All posts tagged: RA treatment

Purging, Bloodletting and Algorithms

At the beginning of the twentieth century, the old remedies of purging and bloodletting were left behind. Lister’s concepts of cleanliness had finally become widely accepted. Human anatomy was documented. The culprits of bacteria were identified. Medical knowledge base was growing beyond imagination. Yet doctors were stuck. There was no cure for a bacterial infection. There was no cure for a strep infection. If you were stricken with a strep throat, there was a good chance that you would die. Doctors had no solutions and people of all ages died from pneumonia, wound infections, meningitis, and more. Infection was feared. Today all this is unimaginable. But then, Ehrlich’s ‘magic bullet’ was yet to be discovered. The world changed forever with the discoveries of sulfa in 1936. Penicillin was refined and put into production in the 1940s. There were many more ‘magic bullets’ to follow. Doctors finally had new tools for their toolbox. It became the age of knowledge plus tools. Life became much better. Lifespans became longer. Today, in the twenty-first century, our doctors have …

Remicade started

                                                                                             Remicade is the new RA drug I am starting. There is a loading dose, another dose two weeks later, another a month later. The regular schedule for me will be 8 weeks apart.  I have had the first two doses. It is given by infusion over two hours. The whole thing lasts about three hours. I haven’t had any reactions. Nausea is a common side effect. I have it with methotrexate so I am armed with a strong anti-nausea medicine and I am good. Last month was tough for me. Flare plus flu.I have been in a perpetual RA flare for three years. The only difference is that sometimes it is much worse than other times. It has been on the worse end of the scale for several months. …

What does ACR20 mean

    Have you ever thought about what the numbers mean when they say 50% ACR20 at 6 months? This simply says 50% of the group had a 20% response at 6 months. It means half improved by 20%.   The ACR improvement criteria includes ACR20, ACR50 and ACR70. Meaning, 20%, 50% and 70% improvement. Easily enough to understand. I was reviewing a research paper on Orencia. I will be having my 8th infusion on Thursday. I was wondering if it was being effective enough and if I should keep taking it. The article had a chart for clinical responses in controlled trials. I reviewed the column that said inadequate response to methotrexate (The reason for being on Orencia; I think my methotrexate response is 50%, but it is not enough for me.) A response of ACR20 3  months 62% 6  months 68% 12 months 73%   This means that at 3 months 62% of the patients had a 20% improvement This means that at 6 months 68% of the patients had a 20% improvement. …

Rituxan- the final frontier

Rituxan, the final frontier February marked the second anniversary of my Rheumatoid Arthritis diagnosis. After two years of treatment, my average pain level was reduced from 10+ to an average range of 4 to 7 every single day.  The constant presence of pain and a body riddled with inflammation continue to suck every drop of energy from my aging, aching body. My treatment was complicated by the addition of thyroid cancer and soon after that with the addition of  breast cancer. Both required surgery. Both required radiation treatment. Both required medication.  Both interfered with my RA treatment. The TNF antagonists, like Embril, are contraindicated for those who have recently had cancer. I am not allowed to have them. The ongoing treatment for thyroid cancer is to keep my body slightly hypothyroid. It helps prevent the cancer from recurring but it also increases the effects of RA fatigue. The ongoing treatment for breast cancer is anastrosole. It eliminates all estrogen in the body. It also puts me at high risk for osteoporosis as does Rheumatoid Arthritis. My treatment originally started with …

Thanks a bunch, medical researchers

It was time to do his urine test to determine  his insulin dose. He was diabetic. He followed procedure carefully.  He went into the bathroom and closed the door. He picked up his urinal and proceeded to fill it. He left the bathroom and handed the urinal to the nurse.  She took it into the bathroom. She dipped her measuring tape into her patient’s urine. She waited as it changed color. She held it up to the chart. A 2+. She went back to the nurses’ station and drew up the units of regular insulin designated for a 2+ test result. She administered the insulin to her patient.  Diabetic management in the 60s.  Blood glucose meters had not been invented yet.