Monday, May 09, 2011

Rheumatoid Arthritis and Me: Part Three

Did I mention that May is Arthritis Awareness Month? Thus this series on disease. This is the last installment, though!

Medicines: The drawbacks, the benefits

Obviously, cost is always an issue and RA meds can range from relatively inexpensive to thousand of dollars a week. Right now, we're using one I'd rather not be on, methotrexate, which is better known as a cancer drug. Yippee, right? Bad for the liver, in high doses also gives lovely mouth sores and I swear, it brittles the hair and nails and skin. Also, it freaks non-rheumatologists out when I say I take 10 pills in one 24 hour period per week. That's our dose right now…5 on Sunday night, 5 on Monday morning. Pfft. What is it?

"Methotrexate is classified as an antimetabolite drug which means it is capable of blocking the metabolism of cells. (Metabolism consists of the production and destruction of important components of the cell as well as the production of energy for use by the cell.)"

While that's great for slowing the process of RA, it has some nasty side effects. And the antimetabolite function means it's really, really bad if you're trying to get pregnant. Which is why I get a little upset when people (admittedly, with the best of intentions) ask "when are we gonna see little Bugigangas running around?" or worse, assume that I'm pregnant because I'm feeling queasy one day. An "oops" pregnancy isn't something to cheer when you're taking the kind of medications I am. I know these are normal questions. But...

As long as I am treating this disease, we won't be getting pregnant. And if we did, the pregnancy would miscarriage...or we're looking at horrific birth defects. So, when we decide it's the right time, I have to stop treating my disease. These are big questions to tackle. Not dinner party conversation. Unless that poor questioner wants to be treated to a detailed rundown of the kind of questions we have to think about. Such as, what am I going to do if the RA comes back in full force? Do we have the resources (and the time to look) for a full-time nurse...for me? Who will do the grocery shopping if I can't walk? My doctors tell me some of their patients couldn't even lift a hairbrush during pregnancy. About 75% go into temporary remission. The other 25% are suffering, agonizing saint-mothers-to-be.

When we decide to start a (bigger) family, it won't be by accident. We're both okay with that. And rest assured, the world will know when it happens!

Now, as I step off my soapbox, let's look at the other meds that make life easier. Tylenol PM, for sleep. Occasional muscle relaxers, though I've not needed them in a while, thankfully. Corticosteroids, sweet blessed things, for bringing down swelling and passing out fake but wonderful extra energy. I feel like a goddess in the gym on steroid weeks. Nothing hurts! I am strong! I overdo it...and bitterly regret that extra 5 kilos I lifted because I forgot I was on a steroid taper. Ouch!

Oh...and then there's the anti-malarial drugs. Almost forgot. These could be responsible for the vivid, detailed dreams I have. Also causes blurred vision, diarrhea, and itching (but mostly in black patients--why?), among other side effects. Nice cocktail, huh?

And thus ends my RA trilogy. Now you know more about arthritis than you probably wanted to know. If that's not the case, here are some websites focusing specifically on RA that have been helpful when I needed support, information or confirmation that I wasn't alone:
Single Gal's Guide to RA: A great resource, sometimes whiny but well-written, on RA struggles and issues.
Rheumatoid Arthritis Guy: Another great blog. He is a self-proclaimed superhero. Gotta love that!
RA Warrior: Lots of newsbites, info on therapies and the like. More upbeat.


Ali la Loca said...

Are the anti-malarials for your RA?? Wow! We had many friends on Larium and others while visiting Moz, but we never took any due to long-term side effects. I hear they're awful...

Ali la Loca said...

Are the anti-malarials for your RA?? Wow! We had many friends on Larium and others while visiting Moz, but we never took any due to long-term side effects. I hear they're awful...

anne said...

wow. The choices meds give, the relief, the side effects....
I say, when you want kinder, ADOPT. Why not? Then you can continue to treat the RA and also have small one(s)....
or perhaps you'll decide that's not something you need to do -- that is also a valid choice, despite what you hear to the contrary.

thanks for the info -- Informative and well-written!