Questions about flares and new medications

If you read our thread, Lupus 101, it contains some tips on avoiding flares. Deep restorative sleep, healthy eating, mild regular exercise, avoiding the sun, minimizing stress (of all kinds, mental, emotional, physical stress) - all of these help.

After Plaquenil (the anti-malarial) the next drugs generally tried are Imuran, Cellcept, and MTX - your Dr will pick one of these 3 and try you on it for 3-5 months - if no improvement, they will try another one of these three.

I'm not sure how any of these are for rheumatoid arthritis -- we also have a forum on RA, this would probably be a good question to post over there.

Hope that helps a bit,

Thank you both for responding so quickly. I'm venting tonight. Just went through another flare. I'm actually looking forward to taking the methotrexate. I am feeling a difference now with the anti malarial medicine, but every time it rains my joints feel like their on fire. Maybe this new medicine will make the difference I need. This site has been very helpful as I live in a small town in Florida and I know of no one else with lupus. I have discovered that unless you have a chronic disease like lupus you really don't understand what we go through. My sister in law said I really don't look sick. If I just took some vitamins everyday and loaded up on vitamin D I would no longer be sick. And just get a good nights sleep. (This is impossible for me as I have stage three kidney disease and my kidneys are working at about 50%. I spend all night getting up to pee.). She also doesn't understand that it's hard for me to plan even a weekend to go over and visit. I never know when a flare is coming, and with it the diarrhea and vomiting on top of joint pain. Just the stress of getting ready for the visit is enough to throw me into a flare. I'm very lucky to have a husband who has stuck with me through all of this. The lupus was diagnosed in Feb and the chronic kidney disease last July. In the last 39 years we have been married I have suffered with migraines, high blood pressure diagnosed at 25. I also have degenerative disc disease (2 failed back surgeries). I have chronic back and leg pain. My bladder no longer works. That was diagnosed in March of this year. I'm waiting on results on a blood test for adrenal disease. This may be the cause of my high blood pressure and potassium loss. My organs seem to be giving up on me. I don't have a lot left. I look fine on the outside except for the times my butterfly rash appears just before my flares. I've learned not to even try to cover my face with make up. It just irrates the rash and makes it worse.I don't know. I'm still trying to figure out how to respond and not react to well meaning people who have no idea what lupus is and think a good night's sleep and some vitamins can fix this. After all I don't look sick.

Susie,

Steroids are used very differently when treating Lupus; the purpose isn't to treat joint (or other) pain but to control inflammation from our overactive autoimmune systems. Our Drs are very aware of using calcium sparing medications when at all possible, and supplementing us as necessary. Our adrenals naturally produce about 5-7 mg of cortisol; most Lupus patients end up taking between 10-70 mg daily at different points in our disease activity. Sometimes our other medications control our inflammation and we are able to come off these high doses; but the decrease must be slowly monitored and controlled. Sometimes our adrenal glands will kick back in to to their 5 mg part; sometimes they won't.

Susie, the Lupus treatment plan that involves steroids is much different than the treatments for the chronic pain that you are familiar with.