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...
So my wife was diagnosed last year in May with Seronegative RA. All of her blood work was negative except for inflammation markers. Inflammation markers were a bit high so she began treatment. MTX wasn't an option because of her liver history and elevated enzymes. She began to see a Rheumotologist and Hepatologist. Rheumy provided meds and vitamins while the hep provided mostly vitamins to lower the enzymes First with Plaquenil, followed by sulfasalazine.
So her daily medication/Vitamin schedule starting in September was:
Morning: 200MG Plaquenil
1000MG Sulfsazaline
Afternoon: Fish Oil 1000MG
Cinnamon 500MG
Late Afternoon: Vitamin D 1000MG
Vitamin E 350U?(I forget the measurement)
Evening: 200MG Plaquenil
1000MG Sulfasalazine
She did this for about 3 months without missing any dose.
Her bloodwork in early November was even better. It showed the inflammation was down. All inflammation markers improved. She continued to be considered Seronegative.
Her symptoms back in May were flares in both feet and hands perhaps twice a day. Symptoms in August were down to maybe 1-2 flares weekly. By October, she went the whole month symptom free! She also improved on her liver blood work. It was all normal. November was also pretty good till right around Thanksgiving.
My wife started to miss a dose here and there. Sometimes she only took half of her daily scheduled pills. So right around the Thanksgiving days, she had a flare up in one of her hands. She went back to her routine doses but could not get it to be as good as she was from July - October.
She has now had 2 flare ups this past week and we're worried again. My question today is...
Does she need to get back to her daily routine doses which the Rheumy told her to continue for her to feel better?
Or
Perhaps she was going to feel symptoms regardless? The fact that she lost inflammation markers a good sign? She had zero inflammation during that great October month. Is she improving?
So her daily medication/Vitamin schedule starting in September was:
Morning: 200MG Plaquenil
1000MG Sulfsazaline
Afternoon: Fish Oil 1000MG
Cinnamon 500MG
Late Afternoon: Vitamin D 1000MG
Vitamin E 350U?(I forget the measurement)
Evening: 200MG Plaquenil
1000MG Sulfasalazine
She did this for about 3 months without missing any dose.
Her bloodwork in early November was even better. It showed the inflammation was down. All inflammation markers improved. She continued to be considered Seronegative.
Her symptoms back in May were flares in both feet and hands perhaps twice a day. Symptoms in August were down to maybe 1-2 flares weekly. By October, she went the whole month symptom free! She also improved on her liver blood work. It was all normal. November was also pretty good till right around Thanksgiving.
My wife started to miss a dose here and there. Sometimes she only took half of her daily scheduled pills. So right around the Thanksgiving days, she had a flare up in one of her hands. She went back to her routine doses but could not get it to be as good as she was from July - October.
She has now had 2 flare ups this past week and we're worried again. My question today is...
Does she need to get back to her daily routine doses which the Rheumy told her to continue for her to feel better?
Or
Perhaps she was going to feel symptoms regardless? The fact that she lost inflammation markers a good sign? She had zero inflammation during that great October month. Is she improving?
I'm not saying that is what happened with your wife, but often, when a drug stops working, the body's immune system has awakened and that drug is now not able to do it's job.
It is possible that your wife needs a dosage adjustment by the doctor and her body's immune system isn't "awakening" but breaking through. The doctor can check that.
It's unfortunate but all these medications can do is put the body "to sleep" or "occupy it's immune mind" so that it doesn't know to attack. (sorry to use simple words but it's an easier visualization this way) When you reduce meds, your body's immune system can awaken. Or at some point, your body's immune system can wake up on it's own and make a current drug obsolete. That's why we often are great for a time span and then have to change. That's also why it's TERRIBLE to get sick (due to the drug's immune suppression so you catch things easier) and have to quit the drugs until recovered. Starting and stopping and reducing can backfire.
There is no cure for this disease although I have heard of people going into remission spontaneously, but it is very rare. Especially if your wife is taking two DMARDS, she needs to stay on them. There are other meds, but they are all stronger, and harder on the body.
So glad of you to come on behalf of your wife, but I would urge her to come here herself. And certainly to follow doctor's orders. I became very med non-compliant with another disease I had, but I never played with my RA meds. With the exception, that I always have prednisone on hand, if my meds are failing me. I'm not doing anything excessive, just the same things the rheumatologist told me to do before, when the meds started failing.