Pills and Needles: A History

Since I was diagnosed with RA, I’ve tried all sorts of drugs and remedies.

At the time of my diagnosis, the rheumatologist I was seeing recommended putting me on a very high dosage of steroids and a drug that I wouldn’t be allowed to drink alcohol while taking (methatrexate).  Obviously health always comes first, but I got the news about my RA just weeks before my 21st birthday.  I resisted this treatment on both fronts, wanting desperately to have a normal college experience, and because a doctor friend informed me that she would only give the amount of steroids prescribed to me to someone that was dying.  Great.  Double whammy.  Not only I did this treatment require my long-term sobriety, it was also good enough to help a dying person make it through their last days.  That was precisely what I wanted to hear at almost 21.

I saw a new rheumatologist when I returned to school.  The first one was back home, across the country, and I was going to need a doctor who could manage my case on an ongoing basis.  She recommended the same treatment as the first, but we agreed to compromise.  We would start with a less severe dose of steroids and a more lifestyle friendly alternative to methatrexate.

It was fall semester of my senior year of college.  I was on a reasonibly high dosage of predinisone, and a low dosage of sulfasalizine.  I was to slowly decrease the steriods (predinisone) and slowly increase the amount of sulfasalizine.

The doctor friend of mine gave me more advice.  If at any time while taking the sulfasalizine, I experienced a rash, redness or any skin irritation, I was to stop taking the drug immediately and call a doctor or go to the hospital, as the rash would indicate that my body was going into shock.  One night, just before I was to take the GREs, I turned beet red, flush and itchy in the shower.  It was late, I was hoping for a good night sleep, and I was going into shock instead.  As it turns out, I’m allergic to sulfer (sulfa-based drugs).

You know what that meant?  No more alcohol for me…  I was put on methatrexate, after my doctor accused me of lying to get out of an exam.  (An issue I will need to return to in a future post, as the accusation comes up quite a lot when you’ve got a physical condition that doesn’t respond well to medication and people around you who don’t understand it.) In addition to the methatrexate, I was given folic acid.
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The methatraxate wasn’t enough to keep the swelling down.  To avoid permanent joint damage, my doctor then put me on Enbrel, a newer RA drug that was still getting advertising play.   Enbrel makes its way to consumers in two forms, pre-filled syringes and sure-click pens.  I started with the pens, still taking methatrexate, and went looking for a new doctor.

My newest doc wanted to work me off the methatrexate.  He likes to say that it’s not a good drug for a young woman.  What he really means is that if I get pregnant while I’m on the drug, right to choose is out the window–I would have to have an abortion.  So although I was on birth control prior to my RA diagnosis, now it’s by my doctor’s mandate.

Since switching to the new doc, I’ve  switched to the pre-filled syringe, replaced the folic acid with leucovorin and also now carry a script for an antiviral.  Apparently, all these immunosuppressants make it difficult for my body to fight of cold sores…

Now, once a week, I push the contents of a pre-filled syringe into my thigh.  I take a couple of pills here and a couple of pills there.  And I try to lead a normal life.

How does it all make me feel?  I’ll get to that next time…