Immunity Ambiguity

Shortly after I began taking methotrexate as my leading rheumatoid arthritis treatment, I suffered a series of bizarre illnesses.

It was about six years ago that my doctor convinced me to try methotrexate because my NSAID was just not working well, leaving me in periodic joint flares that required boosts of prednisone to lift me out of pain. I was anxious to make the switch—would the medication work? Would the side effects be terrible?

One of my coping mechanisms is the Internet, so I did a lot of reading beforehand about methotrexate and its common side effects. A lot of people said the drug made them feel sick for a couple days, so I opted to take the medication on Fridays, thinking that having a weekend to rest would accommodate this potential problem.

The other side effect that concerned me was the dip in immunity. Methotrexate attacks the RA through reducing the effectiveness of immunity and hopefully lowering the disease’s gnawing on the joints. However, this can also make patients more susceptible to illness and raises the danger from even a simple fever.

I was very thankful when after a month of taking the drug, I started to feel better and had an alleviation of my RA symptoms. Additionally, I didn’t experience the illness and malaise after taking it. So far, so good!

But a couple months later, the other shoe dropped. I woke up one morning with an itchy patch on my back that grew into sizzling nerve pain as it spread around my side. Here I was, a young woman with shingles. Luckily, a family member recognized the symptoms and I immediately saw my doctor to start the antiviral medication.

The treatment worked, but it still took a couple weeks for the shingles to fade. My doctor explained that having a suppressed immune system (such as from taking methotrexate) can lead to surprising illnesses like shingles.

Of course, just when I recovered from the shingles I came down with an ear infection over night. Even as a child I don’t recall experiencing them, but now as a grown adult I was in agony from ear pain and congestion. Again, another result of my immune system being completely confused.

In desperation, I searched for a way I could continue taking the methotrexate without falling prey to continuous illnesses and infections. Eventually, I found a simple vitamin regime helped—one multivitamin a day and one tablet of vitamin C.

I can’t really be sure that the vitamins changed the game, but after I took them consistently for awhile I didn’t even get colds (which was previously a regular occurrence). Another important factor, I think, is to get regular rest. When I’m rested, I am less likely to get sick. Eating healthfully also helps, with lots of vegetables. I’m careful to get the flu shot every year and am looking into getting vaccination boosters.

Sometimes I still struggle with the random bug. Recently, I was down and out for a solid week with a respiratory virus. For the first couple days I stayed in bed and rested. But I went back to life too quickly and relapsed a day later. Meanwhile, my husband also caught the bug after me yet still recovered quicker and didn’t have it as bad. What gives?!

The simple truth is that I get sick easier than others and also have it worse when I do. It’s a double-whammy. I try to add up a bunch of daily habits that have made a difference in keeping me fairly healthy. It’s one of the trickier aspects of an autoimmune disease—when the immune system is working the RA is attacking, yet when it’s not, you really don’t want to get sick.

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