Treatment Topic Thursday ...

Thursdays I will devote to talking about treatments, both conventional and unconventional. I will try to go in detail of each topic and hopefully you will find the information helpful. If there is a topic you would like me to research and post about I'd be happy to try to do that, just message me.

Today's topic is Plaquenil (Hydroxychloroquine). This is the first try drug for RA according to my doctor. They start here because it is the least likely of the RA treatment drugs to cause side effects. The interesting thing about this medication is that it's actual original use was as an anti-malarial drug.

It's used to treat the inflammation of both RA and Lupus.

Possible side effects -

abdominal cramps, diarrhea, heart problems, reduced appetite, headache, nausea & vomiting, altered eye pigmentation, acne, anemia, bleaching of hair, blisters in mouth and eyes, blood disorders, convulsions, significant vision difficulties, diminished reflexes, emotional changes, excessive coloring of the skin, hearing loss, hives, itching, liver problems or failure, loss of hair, muscle paralysis, weakness or atrophy, nightmares, psoriasis, reading difficulties, tinnitus, skin inflammation and scaling, skin rash, vertigo and weight loss

That huge list of side effects doesn't exactly seem "mild" to me. I have been on this drug now since my diagnosis in October. I have noticed no improvement in my symptoms as of yet though I was told improvement should be noticed in 6-8 weeks. My dose was increased in November after being on it for 6 full weeks. Still, no improvement has been seen. At my recent appointment i discussed with the doctor that I am seeing no improvement with all the drugs they have me on, including this one. In fact, I am feeling worse. She added another drug to my "cocktail" and wants to see if this one will help the others also work better. So, when i go back in February we will consider which drugs are or aren't helping and again adjust.

For me this is the frustrating part of being at the beginning of this process. A large list of medications to take daily, side effects you aren't sure are coming with this drug or that drug. And continued pain to the point you don't think ANY of it is helping.

Trying to stay positive is definitely an UPHILL battle for me right now. I pray daily for answers, for pain relief and for strength to do the things I have to do. This little saying was posted on Facebook the other day, it accurately describes how i feel many days lately.

Treatment - the sooner the better ...

A comment to a previous post got me thinking more in depth about something i already knew, modern treatment of RA is far more successful at putting people into remission than it used to be.
CNN has this great article from 2012 that talks about this in detail. Click this link to see the article. Advances In RA Treatment - The Sooner The Better
The frustration on my end is of course that I am at the beginning of the RA. I am at the so far nothing is working part. As is the normal course of action my rheumatologist is starting with the first line medications. So far, no difference has been seen for me. I made an appointment for this Friday, as I am just in so much pain. I wasn't actually due to follow up until February. I just don't want to keep waiting when i am seeing absolutely no changes, and an increase of symptoms.
Another issue i have is that my doctor cannot just skip over medications to something more aggressive in treating RA. Thanks to managed care, most insurance companies (mine included) now require step therapy. The basic idea is that to save money, the insurance company requires your doctor to first prescribe the baseline (read into this CHEAPER) drugs first. Before moving on to the more aggressive and newer drugs (read EXPENSIVE) for treatment, you first have to fail at being helped.
But with a disease as potentially dangerous as RA if it's not put into remission quickly, this just seems less than satisfactory. But, what can one do...
I just keep taking my medicines and keeping track of symptoms. I will follow up as often as I need to with my rheumatologist to make sure I stay on track to remission.
Now to brace for the 4-6 potential feet (yes FEET) of snow we are predicted to get over the next 48 hours. *sigh*
Sarah