Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
I was officially diagnosed this morning as a Type II diabetic. I suspected this was coming. My routine bloodwork for the RA has shown a steady increase in the blood sugar number over the last few years, and the last test bumped over the limit. My GP (family doctor) ran the three-month-average test, and that confirms it.
The recent tests also indicated, for the first time ever, high 'bad' cholesterol.
My diet, ironically, has actually improved over the last few years. And my husband is a type II diabetic, so our shared meals have fallen into the recommended parameters for years. This is very frustrating.
The GP gave me Metformin for the blood sugar, and I'm to test and record glucose levels twice a day until I see him in three weeks. He recommends medicating for the cholesterol as well, but we agreed to change one variable at a time, so that's temporarily on hold.
In three weeks, he planned to give me a prescription for a statin, BUT, he said his personal experience with his patients indicates that I'd do better on Repatha. He felt that the statins have a high risk of muscle cramps, something I'm already prone to, and so he suggested a monthly Repatha injection. His feeling is that I don't need to risk any more aches and pains right now. To get this past the insurance company, which would normally require a period of statins first, I'll have to ask my rheumatologist to send my GP a note officially recommending the Repatha as the first step.
So that's where I am right now. Bah. I'd like to share one point, and ask one question:
First, let's all be smarter than I was about other health issues. Dealing with RA has sort of taken up all the oxygen in the room, do you know what I mean? I waited too long to deal with this. Yes, the 'bad' blood test was just a few days ago. But I'd actually already made this morning's appointment with the GP because I just didn't feel right. I was tired, edgy, brain-fogged, achy, sluggish, had some vaguely troubling vision things going on. I was blaming that on the RA (and an overdue eye exam), but wanted to ask about the possibility of depression, so I finally made today's appointment. And here it turns out that this other factor could be culpable; all of my symptoms might be traced to the diabetes. I've known something was vaguely wrong for several months, really. Be smarter than I am, please. Don't assume everything's because of the RA.
And my question is this: is anyone else here dealing with statins and RA meds, with Metformin and RA, with Repatha and RA? I'm sure I'm not the only one here with the same things on my plate. Any suggestions, or questions I should be asking? Thanks.
I'm getting a Stelara shot every three months. I don't understand that monoclonal antibody means, but that can be today's research project!
Thanks for posting and sharing. I have been on prednisone for a looooong time. I have had RA for 12 years now and noticed that my blood sugar has been going up steadily, slowly but surely. In November it hit 96 mg/dl and the maximum is shown to be 100 while minimum should be at 74. Last March it was 91 and the year before it was 91 too. I am a bit worried am determined to talk about it to my doctor. I am on Humira and Methotrexate. I do not want to have another chronic disease on top of RA.
I never said "just forget it" about anything. I only offered my experience with one part of Katie's question.
Beyond that, I'm not sure where you're going. I take a mab. Rituximab. It's been a godsend, I think. After a number of successful years on any drug, do we really know if we've been cured or if it's the drug that's boosting us. On the flip side, when people are failed by a drug, is there another drug or another condition that causes the flip?
I think the best we can do is to do our homework, understand what the benefits of any therapy are, and what the drawbacks might be. There's clearly a shitload of different manifestations of autoimmune disorders, and if you get a sign, follow it. Or not.
And beyond dug therapy, just do what you know best. At this pint in time and our lives, we pretty much ought to know what a GOOD diet is, and know that exercise is good for us, to what ever extent we're able to participate. Do those. As far as lab results go, take normal to mean you have less worry about anything it covers. Normal liver enzymes, normal eGFR and creatinine, normal WBC are always good. I've an ESR of 2 ever since started Rituxan, so it's a "nothing" test to me. I have joint pain that's off the radar (ie, pain, no redness, no swelling), and nothing to show for it, so my normal for that is definiitely skewed.
I think a lot of this is knowing your body - becomes more difficult with meds, I know - and using common sense. If you worry about it, you add stress, and you know the rest.
Good luck.
Linzey the auto immunes seem to drive us to distraction in groups. I see what you mean. I have a new immunology issue surrounding infection and not enough B cell response - after a long time on biologics it does not please me.
joline I am glad the rituxan is still working good for you
organs are pretty precious. you can personally interpret lab ranges anyway you want of course - but sometimes when those numbers show abnormality then a major organ may be evidencing silent impairment in those numbers.
or as I see Joline saying above normal normal normal is like good.
numbers off sometimes mean crappy stuff for the liver and kidneys. sometimes those slides are silent. We can feel joint pain - I am not sure any of us know when are lungs are about to take a slide into cancer from a silent tumor or our liver has crapped the bed or our kidneys just can't filter anymore. the tests have to have some validity in the realm of function.
Five years ago I tripped and got a gash in my leg from barbed wire. I realize my tetanus shot was out of date and thought the gash might require a stitch or two, so I drove myself to my GP to get a shot and to get sewn up.
While I was there I asked if he'd take a look at the weird bump on my pointer finger, first joint. I had noticed it a week before but it didn't hurt, and other than what I thought was maybe menopausal tiredness, I was asymptomatic. I would have never, especially in the busy time of the year on the farm, have made an appointment to have it checked out.
My GP suggested the bloodwork which eventually led to my RA diagnosis. Even though I was classified as moderate-to-severe, the honest truth is that I had no symptoms that would have sent me to a doctor - I just felt tired, and a bit more achy than usual, but I had a physically demanding job and I was getting older and it was the busiest time of the year. I would not have interrupted the work schedule and handed out the $40 co-pay to have been told 'well, you're just getting older," which is what I honestly thought was going on.
If i wasn't have the routine bloodwork done, my type II diabetes would not have been discovered, because - again - I was not experiencing any severe symptoms, and actually assume that the fatigue and brain-fog was solely due to the RA. When my Dad's type II was discovered, his blood sugar was over 400 and he was immediately hospitalized; he nearly lost a foot (he had other medical issues which exacerbated things, too). My number was 135.
So I could be bitter that I have type II diabetes, and I could be bitter that I have RA, and I could be bitter that I have a scar on my leg from the barbed wire.
Or I could choose to look at that scar on my leg and realized it saved my life; if not literally, then it certainly has saved the quality if it. I found the RA before I experienced any organ damage or serious loss of mobility. I found the diabetes before it affected organs or my eyesight.
Seems like an easy choice to me.
I do want to share 2 pieces of information with you. My husband has been able to reverse his diabetes. He has a stron family history of type 2 diabetes and he knew when his weight was creeping up a couple years ago that something didn’t feel quite right. His blood sugars had been creeping up but by bit in the years previous but once they crept over the line where his doc would have started him on anti diabetic meds he said give me some time to try and improve my diet etc and see where things are at. He really made a complete 360 and started getting serious about eating ultra well- reduced his carbs to next to nothing (no bread, rice, potatoes, sauces etc) ate lots of salads, fish, healthy lean protein and started going for more walks (looooong walks) and did yoga 3-4 days a week. Over a period of a year I think his numbers are nicely back in range. Mind you he was not very bad to begin with but he was able to reverse things.
The second thing is that he has experienced has been high cholesterol. He took statins for about 15 years and while they did help his cholesterol they have ended up causing him a ton of issues with muscles. Initially the doctors would not admit it but more and more they are acknowledging what a problem they can be for muscles. His muscles get so stiff that he would get up in the middle of the night to roll them out just to get comfortable enough to lay down. He used to bike 50k 2-3 times a week but now he cannot do it at all as his muscles stiffen up like a board. He can’t lift weights etc. He has been off statins now for 2 years and hasn’t fully recovered. He has done a lot of research into all this and has learnt 2 important facts: 1. Statins can cause blood sugar imbalance, 2. Sugars in your diet are heavily responsible for increasing your triglycerides ( not sure if yours are up)?
Often the docs only check HDL/ LDL, total chol and triglycerides. They do not check what the breakdown of the LDL chol is. I do not know the subject matter well enough but apparently there is an alpha and beta within the LDL and only one type is bad. So technically if you do not have the bad one it is not necessary to treat it. He paid for this test and discovered he never should have needed treatment in the first place because of the high LDL not being the bad kind (can’t remember if it’s alpha or beta that’s bad). You may want to ask your doc about that. Also, my brother has managed to normalize his high cholesterol with dietary changes. He swears by- high fish diet (not tilapia or bass- they’re like eating bacon apparently), no sugars, and probiotics plus lemon water to create alkalinity in his diet (1 lemon to 1 litre of water).
I know it’s a lot of info. But something to consider. All meds have side effects and if you can avoid taking one, all the better. If your doc recommends you take metformin, you can still make dietary changes and see where it leads you. Maybe you can come off it eventually. Your job sounds physically taxing and with RA I’m not sure how much additional activity you could endure but if you can go for walks it will definitely be a huge help. Walks work similar to insulin- they assist with getting the free sugars in the blood used up/ enter cells. It’s an excellent part of the solution.
Wishing you good luck with what lays ahead. With your level headed approach to things, I’m sure you will conquer this too.
I know it feels like we live by crisis management... at least, that is how I feel. You make the best decision for you at this time and hope there will be better results or more options later.
Hope the meds work for you with no side effects.
Kim