give me a shot of a strong pain killer. Before he had someone wheel me back to radiology. Said if it had been anything less severe it would have likely knocked me out. As it was it just got me to the level of coherent and to where I could stand the tests.~~~~ It takes about 2 weeks for the average person to adjust to long-term daily narcotics. When I first started mine, they made me fall asleep 20 minutes after I took them for the first few days. Then it was just sleepy, and by the end of 2 weeks I had no problems. The only effect I've had is pain relief. No 'high' feeling. Damnit! But then again, a 'high' Kitty might not be in the world's best interest LOL!!! I was able to hold down a full time job in a medium security prison, (employee, not inmate, smartasses!), and drive my car. No one even knew I was on them. Each time my doses are titrated up it only takes about 2 days to get rid of the sleepy feeling now. When I saw a Pain Clinic Dr a few years ago, I asked her about the long term effects of narcotics. She said that the best part about them is that there are none. No liver problems like there is with Tylenol and other analgesics. No brain lesions or brain chemical imbalance problems like there are with anti-depressants the Dr's prescribe for pain control. No blood thinning or clotting problems, etc. Just blessed relief! I know some people are allergic to some painkillers, but my advice is to at least try them. I found out I'm allergic to all of them except Demerol and Methadone. I know most Dr's don't prescribe Demerol long term anymore because it's supposed to morph into bad metabolites in your body, but I've been on it for 13 years with no problems at all. I've never experienced it, but constipation is supposed to be the most common side effect. Using a fiber drink is supposed to take care of it. -g- Kitty > Something else that is true for me and I think is generally true, when you > are in a lot of pain narcotics do not knock you out the way they would [quoted text clipped - 3 lines] > less severe it would have likely knocked me out. As it was it just got me > to the level of coherent and to where I could stand the tests. good point. it got me remembering when I broke my wrist and they shot me up with Demerol. I mean, it was 50 mg, a commonly given dose in hospitals. Didn't touch the pain at all, just helped me relax a bit. The only thing that really helped with the pain was whatever they shot my arm full of before they tried the closed reduction. Numbed me up so good that I found it rather interesting to watch. But the demerol could have been tylenol for all it helped me. SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare >> Something else that is true for me and I think is generally true, when you >> are in a lot of pain narcotics do not knock you out the way they would [quoted text clipped - 11 lines] >interesting to watch. But the demerol could have been tylenol for all it >helped me. What people do have to worry about is that pain keeps them from getting quality sleep. If you start taking any medication that alleviates the pain you could find yourself falling asleep at the wheel just because of accumulated fatigue. It's not a direct result of the medication but can happen. Thumper To reply drop XYZ in address > Annie wrote - > [quoted text clipped - 26 lines] > > Kitty Oh Kitty, I would LOVE to give him to you (through email only, he's generally a nice guy). I guess the biggest problem is "my" RD no longer sees patients unless they are on Remicade, so my PCP is now "following" my RA. He worries about "addiction", and I basically told him last visit that if my pain isn't somehow controlled the I would be "checking out" so addiction wasn't a problem. Of course, I don't feel that way now, but at the time.... He is wary of putting me on "new" drugs until he can see what the liver levels are after adding Arava... I'm not a happy girl, but I suppose it could be worse. I did ask him to speak to my RD (I still think of him as "mine") about pain control, and he said he would... There is one other doc on the Western Slope that specializes in Rheumatology, and he is 10 months out for new appointments (and he does the SSDI exams, so we've met, ick... I've never been hurt that much by a doctor, ever, even when the adhesions in my knee had to be broken.). It's a 4 hour drive over two passes to reach an RD in Denver... Don't know about y'all, but my joints do not handle the change in altitude very well. So I'm kinda stuck, but I'm hanging in there. I know that all sounds like whining, but I wasn't. I always think it could be worse... The one time I thought it couldn't get any worse, my mother died... It can ALWAYS be worse. Smokie Darling (Annie) Hey Annie - Now that I know you're in Colorado, I have an idea for you. Get your insurance to OK a second opinion and go to the Mayo Clinic in Phoenix. I had my sister do it when she lived in a small town in Utah, hours away from a RD. Mayo worked up the best course of action naming drugs to use, etc. You can have them put down the best painkillers for your situation, too. They send a letter to your Dr outlining it all. It's worth a try. -g- Kitty >so my PCP is now >"following" my RA. He worries about "addiction" Is this twit associated with a hospital? Joint Commission on Healthcare Accreditation Organization (JCAHO) has some very specific policies on pain management. Go to www.jcaho.org and do a search for pain under the public section. My RD feels very strongly about pain management. He and I went around a few times until he finally convinced me to try it. Then he had me try taking it before doing an activity that I knew would cause pain and guess what happened? Because I was taking it before the pain got out of control, it took less medication to control it. As for addiction, I have been on the same pain med for 6 years. Sometimes I take more, sometimes I take less but the script has not changed. Oh wait, he decreased the number of pills I get with each refill because I wasn't using near that amount. Here are some pain sites. I would recommend that you educate your PCP: http://www.theacpa.org/ http://www.painfoundation.org/ http://www.aapainmanage.org/ http://www.ecn.ab.ca/cpac/ If that doesn't work, we'll send out the gimp posse. Let's just say it won't be pretty. Sarah L "Friends are those people who know the words to the song in your heart and sing them back to you when you have forgotten the words." (unattributed) >>so my PCP is now >>"following" my RA. He worries about "addiction" [quoted text clipped - 11 lines] >not changed. Oh wait, he decreased the number of pills I get with each refill >because I wasn't using near that amount. What's wrong with addiction as long as it works for the pain and is managed by a doctor? It sounds like those fools who don't want terminally ill cancer patients to smoke weed to alleviate the nausea caused by Chemo. Thumper >Here are some pain sites. I would recommend that you educate your PCP: >http://www.theacpa.org/ [quoted text clipped - 9 lines] >"Friends are those people who know the words to the song in your heart and sing >them back to you when you have forgotten the words." (unattributed) To reply drop XYZ in address > My symptoms are not bad enough to affect my driving ......really, I've no excuse!...... :o) & being newly diagnosed, I know nothing about any of the medications used to combat RA. Driving is very important/essential to me, are the current drugs used going to curtail my driving? > Thanks. > George. No They should not. Unless you are on some narcotic for pain. Rose I always make sure I have a clear schedule for 2-3 days when I start a new med in case it makes me sick or such. But unless the pain meds stop me from driving, the only other time I can't drive is when I have tummy problems from some meds that keep me near the house. SignatureCyberhugs, DianeW It is only with the heart that one can see rightly; what is essential is invisible to the eye. --Antoine de Saint Exup?ry > >> My symptoms are not bad enough to affect my driving [quoted text clipped - 8 lines] > No They should not. Unless you are on some narcotic for pain. > Rose |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2009 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.