Plaquenil takes about 3 months to really kick in. I remember starting to feel a touch better at 3 weeks and that slowly grew so that by 3 months, I felt a whole lot better. My only side effect was hair loss...which will grow back once you stop it.

But it has to build up in the blood stream slowly and that takes time. Don't make any rush judgments until you've had more time on the drug. Time to be a patient patient.

hugs.........Jen....was on Plaquenil for 6 years+

Took me 7 months to get results, and it was pretty dramatic results.

Hi Steph,
We're the same age. I feel really lucky to have finished my grad degree (public health) right before RA hit me. I know I couldn't do it now. I think you're being very reasonable in thinking that pushing yourself to keep up with school and work might not be the right choice right now. As others have said, Plaquenil takes quite a while to kick in, and you might find that you have more energy when it does. Or you might add another drug that helps- Plaquenil is among the milder RA treatments out there. Even if you never finish your degree, that is ok. Choosing to minimize your stressors is difficult but so necessary. Stress isn't something most doctors talk about, but I recently mentioned to my rheumatologist that I had stepped down from a board I serve on and am considering a job change that I think would be less stressful, and she said both of those things would do my joints good. Choosing to put your schooling on hold might do more than just give you some free time- it might help your RA too.
Caren

Thanks for all the support. I had a very emotional visit with my therapist yesterday. All of my other issues tie into having chronic illness. Jen had written within the last few weeks about the links between mental health and RA. My diagnosis was one of the things that pushed me back to therapy - I could not handle it. I've only just started working with my new rheumy and my therapist (doctor of psychology) said he would write a letter for me.

I worry about a lot of things; part of it is definitely due to my mental health diagnoses, but I think some of it is just reality. Like I said in my original post, I think about how much longer I can do this. I just turned 36. Even if I stayed in school now, I would be 39 or 40 when I finish my MSW. I know that's okay, but then I think about the additional $50k+ in student loan debt (on top of my already existing $60k), and I think, will I be able to work long enough to make a living and pay that back?

I said 'school is not fitting into that equation right now, and that's okay'. I don't know if it's okay. I think I'm working on accepting it, but I don't know if I'm 'okay' with it.

Steph, I just wanted to let you know that I'm in pretty much the same boat. 36, working full time and I've been going to school part time forever. I'm so close to completing my BA that I was finally starting to hope, to plan for grad school and my dream job. But I'm struggling. I've already pushed graduation back a year and a half due to RA. Facing the fact that I might not be able to go to grad school and achieve my career goals has been devastating and I'm still dealing with it. I might end up living on disability, unable to repay my student loans. Because of the shame, stigma, and disappointment, I find that harder than coping with the day-to-day reality of RA, which is messed up.

That's pretty depressing, and I'm clearly not OK with it, BUT, I'm trying not to give up. I only have four classes left after this semester and I consider finishing my BA an absolute must, as both a personal goal and something that will open doors for me. So I'm still chipping away at it, very slowly. I'm leaving grad school up in the air, hoping that I'll find the right treatment and be able to make plans again. And in the mean time I'm mulling over other possibilities for my future, trying to think of how I might earn a living while accommodating my health issues.

Only you can say how important that MA is to you, or how much risk you're comfortable with. My advice for you (advice I'm trying to follow myself) is #1 take care of yourself, #2 leave doors open, and #3 try not to think that disability is inevitable. Things are uncertain, not inevitable. You don't know what's around the corner. If you take care of yourself and you are able to achieve some control over the disease, you may find that you can return to school and pursue your career. If not, well, taking care of yourself is still the right thing to do.

I am also learning that this disease will sorely test your patience. Don't be surprised if Plaquenil alone isn't enough to get the RA under control. Treatment is trial and error. For me, it's taking an awful lot of both ...

I think you have to do what is right for you, and forget about "what will people think?"

I completed my MDiv in 2013, after 7 years part time work on the degree. I didn't start until I was on a really good med combo, and going slowly was the only way to do it. I was also not working full time, and on disability. About 5 years into my degree, I questioned whether it was ethical for me to be going to school, if I could not work. So I talked to the health reps, and they said with the kind of RA I was describing, my meds could fail at any moment and they did not want me coming back and teaching, and then having to take constant leaves or quit again.

So I took the advice, thinking that the rep was wrong, because my great med combo was never going to fail. Turns out a month later mthx did fail, and then a month after that I had a reconstruction surgery on my foot that failed, that causes me great pain 7 years later. So I guess that the rep was right.

I think that having a serious disease like RA is a liability, to work. But I do not see working full time and going to school was ever an option for me. I like high marks, that means a lot of studying, and if you have kids, that means neglecting them, even if you are home full time, I like was at various points. I don't want to discourage you from getting your MSW, but how much extra will you make from it? My daughter is a social worker too, and she looked into a MSW. She decided if she was going to make the effort to get another degree, she would be better off getting her law degree, becoming a judge, and really helping make appropriate decisions for the kids in foster care. (She is in child protection) She is totally healthy, and has not done it and I have to think she probably won't.

As for the Plaquenil, these drugs do take time. I had no luck with it at all - I even tried twice - no side effects, but totally a placebo drug for me. But I know people it has worked for, so don't give up yet. But if you do hit 6 months and it is stil not working, maybe best to move to methotrexate?

I'm glad your therapist is writing to your rheumy so he will understand your frustration. I know that having mental health issues linked to abuse makes everything harder. We have PTSD and become control freaks...we have to in order to survive as our childhoods were not under ANY control......and RA makes us feel so out of control. And having to wait to see if a drug works can just add to that frustration.

You might want to suggest to your therapist that you add a second faster acting drug while you wait...like Arava or even methotrexate. I took both Plaquenil and MTX for years after just Plaquenil was not strong enough. But that way you'll get some immediate relief while waiting. If Plaquenil really helps, you can always drop the other drug or use the extra "umph" to help you with school.

But always remember....you may be 36 now and wondering how you will ever work long enough to recover what you owe in debt but your chosen career lends itself well to working longer than most careers. You work with your mind, not your body.

I'll be 65 in August and if it hadn't been for my broken neck, I'd still be working full time. Work helps to distract me from the pain....not enhance it. But no one will hire me as I'm way too much of an insurance liability.

I'll have been tackling Ra for 40 years next year and I can tell you that it becomes easier with time. You get to know the signs of when you'll worsen and how to deal with it. I have all kinds of splints I use at night for flaring joints so no one at work saw a thing. If I really needed help with a joint, my doc was great at making the time to give me a quick cortisone shot so I could function. You will learn the ins and outs of dealing with this chronic disease and it does become a lifestyle that you can do along with full time work.

And stay in therapy....it helps me more than all the meds put together. My therapist keeps me sane. And right now, waiting to see if I have this Relapsing Polychondritis, he is my lifeline to sanity. Makes me feel like life is abusing me now. Haven't I had enough by now? Time for my nightly pity party so I can get up happy tomorrow.

Gentle hugs and know you can write me or message me about the mental health issues anytime.

gentle Ra hugs............Jen

Again, thanks everyone.

Plaquenil is only the first med with my second rheumy. My first rheumy that originally diagnosed me in 2013 started me on methotrexate immediately, up to 10 pills. When that didn't help, we added Enbrel... which didn't help after 12 weeks when I got a horrible respiratory infection and stopped. After I healed, we added Humira, which didn't help after 13 weeks, which is when I got a horrible respiratory infection and stopped. After a few more months of tests and a boatload of crap trying to get Xeljanz, I decided 'to hell with it', went off all meds, and got some tattoos.

This new rheumy says my RA is mild and that biologics are not necessary. Imaging doesn't show any damage (according to him) so he feels it's not necessary to be more aggressive.

Jen, as usual, you hit it on the head: I'm a control freak. Maybe not control freak, but I'm definitely a solid planner and I freak out when plans change. The nebulous nature of RA and the whole not ever knowing what's going on or how I'm going to wake up tomorrow is a bit much.

Marlene, what you said really resonated with me, about was it even ethical for you to go to school. I wonder that too. I'm able to do my job now, but one day I might not. That could be due to the RA or the mental health issues.

Etain, I completed my bachelor's last January and graduated in May. I enjoyed my undergrad program and made some great connections. Even though I was working full time, I felt able to balance it. I was diagnosed a little more than halfway through my program. I think what made it okay was that for large chunks of time I was only working part time or four days a week. It seemed to leave me more time to do homework, even on higher fatigue days. I don't know what's changed... Something has, though.