Counting My Blessings: Medications
While the holidays can be wonderful, all the holiday cheer can also highlight the aspects of our lives that make it hard to feel cheerful. RA can bring out the Grinch in me, so inspired by the Whos down in Whoville who sing in spite of their loss, I am challenging myself to think about all that I can be grateful for. This series will spotlight the elements that make life with RA easier for me to bear.
I imagine that I am not alone in my love-hate relationship with medication. Prescriptions can have side effects that range from bothersome to intolerable, some of them can increase the risk of additional medical issues, and they are often expensive. All of that being said, medications can also bring relief and comfort. I am very grateful such a large range of prescriptions exists, providing my doctor and me with options in finding those that are affordable, tolerable as far as side effects go, and that have a positive impact on my symptoms and even on my disease activity itself.
Sleep Aid. If I had a nickel for every proverbial sheep my RA has left me counting, I would be one rich lady. The aches and pains of arthritis can make finding a comfortable position nearly impossible. If slow motion tossing and turning could be an Olympic sport, I’d be a gold-medal contender. It’s ironic that a condition that can cause such fatigue can also make it so hard to sleep. In a continual effort to find a slumber solution, for 15 years I tried virtually every sleep medication that was available. I wasn’t wholly satisfied with any of them, as they either didn’t help at all or they successfully knocked me out but left me feeling horribly groggy the next day. To add to the irony of the RA sleep situation, the medication that has ended up being my solution was not even designed as a sleep aid.
After the slough of medicines I’d tried, my doctor suggested Trazodone, a medication that was originally designed as an anti-depressant. She explained that it wasn’t very effective in treating depression for most people, but it did tend to make them tired. I followed her suggestion to try it, and it has turned out to be a lifesaver. On all but the worst nights it helps me sleep, and it doesn’t leave me groggy the next day, provided that I don’t take it in the wee hours of the night. A decent night’s sleep not only helps my body recharge physically, it provides emotional stamina as well. I find that if I’ve slept well, I can meet whatever the day may bring with far more grace and patience. The fact that a pill (or even half a pill) can make better rest a reality for me is cause for celebration indeed.
Painkillers. Again, I don’t love the foggy-brained feeling, the grogginess, and the tired restlessness that painkillers can cause, but if I’m in a really bad flare and am going to be in bed anyway, painkillers can feel like a gift from above. Even though they don’t eradicate the pain, decreasing it significantly can be enough to allow me to get some rest, which is beneficial in and of itself. Sometimes I can get in a downward spiral of pain, worry, and sleeplessness, but a painkiller can suspend the spiral by decreasing my anxiety and allowing me to rest. Once my body can relax, it can slowly start moving up and out of the flare. In this way, taking a painkiller can be a bit like hitting a reset switch, enabling my body to get back on track toward healing.
Biologics. I have taken Enbrel, intravenous Orencia, Xeljanz, Humira, and now Orencia in subcutaneous injections. These medications either a) worked great but then lost effectiveness over time, b) weren’t effective for me, or c) have a mild positive impact. As I currently do not have a “wonder drug,” some may question why I list biologics as something I’m grateful for. The fact is that’s a pretty long list of highly sophisticated drugs to have tried in a 14-year span. When I was first prescribed Enbrel, it was the only biologic option. Now there is a variety to choose from; when one doesn’t work, there are still other options on the table. That is not only reassuring for my present reality, but it is incredibly promising as far as the options that are likely to be available within the next few years. I have some ancestors who had RA, and there were very few treatments available to assuage symptoms, much less address disease activity at the source. Of course I’d rather not have arthritis, but if I have to have it, having it at a time when there are treatment options available and the possibility that a cure will be developed within my lifetime is something I feel grateful for.
When was your last flare?