RA Dilemma Number Five
There is another dilemma to face when you have rheumatoid arthritis. I was surprised by this one. After all, I have had RA for seven years and feel I have covered a lot of ground in that time. I know infection posed a very high risk while taking RA meds. My mind thought flu or maybe pneumonia. This one started five months ago.
Suddenly and out of the blue, my right breast developed a lesion and stated to drain. I felt feverish and went to see my oncologist who sent me to the breast surgeon oncologist down the hall because she was the one who had the ultrasound machine. She came in, introduced herself and looked at my lesion. She instantly knew that it was caused by necrotic breast tissue due to radiation for breast cancer. The radiated tissue gradually degenerates, expands until it pushes through the delicate breast skin and drains. It cultured positive and I was sent to the wound clinic.
Eventually, it was determined that the only solution was a partial mastectomy. That done and a week later, I developed a severe infection and cellulitis. The incision had popped open and sprung a leak. I was treated with antibiotics. I was again sent to the wound clinic. The nurse debrided the wound. I was instructed on packing the wound (deep) with iodophor. Eventually, the drainage lessened. The iodophor packing were stopped. Inserting cellulose/collagen/silver slices were started. Progress is being made and I think within a month I should graduate from the wound clinic. That will make a total of six months of aggressive treatment.
Now for the RA dilemma. Both oncologists insisted I stay off methotrexate. They felt if I would continue methotrexate, I would have a repeat of breast necrosis. The radiated tissue will always be problematic, but the methotrexate will make it worse. I agreed. No more methotrexate. I didn’t want to have to deal with another wound for another six months.
I had been on methotrexate for seven years. Initially, I suffered through the usual side effects, but over time the symptoms disappeared especially once I started taking methotrexate by injection. It helped keep me even. I still had problems, but my base line was much better. Now I am having worsening flares.
The difficult part for me is that I have many joints affected. In a flare with all of the joints spewing inflammation factors, I start feeling sick. It feels like a flu. So, in addition to joint discomfort, my whole body feels ill.
My big worry is the inflammation and what it is doing to my body. I’ve already had three cancers. I am now reluctant to restart Actemra because of the infection risk. It is a complication when taking any of the biologics. It is a complication when taking methotrexate as well. I am at a higher risk because I am older. As I have more complicating factors, I have to pay closer attention. I am doubtful I will start another biologic until RA drugs become more targeted and have fewer complications.
With improved health, I have restarted my exercise program. I have eliminated foods that are inflammatory. Revved up protein, vegetables and water. Not the answer, but I do believe in being proactive.