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more meds and still no sign they are working

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Rheumatoid Arthritis
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Posted 1/8/2012 6:29 PM (GMT 0)

I am back on the Cimzia after stopping before a recent biopsy.  Now I have back Iritis in both eyes, need further surgery for gum disease and my joints aren't feeling too good either.  Rheumy put me on a pill called ARAVA, said to continue the Cimzia and wean down to 5 mg of prednisone, then 2 1/2 mg.  I can already feel the difference not having the extra prednisone and think that is the only thing helping.  She said to give the Cimzia another month and also the arava.  In the mean time I am scheduled for the gum surgery and concerned about a possible infection.  No one has suggested an antibiotic (will check with the periodontist).  None of my other doctors seem to know much about these meds we take and don't bother to consult with the rheumy.  Have to do a lot of questioning.  anyway - anyone think I should push for an antibiotic before the gum surgery?   Anyone been on Arava that can share their experience?

thanks

Alicat

Posted 1/8/2012 11:12 PM (GMT 0)
Arava is a DMARD like MTX, but MTX is still the gold standard. My RD says she has to watch the live panels closer with Arava than even MTX. That being said, many people do well on Arava. It can raise your bp, so be aware of that, Alicat. Have you tried the TNF blockers like Humira and Embrel, or did you start out on Cimzia?

My dentist always gives me an antibiotic if he is going to do anything he thinks might lead to an infections. He always asks me what meds I am on now...asks about any changes, is very diligent on that front. I would call the RD's office and tell them what procedure you are going to have done and ask about antibiotics. I would also call the dental office and see if you need antibiotics and if you need to start them before the procedure is done.

Best Wishes,
Vannie
Posted 1/9/2012 12:37 AM (GMT 0)
I started out on Enbrel but had a reaction at the injection cite so was switched to Humira, which worked wonders for about 3 years then stopped working.  Had one remicade infusion and broke out in a rash all over so then she said we'd try the cimzia.  Will give it a little longer as maybe it just hasn't kicked in yet.  It took a few months on the humira before that really worked so we'll see.  After two days of really fast hear beat I have decided I am not taking any more of the Arava. 

Will be calling the dentist tomorrow to discuss antibiotics

Alicat

 

Posted 1/9/2012 3:11 AM (GMT 0)
Happy to hear you are calling the dentist, Alicat, and I think you are right to stop the Arava. Need to check with the doc. You could call your pharmacist, too, but I know I have read of heart issues with Arava, especially high bp.

Hope all goes well for you!

V
Posted 1/9/2012 4:04 AM (GMT 0)
I think it's good your checking with your dentist about an antibotic...I
would be calling everyone and getting into my primary doctor and getting an antibotic
just to be on the safe side, and start the antibotic before the dental procedure...
many well wishes and I hope it goes good for you...with low pain at the dentists...
Posted 1/9/2012 5:34 AM (GMT 0)
My Dentists' normally give me an antibiotic before a surgery or extraction. I was on Arava years ago and it worked well for me for about 2 years. We tried it again years later but it didn't help the second time around. It didn't bother my heart nor did it seem to raise my blood pressure much. Mind you, my blood pressure normally averages round 110/68. Good idea about your stopping the Arava since you are already having increased heartrate.

Hopefully your Dentist knows his/her drugs accurately. Your Pharmacist should be one of your Best Friends. I had a Dentist once from another country who wasn't overly concerned about the drugs that I was on nor did he seem aware of some of these types of drugs or their interactions with others.

He had given me a script for an antibiotic before my surgury. When my Pharmacist saw it she told my Hubby that I could not take it because of the interaction with Methotrexate. The antibiotic would increase the potency of Metho by 8x. She phoned my Dentist to fax her another script for a different antibiotic which he did. Thank God for her. That was an eye opener. We dropped that Dentist, of course.

Sorry that you are not feeling the best. Hopefully you will do well with your surgery and recovery.
Posted 1/9/2012 7:41 PM (GMT 0)
I don't know what antibiotics counteract with what RA meds but I would definately check it out with your doctor and the dentist.

I had a procedure done by the dentist and went back about 3 days later complaining of a possible infection in my lower gum area. Because it didnt show up on his x-rays and because it wasnt near the procedure site he did not give me an antibiotic. It took approximately 3 weeks, an E.R. visit, many x-rays and surgery to clear up an infection that ate a hole in my jaw bone. The surgeon said that all of this could have been avoided had he given me an antibiotic right from the start. So, don't take no for an answer.
Posted 1/9/2012 10:18 PM (GMT 0)

With what what we pay for health care and meds you would think these doctors could take a few minutes to look up the meds we are on and what we can and can't take with them.   Really irritates me that I have to be my own doctor most of the time.  thank God for this website and for the internet as I do a lot of researching and ask a lot of questions - and don't worry, I will get an antiobiotic and I will  make sure it's the right one before the surgery or I will seek another dentist.

thanks so much - I'll let you know what happens

Alicat

PS no rapid heart beat today so I am thinking it must have been the Arava.  Left a message with my rheumy that I was stopping it and she didn't call back.  Hopefully the Cimzia and prednisone will keep me going.

Posted 1/10/2012 2:42 AM (GMT 0)
Alicat,

My Rd told me no Sulfa drugs while I am on MTX. I know a lot of people who have had trouble w/Arava causing heart issues. Will be interested to see what your rheumy says. Hang in there!

V
Posted 1/10/2012 7:04 AM (GMT 0)
Hi Alicat

i was on Arava for about 10-12 months and it Really Worked i started to Feel Great - yep then the Down side my Liver enzymes went crazy so had to stop.

i'd Definatly be seeking Anti biotics ,do you know what caused your Gum Disease?

you have to keep track of your own meds don't trust that the Doc's will do it.

Posted 1/10/2012 11:56 AM (GMT 0)

I'm getting really upset now.   I am allergic to sulpha, which I tell all  my doctors.   When I got the prescription there was no print out with it so I have learned about the side effects etc from this forum and from researching the internet.   When I asked my rheumy all she said was that she'd have to do regular blood work to check my liver counts and never mentioned any other side effects.   Also didn't know that many antibiotics have sulpha so now willmake sure to let the dentist know that too.  I swear they are all trying to kill me with these drugs!

Also, yesterday after a nice lunch out with my husband I started having stomach cramps and knew I wasn't going to make it home in time.  Thank God my friend lives close by but I didn't quite make it to her bathroom either, had projectile diarrhea! I was only on the Arava about 6 days and off now for two.

Alicat nono

Posted 1/13/2012 3:24 AM (GMT 0)
How are you doing, Alicat? Had you on my mind lately.
Posted 1/13/2012 10:00 AM (GMT 0)

Hi Vannie,

I haven't had any more racing heart  episodes since I stopped the Arava so I am assuming that's what caused it.   I'm weaning off the eye drops for my Iritis and will see the eye specialist in two weeks.   I still haven't heard back from the periodontist about whether or not he's going to prescribe an antibiotic for my gum surgery next Tuesday so will call him back today.  I was supposed to decrease my prednisone to 2 1/2 mg yesterday but will wait another week as my hands are still swelling and hurting and I have to wait a few days after the surgery to take my Cimzia which was scheduled for tomorrow.  I'm still nervous about the gum surgery as I still don't know that much about the Cimzia.  I think I was on Humira when I had the gum surgery done last time and I would think it would be in their records.  I have never been given an antibiotic for any dental work and really don't understand.   My husband had a total knee replacement two years ago and he has to take an antibiotic for the rest of his life for even cleanings. 

I'll let you know how it all turns out.  At this point I'm not sure whether to postpone the dental work again.

thanks for asking - hope you are doing well

Alicat

Posted 1/14/2012 2:26 AM (GMT 0)
I am doing better, Alicat. Took my 10th shot of Humiar this past Tuesday, and it "kicked in" today. Finally gave in, and upped my pain meds and I feel so much better. I was coming home from work at night and stuffing my face with carbs...I just felt so awful, and that is what I did. Then I remembered reading that you can't diet successfully if you are in pain because being in pain makes you want to eat. the light bulb came on! So, now I am taking 250 to 300 mgs of Tramadol a day, and feeling so much better.

I am concerned about the peridiodonal sugeron not calling you back or suggesting antibiotics. That just sounds strange to me. Did you ask your RD about it? He/she would know for sure!

Hugs to you, and let us know how you are doing.

Vannie
Posted 1/14/2012 1:31 PM (GMT 0)
dentist office finally called back and said the dentist doesn't think I need an antibiotic.    Rheumy didn't really answer me, just told me what to do with my regular meds.   Hoepefully they're right.

Glad the Humira has kicked in.    So far that is the one that worked best for me until it stopped working after about 3 years.

I'll let you know how I make out Tuesday with the gum surgery.

Have a great day!

Alicat yeah

Posted 1/14/2012 1:37 PM (GMT 0)
Will be thinking of you Tuesday, Alicat! Will be great to get it overwith, eh? ; )

Best Wishes,
V
Posted 1/14/2012 2:41 PM (GMT 0)
Shouldn't be too bad this time, only building up the bone under four teeth this time.  Already had the full mouth done in the past and repeat of two quadrants.  Losing my dental insurance April 1st so don't know what I'll do after that if I need more surgery.

Alicat :-)

Posted 1/16/2012 1:01 PM (GMT 0)
OK, great - now I have a huge boil in my groin area and just read that prednisone and prednisolone both can cause them. I'm still taking both. Also read that it is a type of infection and I am scheduled for gum surgery tomorrow morning at 8:15. As soon as the my primary doctor opens I will call to see if the nurse practioner can see me today to see if I should have an antibiotic and postpone the surgery. Have tried hot soaks but it's just not wanting to drain and very, very painful. What next??? anyone ever get boils from the immune suppressing meds?
Alicat
Posted 1/16/2012 3:28 PM (GMT 0)
Awe Alicat,
Hope you can get that antibotic soon, and hope your feeling better...
Many Prayers and well wishes to you....
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