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Surprise! Pneumonia!

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

Restart Enbrel

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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • texitis
    6 months ago

    Balance indeed. Since starting on a biological immune suppressant, my spouse and I together, made the decision to avoid contact with crowds of any kind. We stopped going to church (still pray @ home), stopped airline travel, strategically time shopping to times when there were no crowds.
    The worse upper respiratory infection I’ve contracted over the years was from standing in line @ the pharmacy to pick up a prescription.
    It’s important to always be aware of your own body’s reactions. RA is a perpetual state of inflammation and can include low grade fevers. Knowing your own body and communicating with your health care providers is critical.
    Sorry you had to deal with pneumonia, glad to hear that you’re doing better.

  • Kelly Mack moderator author
    4 months ago

    Thanks so much for your comment texitis. Sorry that you have had to make those changes, but definitely understandable. Really good that you are aware of what you need. Hang in there. Best, Kelly ( Team)

  • Nanci Burns
    5 years ago

    This is why I refuse to take any DMARDS or biologics. I have vicious allergies to some kinds of pollen & mold, so my sinuses & ears get infected often. It’s a short trip from sinus infection to bacterial pneumonia. I will not take any drug that suppresses my immune system.

  • Jill Fontana-Langthorne
    5 years ago

    I am feeling better and yes the RA worsened. I was also diagnosed with Lupus last spring.(My rheumy calls it overlapping?) good news is Lupus is mild. Just never sure which is flaring but now I know why I’ve felt so bad. At least the pneumonia is gone!

  • Kelly Mack moderator author
    5 years ago

    Good to hear!

  • Jill Fontana-Langthorne
    5 years ago

    I also just went through this during the holidays.Pneumonia! I am on methotrexate and have had a rough time this past year with bronchitis and a cough that was becoming chronic. I too feel that Catch-22… but now I feel I am not alone. Sometimes I feel I need to live in a bubble! I am over the pneumonia but almost afraid to start methotrexate again!

  • Kelly Mack moderator author
    5 years ago

    Hi Jill, sorry to hear you have struggled with bronchial problems too! No fun. I totally understand your fear about restarting the methotrexate. I postponed going back on my meds for an extra couple weeks because I was nervous and also wanted to make sure I was truly over the pneumonia. However, the down side was that my RA really worsened when I was off my medications. Hope you are feeling better.

  • Stephanie Vincent
    5 years ago

    This article jumped out at me because I too got pneumonia while on Enbrel. I had to jump through hoops to get on it (no insurance!) and was so excited to try a biologic. I ran a fever a couple of times and had to skip doses, and then ended up with pneumonia 3 months after the first dose. My doctor told me he thought I couldn’t take a biologic again due to getting so sick so quickly. Good luck to you!

  • Kelly Mack moderator author
    5 years ago

    Thanks for sharing your story Stephanie. The strong medications can really make us susceptible to illness. One of the down sides. I take comfort that I think the Enbrel is working well against my RA. One day (or week) at a time! Hope you are doing better.

  • Gwen
    5 years ago

    this article popped out at me as I sit here recently diagnosed with pneumonia and questioning the use of methotrexate. This is the second time I’ve had pneumonia in two years. I was diagnosed with RA in about 2007, so I’m still learning the disease and my personal reaction to it. This article gave me a little more insight.

  • Kelly Mack moderator author
    5 years ago

    Hi Gwen, glad my experience helped. I find it is a delicate balance to find medications that will improve my RA and yet won’t make me sick all the time. Everyone probably has different reactions. Hope you find a combination that works for you.

  • Rob
    5 years ago

    Hi Kelly,

    Sorry to hear about your bout of pneumonia. It sounds like its been a bit of a haul getting over it. I hope you are indeed recovered and that you’ll be able to resume using Enbrel soon. Informative article about the balancing act people with RA have when using their medications. Need to make sure my wife reads this if she hasn’t already.

  • Kelly Mack moderator author
    5 years ago

    Thanks Rob! Appreciate the feedback. Fingers crossed–I’ve been back on the Enbrel and so far am doing well. By the time I restarted by RA had worsened so glad to be feeling better on the medications and not getting sick again. Hope it stays that way! 🙂

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