I felt fine, but my family insisted otherwise. “We’re taking you to urgent care. There’s something to that cough.” So early on Cyber Monday, while others are huddled around their computers (actually before – we got there at 7:00 a.m.), I’m whisked off to the clinic during my visit home for Thanksgiving.
Turned out to be a good idea because: Surprise! Pneumonia!
I had fluid lingering in my lungs, causing shortness of breath and pain in my side. But in a humorous twist, I didn’t start feeling bad until the doctor told me how sick I was.
Treating the pneumonia
Antibiotics, cough suppressant, and steroids
First I was started on a strong antibiotic (in case of bacterial infection) and cough suppressant. When I returned to my internist for a follow up a couple days later, they put me on a heavy dose of steroids and nebulizer treatments.
This year I’ve had two bouts of bronchitis. But pneumonia is a whole different level. It’s bone-exhausting. I couldn’t get out of bed for about a week. Breathing was exhausting. Resting was exhausting. I’d wake up and feel, you guessed it, exhausted.
It’s been a few weeks and I’m feeling more like myself, but not completely back to normal. Frankly, I don’t think the antibiotic did anything to help and that it was the pill and inhaled steroids that have been most effective in opening and healing my lungs.
Cease taking Enbrel
As soon as I was diagnosed, I called my rheumatologist to let him know and to ask about my RA medications. I had to stop the Enbrel and am waiting until I am recovered before restarting.
Risk of pneumonia with RA medications
My doctor told me before that Enbrel and many of the drugs for treating RA can put patients at greater risk for infections and pneumonia because of the nature of these medications — they deactivate the disease by lowering the immune system activity. It’s a catch-22.
Boosting immunity due to immunosuppressive drugs
In fact, before starting Enbrel he made sure I had the Pneumovax (a vaccine to help prevent pneumonia) and other vaccines were updated. The goal was to boost my immunity as much as possible to ideally prevent common infections.
Constant infections or uncontrolled RA?
I am returning soon to see my rheumatologist and also my internist to check on my lungs and progress recovering from pneumonia. My hope is that I will be well enough to restart the Enbrel, as I am feeling the loss against my RA.
Worried about overall health
It’s such a dilemma. I believe the RA is better with the Enbrel. While I live with a severe case and a lot of permanent damage, I’d love to continue this treatment if it will calm active attacks on my joints. However, I can’t be regularly getting bronchitis, pneumonia and who knows what else. This is not sustainable, nor is it good for my overall health.
How do I find that balance between constant illness or uncontrolled RA? This is the million-dollar question and one I intend to ask my rheumatologist. He won’t have an answer, but I will still seek it anyway.
Planning next steps
What are the next steps in the journey? I re-try the Enbrel and become more vigilant about minimizing my exposure to illness. Additionally, I need to be quicker to jump on any symptoms of illness. I should have seen a doctor sooner and I should be more mindful about symptoms that could be an infection or worse.
Get better at seeing a doctor sooner when feeling ill
My feeling is that I developed pneumonia following bronchitis that originated with a chest cold during the course of 6 weeks. I thought I was better but ended up slowly getting worse. Perhaps if I had nipped it in the bud, this downward spiral could have been avoided.
I just have to admit that I can’t jump back from an illness like I used to. My RA and my immune system are a different, dysfunctional animal. I have to listen to these messages and take the time to find a healthier path.
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