Skip to Accessibility Tools Skip to Content Skip to Footer

The Medication Game

It’s been a rough few months, and my medication list reflects this. Whereas only a year and a half ago I was on just one drug for rheumatoid arthritis, I’m now on four. While I’m grateful to live in an age of so many RA treatment options, I wish I didn’t require so many of them. My current medication regimen not only reflects the severity of my recent disease activity, it also comes with baggage of its own. Like all luggage, my medications feel necessary to have along with me on this journey of my life, but they get heavy to carry around.

I’ve been on a variety of biologics for the better part of the last 15 years. While the benefits of the drugs on my RA have varied, the negative effects have been very similar. As rheumatoid arthritis is an autoimmune disease, the most sophisticated medications used to treat it suppress the immune system. That means that the internal army that is shooting “friendly fire” at my joints is subdued. This ends up being a great thing for all potential targets, my own body and foreign invaders alike. While my joints see less pain and inflammation, my body is also prone to more infections.

On top of the colds that I seem to contract more frequently than my peers and that tend to hang on for much longer durations, I almost always develop sinus infections whenever I get sick. If there’s a chance of secondary infection, the odds are in favor of my getting it. Even when I’m feeling pretty well, I experience recurring yeast infections that crop up every four to eight weeks in spite of the top-of-the-line probiotics I take daily in addition to eating yogurt every morning for breakfast. Furthermore, the yeast infections I get are too stubborn to respond to Diflucan pills or the one-day or three-day medication options available, so every time I get a yeast infection I am inconvenienced with seven nights of treatment. I’ve gotten to the point where any time I see a sale on over-the-counter yeast infection medication, I stock up on multiple boxes.

While I’ve had cold sores since I was a teenager, I used to go months or even a year between outbreaks. Now I’m getting them every two to six weeks. Fortunately my doctor provides plenty of refills, so I always have medication on hand for them, and I’ve become so familiar with the tingling sensation of a fever blister that I begin treating it at the first twinge I feel. This prevents them from becoming too unsightly, but it still means I’m usually taking cold sore medication on a monthly basis. The pattern here is that because of my RA medications, I develop infections that require treatment and therefore… even more medication.

In addition to extra prescriptions, the RA medications I take lead to an increase in doctors visits. One of the drugs I’m on is Plaquenil, which necessitates monitoring by an ophthalmologist. The recurring cold sore outbreaks and yeast infections have led to additional visits to my dermatologist and OBGYN. At my last appointment with my OBGYN, she noted that there was bilirubin in my urine, and asked when I was going to see my rheumatologist. In an effort to miss less work, I try to lump my various doctor appointments together, so I told her I was actually headed straight to his office for a checkup. She said that in that case she wouldn’t request additional labwork, since I have labs done at every rheumatologist checkup in order to monitor liver function. This is because I take Arava, which can pose a threat of liver damage. Fortunately, there was not bilirubin in my blood, which could indicate a problem with my liver. My doctors told me that as long as there is bilirubin in my urine but not in my blood, I shouldn’t be overly concerned. Yet, it’s hard to feel at ease when any lab results are abnormal, although I was relieved that my OBGYN said I didn’t need to return to her office for additional urinalysis labs.

As I write this, I’m contending with a cough that started as a result of allergy-induced post-nasal drip. The cough has lodged itself deeper in my chest, and is becoming more severe. I’m pondering whether to go ahead and go to the doctor, as less than two years ago I was struck by a case of walking pneumonia. When my internist diagnosed me, she referenced the immunosuppressant drug that I was on as the likely cause. As I’m on even more immunosuppressants now than I was then, I don’t have the luxury of assuming a cough is just allergies when I run the risk of once again developing walking pneumonia.

I’m actively working on reducing the stress in my life, which I know from experience will decrease the severity of my symptoms. I’m also striving to do at least a few minutes of yoga daily, to eat well, and to get lots of sleep every night. If I can lower the activity level of RA in my body, I will also decrease the need for all these medications. However, until I’m successful in that endeavor, I’m left with the choice of debilitating pain and fatigue or a treatment regimen that comes with a whole lot of baggage.

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

Comments

  • Robyn
    3 years ago

    While not on biologics, I pulse prednisone which is also immunosuppressive.
    Check with you doc and see if he is agreeable to selenium which has no untoward effects for me at all. When I get that first tingle, I take 400mcg and repeat again later in the day. Usually 3 doses does it, NO outbreak!
    Make sure to research yourself though please.

  • Tamara Haag moderator author
    3 years ago

    Thanks for the suggestion, Robyn! I wish you all the best, Tamara

  • Lori f
    3 years ago

    Hi, thanks fir sharing you journey with medications. I am currently off all immunosuppressants because I have an infection inside my jawbone. I spent 2 nights in tge hospital and have a PIC line so I can give myself IV antibiotics every morning. I am not sure what i will do about medication after the antibiotics are finished and the infection us cleared up

  • Tamara Haag moderator author
    3 years ago

    Hi Lori, Thank you for sharing! I’m so sorry you’re dealing with such a severe infection. Since writing this article I too have been taken off of immunosuppressants due to infections. However, mine was not so severe as to require IV antibiotics. I can imagine the anxiety you must be feeling. I wish you all the best and hope your jaw is infection-free as soon as possible!

  • AnnieD
    3 years ago

    It seems to me each time I turn around something else goes wrong. I appreciate your article because it makes me know that I’m not the only one going through this.. but, it also makes me sad. Right now, I developed an ulcer. It’s pretty common. But, it’s just something else to have to go through. I’m constantly sick, no one gets it, and they have no idea all the complications that come from the medications. Thank you for sharing!

  • Tamara Haag moderator author
    3 years ago

    Hi Annie, I know exactly what you mean about the frustrations of side effects and dealing with chronic illness! Sometimes there are those issues that might not be a big deal if that was the only health problem to contend with, but can feel like the straw that broke the camel’s back when added to lots of other health concerns. It’s true that many people have no idea what it’s like to live with these issue, which makes me grateful for this community so that we know we are not alone in these struggles. I wish you all the best!

  • cstrick6
    3 years ago

    Wonderful article, Tamara! I too deal with continual yeast infections which are difficult to get rid of. A few weeks ago, we had the opportunity to go to St. John’s. I took my RA meds(Humira shot) & methotrexate prior to going so I could enjoy our time away. Unfortunately, I got a chest cold and now have pneumonia. It can be so frustrating. The last few months have been a month long virus and now this. It’s a see-saw dilemma of taking my meds vs no meds. This year, it’s been difficult to find a good balance. I just ordered some Tumeric & GLA to get through this time without the RA meds. Anyone have any good results with supplements?

  • Tamara Haag moderator author
    3 years ago

    Thank you for sharing, Chris. I hope that you recover as quickly as possible from the pneumonia, as I know how utterly exhausting it is. I’m sorry you are having these struggles. It’s good to know I’m not alone, but for your sake and everyone else’s I wish there weren’t so many of us with these challenges. I wish you all the best!

  • jan curtice
    3 years ago

    The RA-Medication-Wellness/Sickness cycle is frustrating and confusing. Where’s the balance? What is the best answer for me? Recently, I met with an endocrinologist. He explained to me how the meds had changed me and my endocrine system. The big one was the impact of the prednisone. He gave me ways to help combat the physical deficiets, deal with the lowered immunity, manage stress, and cope with crisis. I am feeling and doing much better after our visit. I actually feel as though I have some control over this nasty disease. Seeing an endocrinologist may be something to think about. Feel better and stay strong. =^^=

  • Tamara Haag moderator author
    3 years ago

    Hi Jan, Thanks so much for sharing that information. I actually have been seeing two endocrinologists over the past 30 years due to having hypothyroidism, but neither of them ever presented the type of information you’re talking about. It makes me think I may need to look for a new endocrinologist!

  • Poll