This is along the same lines as Jesse88's thread on boosting the immune system, but I didn't want to hijack that one.
I really hope I don't sound crazy, but this immune system stuff has me a bit panicked.
The other night, I had to take my husband to the ER for a tetanus shot and stitches after cutting himself, and there was woman in there with a face mask on; I wondered if she was immunocompromised. It got me thinking of some questions that I wonder if you all might answer:
What happens to someone with RA on medication if they get a cut? Or a cold? Must they go off the medicine to deal with it, or can antibiotics be taken while on MTX or biologicals? I know Gimpy said that he is taking MTX while on AP, but I wasn't sure if these antibiotics in AP are similar to something prescribed for, say, strep throat.
For those of you who have school-age children, how are you able to still care for your child when s/he is very ill? Must you go off your medicine in order to not get sick?
If a physician does take you off the meds to allow for getting well and then you go back on the meds soon after, do those initial side effects that some speak of happen all over again? I guess it would depend on the amount of time off the medicine and whether there was any in the body residually...
Thank you for any of your experiences on this!
Christina
Well, I'll tell you this...I have had many o' porcupine quills stuck in my fingers, but this is the first that's given me an infection and the first since I started taking Enbrel. Coincidence?....Maybe. I'm not coming off my meds though, haven't even informed the doc.
My RD seemed mostly concerned about a respiratory infection turning in to pneumonia. So if I get a cough I'll need to take antibiotics. And I have to get a flu and pneumonia shot for the first time ever.
Christina,
talk to your doctor about your situatio because the is in the best position to understand your current health situation.
But, my general rule of thumb was if I was on anti-biotics I skip the meds. A cut shouldn't be a problem unless major enough to require stiches. A cold simply needs to be watched for lung problems and of course sinus infection. Use common sense when dealing with your kids when they are sick. Wash your hands and make sure the kids do also. Teach them to sneeze into the crook of their arm instead of their hands. Avoid physical contact with people obviously sick.
Unless you are unlucky if you need to stop and restart you will be unlikely to expereince new side effects.
ANytime you are unsure whether to take your meds or not call your doctor. You will soon get an idea when it is ok and when it is not. When in doubt skip the dose, its better to be safe than sorry
I've been on biologics and dmards for the last few years and I've traveled to 4 different countries, spent time in indian villages, taken public transportation, and probably done things that I shouldn't have done - like eat from street vendors. But I did it and I never contacted any disease. I won't be traveling to Mexico or S. Amer. this year because of Dengue Fever. That's taking too much of a chance.
I use bacterial soaps, essential oils, and generally good hygiene, common sense and some caution. I've never had an infected cut or scrape. Haven't had a cold, sinus infection, or lung problems even though I have interstial lung disease.
I'm 3 weeks into recovery from a total knee replacement and had to stop taking MXT and Remicade 3 weeks prior and restarted meds 2 weeks post op. I was in a very painful flare due to being off meds and now meds are back working and flare is just about controlled.
Children and germs I don't know about. My child is grown and none of our friends have any children, so I'm never around them. I think Buckeye gave you some good info re: children.
You have to live your life-meds or no meds. Just use common sense. You'll get into a rountine and eventually they will become just another part of your life. Whenever in doubt contact your RD. He/she will become your new best friend. Lindy
Thank you for these responses! I really feel better now after reading your common sense responses. I used to be a field and lab research assistant for a biological water sampling program, so I started my son early on the importance of keeping clean hands and work-space, doorknobs, etc. He has even inherited my absolute need to open restroom doors with a paper towel. ;)
Lindy, good luck with your knee replacement recovery--my mom stayed with us for a few weeks last year after her Uni-Knee surgery; she feels like a new person. I'm so sorry you can't return to your favorite places in Mexico and South America, but you are an inspiration for those of us who love to travel.
buckeye, I appreciate the good advice about clearing everything with my doctor--it's such sound advice. Thanks also for sharing your experience on skipping doses of RA medicine and on antibiotics.
Orion, I am about to return to the classroom in 2 weeks; it's great to hear that you are a teacher, too! I'll be teaching college kids, but it's hard to predict whether their hygiene will be better or worse than that of the little ones! I also didn't think about getting a flu shot--that's a good point. By the way, if I remember correctly, you were starting a new medicine due to some side effects on the MTX, right? I hope it's working well for you!
Linncn, I am so intrigued by some of your posts that I must ask: do you have lots of exotic pets, do you own a pet store, or are you some type of zoologist? Please tell!
Thanks again to all,
Christina
I am the keeper for a small business called Science Alive, that belongs to my bro and his wife. They take these animals into classrooms around the state to supplement the science programs. Like, if the class is learning about the rainforest, they bring in rainforest animals. The kids love it because they get to see and touch all these creatures that most people only see on animal planet or at the zoo. So I'm always messing around with porcupines or the anteater or the binturong. We have a kangaroo and a spring hare and all kinds of cool stuff. It's a pretty ok job, and I really like my bosses too!
I have just changed doctors because i felt like my other rhuematologist was not doing enough for me. The new doctor was very proactive and has taken me off nsaids and put me on mtx and wants me to take enbrel (which is financially out of reach) as i have to pay 33% of my prescriptions but oh well i HAVE HEARD MANY GOD THINGS ABOUT MTX BUT HAVE READ ABOUT IT AND IT SOUNDS HORRIBLE SO AM VERY APREHENSIVE ABOUT TAKING IT. My Rh factor was 408 is that high or moderate or low?
I cant find it anywhere and forgot to ask doctor so if someone could tell me it would be great
Hi, the others have covered a lot of your questions. I go off of mtx if I have to take antibiotics. I had to go off the mtx during a heart operation (not caused by the RA or meds, inherited) I couldn't go back on for 3 months, my RA went through the roof. The best help I had was prednisone (15mgs), that doused the pain. Then back on Remicade/and Mtx in March. Now I've been waiting for the meds to 'work'! The pred again has gotten me to this point without pain (down to 5mgs).
This is a complex disease, with complex medications that need to be sorted out with your doctor. Each situation is diff., we all react to the drugs differently (seemed like such a long time for mine to work), I still have stiffness in my hands, and problems with my feet (burining pain, cramps), but I feel I'm improving.
Please continue to ask questions, we all learn from them and the posts that follow. Lynda
Hi doobgirl32! I'm pretty new here myself (and not yet on any medications), but I just wanted to suggest that you might want to begin a new thread called "Questions about MTX" or something to that effect. You might get more responses that way if people see the title. Good luck to you with your new doctor! From everything I've heard, being proactive gets results. Best to you! :)
Linncn, my son and I are both self-proclaimed "biophiles," so I can tell you that I'm so envious of your cool job and he would LOVE your family's program! When he was five, he came to me and announced that he wanted to be an aye aye for Halloween. He's grown up on Animal Planet and Discovery, and when Steve Irwin died last year, it felt as if we'd lost a member of our own family.
I do see that your job comes with some hazards, though! Hope the finger from that quill is better.
As far as being around other people and having the compromised immune system, I am cautious but not OC about it. I probably could and should be more careful because when or if I do get sick, it takes a long time to get rid of it. The last time I had a cold, it hung around for 9 weeks and I was really miserable for most of it.
I am naturally a little bit of a germ-a-phobe because I teach, but I cannot blame that on the meds, 'cause I have always been that way.
I will tell you the truth, I am more healthy physically since I started the MTX and Humira than when I was taking nothing. I had pneumonia, that I probably had before I started the MTX. It was just bad luck that I was already sick. Because I was just starting, it was a little more tricky getting healthy. By the way, I usually get pneumonia in the spring anyway. Gotta love the blooming stuff.
When I had Knee surgery in June, I happily took my MTX but was not on the Humira and held off until the stitches came out. The stitches came out and boom I started the shots. No ill effects there. I have just now gotten my first sinus infection since I started taking the meds. My Rheumy said take the MTX, but if the symptoms are not completely cleared hold off on the Humira. I could have probably taken the Humira, but will wait until the antibiotics are gone. Also, I needed to rearrange the Humira due to flying out for a funeral. Hubby is worried about taking such an expensive drug with us.
So, ask questions if a cold/infection rears it's ugly head. In a College setting you can back away from students you think may be sick. Unfortunately in an Elementary setting I have kids that want to sit in my lap still. For me I always check the temp of the students that are sick. If they have an active fever, I call the parents, and let them know state policy about children and fevers!! I am kind of mean, but I cannot understand why parents send an obviously fevered child to school. Mine stay home!! I have never sent my kids to school with a fever, that is asking for troubles.
The last year we lived in FL, our school district adopted a mandatory attendance policy. If a child missed more than 3 days in the year, they could not promote to the next grade, period. They figured it would make the students who skipped, attend. So guess what? The students HAD to go to school sick. The teachers were never there because they caught everything, poor things. My youngest got really sick and was hospitalized and out of school for 5 days. He is a straight A student, made up all the work and we still got notified he was not allowed to move up to the next grade. I fought hard and went to the school district and brought his hospital discharge papers and after a lengthy fight, got him promoted. I was happy we were moving out of state.
I am a bit of a germaphobe too. The boys know they are not to bring anyone home if their friend has so much as a sniffle. During cold/flu season, I use a bleachwater solution and wash down the bathrooms and all doorknobs. Unfortunately, my eldest son has a cold right now that he has passed to me. I'm a very huggy/kissy mom, so it's my own darn fault.
I didn't so much get sick from the kids last year as I think it was from just being out in public and grocery shopping etc. The kids never started anything that went around the house...I did. We are careful tho and if any of their friends have colds etc. they do not come over.
As far as if you can take antibiotics when on mtx etc. I think it is doctor preference. Mine says I can take the antibiotics but if I have a fever I can not take my meds.
Hi Binge, My surgery actually was supposed to fall between infusions but because of scheduling delays (long story about orthopod's staff) my infusion was a couple of weeks further apart. The common surgical protocol for MXT is to be off for 2 weeks prior to surgery. Both my primary and RD said if push came to shove they'd settle for 1 week prior. I decided that to be safe I'd stop 2 weeks prior to surgery and I restarted 1 week post op. My prior RD told me to stop MXT when I had gum surgery a few years ago.
We seem to receive a lot of different directions and information from our doctors. The disease itself is complicated and then there's the conflicting information to make it even worse. Sometimes my primary and my RD don't agree and have to have long conversations about me. I've come to the conclusion that whatever works for my body, works for me. We're all so different in our disease process. Did you have replacements recently? How are you doing? The important thing is we're doing fine. Lindy
Hey grammaskittles!! Glad to see you back. Everybody missed you
DrMalcolm...yeah, you and your son would love my job. But I guess, as with just about any job, their are the tedious parts too. Thanks for your interest, it's fun when someone thinks you have a cool job. I don't know why, but it just is.
Hey Lindy. Yes, I had knee revision surgery at the end of May. Everything went well and the PT was always ahead of schedule and I'm back to my "normal" now. I'll probably be scheduling hand surgery in the very near future to straighten out my hands. I am very encouraged as to what the surgeon had to say.