Author: Mary Mann

RA, Nighttime and Cortisol

We all agree that mornings with RA is not easy. Stiffness, pain,  and suffering that feels like it lasts forever. I have learned to manage morning pain well.  I usually wake up about five or six to use the rest room. At that time, I take  pain medication  and I go back to sleep. When I wake up around eight,  the edge has been taken off my discomfort. I  have coffee and read the New York Times for an hour. And then I am good to go. Some of us with rheumatoid arthritis (RA) experience increased pain at night.  When I am in a flare, I have a hard time sleeping.  My body feels worn  and  ragged. Knuckles, wrists, shoulders, feet, ankles, pelvic girdle, spine. And even my elbows. Nighttime pain is different. It feels heavy. It feels overbearing. It feels endless. It just seems too much. Research has shown that people who experience nocturnal pain have an increased number of swollen, painful joints. They are sicker. For normal bodies the inflammatory system works to …

Targeted biologics for RA Part One Rituxan and Orencia

The following are targeted biologics approved for rheumatoid arthritis.  Targeted means these drugs  dampen a particular  part of the body’s overactive inflammatory process. Rituxan Orencia Actemra Kevzara Kineret Some of the  biologics will not work for you although they work for some other people. Some biologics work for a short time then stop working.  Some biologics work for years then seem to stop working suddenly. Sometimes an insurance company will stop covering certain biologics and insist a patient use a limited selection from their formulary. Some people are affected by the possible, serious side effects of these drugs. These complications happen to somebody so pay attention when your doctor briefly mentions them. Doctors do not know which drugs will work for you. Docs give it their best shot. It is trial and error. There is no system to finding the biologic that will work for you. This is the current medical  scenario. In this article we will discuss Rituxan and Orencia. Rituxan (Rituximab) In 1982,  Rituxan was created by Ronald Levy for the express purpose …

Surviving Covid-19 with RA

Those with rheumatoid arthritis are more likely to become ill with covid-19 and they are more likely to be hospitalized or die. In addition, if you are on an immune suppressing biologic your  covid-19 vaccine will only be about 65% effective as opposed to the 95% coverage most people enjoy. The reason that a third vaccine will soon be available to those who are immune compromised is because those hospitalized with breakthrough infections are from the immune compromised group. This is not a booster shot. It is a third vaccine. Those with RA who are on an immune suppressing biologic will be eligible. Although those who had RA were included in the vaccine studies, those with RA who were on biologics were disqualified from participating.  So, there was no data on the effect of immune suppressing drugs such as the biologics on the effect of the vaccine. The vaccine is safe for those with RA. Protection from the virus is limited for those on the biologics. It has been found  that those with RA who …

RA In the kitchen

In the kitchen with RA When I was twelve, I road my bike downtown with my mom’s green stamp book in my pocket. I road my bike back home with my first Betty Crocker Cookbook . I still have it. Now I have many recipe resources including the food section in the  NY Times, All recipes and Martha Stewart emails, and King Arthur Baking Recipes. Now I have Rheumatoid Arthritis and my life has added uphill challenges. Between RA pain and fatigue, doctor visits and drug complications,  ambition frequently descends into the basic mode of  required activity. That activity is as basic as  getting dressed in the morning. Cooking?  Is it really necessary anymore especially when you add the difficulties of RA to the mix?  For some of us, it is. I like to cook. I like the taste of homemade meals. I like the fragrance of baking bread coming from the oven. I enjoy working with my tools and ingredients in my kitchen.  Fresh fruit and veggies. Organic chicken. Cream, buttermilk, unsalted butter.  Working …

TNF inhibitors

The next line in the treatment of RA TNF inhibitors/TNF blockers are a group of biologic medicines that suppress the body’s response to TNF. TNF (Tumor Necrosis Factor) is a complex protein produced by the white blood cells in response to inflammatory events in the body. Those who have rheumatoid arthritis may be given a TNF inhibitor as part of their therapy. This is the third article in a series about the treatment options for rheumatoid arthritis. You can download the articles or you can read them on Marysarthritis.com. Many insurance plans may require that you start your therapy with a nonbiologic such as methotrexate (MTX). As troublesome as the side effects are in the beginning, methotrexate has a good success rate. When MTX isn’t enough the doctor may order a combination of methotrexate with sulfasalazine and/or leflunomide. A TNF inhibitor may be the added to the methotrexate. Although the TNF inhibitors are basically similar, they do have differentproperties. If one doesn’t work for you, another might. Your doctor will order a TB test and …