All posts tagged: Plaquenil

RA flares without the biologics

I am living through my days without methotrexate. I am not on any of the biologics. Hydroxychloroquine is no help and has been set aside. At first, I felt left alone in the world without armor.  Would a flare become so severe that I would spiral down and down into total pain and immobility as I had in 2013? That was my fear. For years, a low level of pain humming in the background has kept me company. I have a degenerating spine. There are long fancy words for what has attacked my spine. Plainly said, I have a bad back. I could say I inherited it  from my dad. I am accustomed to pain. Now I have RA. Over the years I have learned to ignore the humming pain. However, there is a tipping point after the start of a flare where something needs to be done. As a flare starts  pain grows louder in the small joints in my feet. The rest of my feet ache. My left ankle develops sharp pain making …

Plaquenil and the eye

I have a question about the drug, Plaquenil, AKA hydroxychloroquine. My interest stems from the book I am writing, Nurse Mary’s Guide to Rheumatoid Arthritis. After reading several additional medical reports about Plaquenil, I realized I needed to look further and to expand its section in the medication chapter of my book. Another reason for my interest was that I had been taking Plaquenil for six years for my RA.  I was taking it in addition to methotrexate injections and Medrol. I had  also been taking it while I was taking tamoxifen for breast cancer. I no longer take tamoxifen as I developed a rare serous uterine cancer associated with using the drug. None of my doctors questioned the risk involved in taking both drugs. I also made the mistake in thinking Plaquenil was a mild drug. In fact, it does treat mild RA and more aggressive RA when given in combination with other drugs. The drug itself is not mild. Hydroxychloroquine  was developed as an antimalarial in 1955. It was a refined version with …

I thought I was going bald, it was just the MTX

About six weeks ago, I started noticing my hair thinning. I thought it was odd because my dad had thick hair in his older years. I expected my hair would do the same. My hairdresser also noticed the thinning. It was real. Next, I started noticing bunches of hair on my comb. “My hair is falling out,” I thought. Right again. I quickly realized that it was the methotrexate (MTX). Hair loss only occurs in 1-3% of those on MTX. I have been on it for five years and the last three years I have been giving myself 25mg injections. It works for me. I am also on hydroxychloroquine (Plaquenil). Plaquenil can also cause hair loss. I started taking MTX every eight days instead of every seven. Every nine days starts an RA flare. I stick with the eight days. I also cut the Plaquenil to 200 mg daily from 400 mg daily. My hair is no longer falling out. However, my hair hasn’t grown since my last haircut. Unfortunately, it was the second worst …

Vitamin D deficiency and RA

The first doctor to test my vitamin D level was my oncologist. My level was 60 ng/ml. He suggested I lower my supplement amount. I lowered it to 2000U. My next test level was 16 ng/ml. He said,” Just keep doing what you were doing before you changed it.”  I raised my supplement to 4000U and my blood levels have been normal since then. Without a supplement, I was deficient in vitamin D. I have rheumatoid arthritis. Vitamin D deficiency is common in those with RA, type I diabetes and multiple sclerosis. Additional factors that influence vitamin D levels in those with RA include corticosteroid use. Drugs such as prednisone and Medrol can reduce calcium absorption and impair vitamin D metabolism. Hydroxychloroquine (Plaquenil) is also linked to malabsorption of vitamin D.  I am on both drugs and I do take the above supplement. Those with RA who have a deficiency of vitamin D will have difficulty concentrating, pain may worsen, fatigue and depression increase. Vitamin D is a hormone involved in bone and calcium metabolism. …

Four years of RA

  I was diagnosed with RA four years ago, this month. The first few years were whirlwinds as I was also diagnosed with two cancers that each involved surgery and radiation treatments.  My RA moved to the back seat then to the front and again back and forth. Now it is center stage.   In 2015, I was started on infusions of Orencia. Once I realized that the biologics only help your RA by about 50%, I settled in and appreciated that they helped that much. In July the next year, I developed a horrific flu. I haven’t had a flu for years. It was exhausting. Plus, the Orencia was not working any more. I started having bad flares. My rheumatologist stopped the Orencia. After a few weeks, I was started on infusions of Remicade, a TNF inhibitor. By the third loading dose, I was having a severe flare plus I was having a bad reaction to the Remicade. I was ill. It took two months for the Remicade to clear my system and for …

RA update

Methotrexate, Plaquenil and Sulfasalazine are my RA arsenal and are sometimes called triple treatment. I call it Triple Play. These drugs are supported with prednisone and Meloxicam. I have the leeway of increasing the prednisone to 15 mg for a flare. For the time being my RA Doc prefers to keep me at 7.5 mg on a daily basis. My hands and wrists are good. My left shoulder has been a problem, but not a big one. My feet and ankles still rebel. My middle toes on each foot are swollen. I have a minimum (all joints) pain level of three but lately the level has been closer to five. Still, I am functional. I do remember clearly the days of severe pain(I would have to say off the charts. Pain that felt as if all my joints were filled with broken glass). That pain level is my benchmark for how I am doing. My meds are working. I am much happier. I do understand that my RA is progressive. I understand that meds frequently …