Category Archives: medicine

My Adventures with RA Meds… RDBlog Week… Day 1…

You may, or may not, know my story.  If you don’t, you can find details here.  The back story is kind of interesting, especially if you want to know where my head was in 2011.  Reading back over it, I realized that I have spent 9 long years knowing I have RA.  I’ve come a LONG way (physically, location wise, mentally) in those 9 years.

During those years, I’ve head good experiences and horrible experiences with my RA meds.  I guess maybe it is a good thing, now, to reflect and consider that adventure…

When I was diagnosed, I was IMMEDIATELY put on prednisone to try to get the inflammation down in my joints.  I was also started on Methotrexate (MTX).  From the get go, MTX made me nauseous… as I went from 2 to 4 to 6 to 10 pills it made me more and more nauseous.  I would take my pills on Friday night as I was already laying in bed because as SOON as I swallowed them I felt dizzy, light headed and like I was going to throw up.  It was not pleasant, but it worked.  I honestly thought that was going to be my forever.

But I talked to my doctor (I miss Dr Booth a lot) and we decided to start on injections to see if that helped any of my side effects.  MTX, with injections, still made me kind of dizzy for a couple hours, but it was way better for me than the pills.   I could get an injections and still go live my life and (at least for several years) it was effective.

Sometimes I had trouble getting MTX (like when there was a shortage for a couple months) and sometimes pharmacies would give me grief (no, they don’t MAKE your MTX with preservative like you can get any LITERALLY any other pharmacy on the planet… you need to make your doctor write your prescriptions in the RIGHT way so we can take ALL all all all all of your money) but for the most part, my adventures on injections was pretty simple.

It wasn’t the be all and end all medicine for me, though.  It did about half the job and Dr Booth could still see/feel the inflammation in my joints.

So I started on Enbrel.   Stomach injections… pricey…. but for about a year IT worked the other half the way to being nearly (if not quite) “in remission”.  It was close enough that I could function nearly normally.

Then I had surgery.

AAAANNNDDD Enbrel decided it was done working for me.

Quick switch to Humera… which worked pretty well for me for about 18 months…. until I had surgery… annnndddd… that gave up the ghost as well.

The doctor said that the stopping working was probably only coincidental to the timing of my surgeries.  That sometimes they just only work for a certain amount of time and then stop working.  Yay…. She also told me that there are a lot of people who have the same story I did of working a while then stopping working because their RA doesn’t respond long term to those medications but that (in their INFINITE wisdom) the insurance companies will only allow the Dr to follow on rabbit trail to controlling the progression of the disease.  The cynic in me honestly believes that the drug manufacturers have enough pull on the whole freaking society that the reason you HAVE to take A then B then C is because they all want a share of the money.  And… when you’re talking anywhere from $2000 to $10000 a month it’s kind of a nice pie to be able to share in.

Then I started Orencia infusions.  Those have stuck the longest.  So far we are at about 6 years and counting.  They still are doing their half for me.  It means getting tied up in the infusion center for a couple hours a month, but that is kind of a small price to pay.

Also, MTX quit working so well for me and I started (two years ago now) on Arava.  I like Arava way better than MTX.  Even with the injections I still had some side effects… hair loss… dizzy for a couple hours… and I had to always travel with injection materials.  Arava is a one pill a day thing and I’ve had no side effects with it.  It is taking care of the other half of the situation for me.

So far, I’ve had no issues with getting my Arava and I’ve been approved to keep taking orencia until 2020… add in losing weight, exercise, and eating better and right now, I’m doing pretty good.  Knock on wood… I hope that continues for a long long time.

 

Love and Light
April
9/24/2018

 

 

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Methotrexate… a rant…

Okay, so I gave you fair warning.  This is a rant.  I try not to let it eat at me and fester, but there are just some things that are so irritating that I have to let lose.  THIS is one of them.

Methotrexate has always been kind of a sore spot with me (not to… you know… make bad jokes about stomach shots and stuff).  For a while I had a hard time finding a store that had sufficient available Methotrexate (liquid) to fill my prescription.  It isn’t a profitable drug.  Passe.  So the makers don’t always manufacture sufficient.  Or there is a mass recall (this has happened more than makes me comfortable).  Add to that, my DOCTORS have suggested that I would be better off using the “with preservative” kind and have written my scripts as such.

Most pharmacies don’t have a problem filling what is written.  Most… If they have it.  I’ve had trouble with one chain in more than one city… in more than one state… in more than one TIME zone… when it comes to this drug.

In Texas it was ‘suggested” (okay… they told me flat out) that they don’t carry my medication as it is written.  I need to go BACK to my doctor and MAKE her write my script either as pills (which make me really REALLY sick) or as the injectables that they DO carry because the company they happen to chose to use doesn’t carry the with preservative vials.  So… I said that they wouldn’t be my pharmacy, I trust my doctor and it is HER job to write what she wants me to take… not theirs to prescribe what they want to sell me.

Now I find myself insured with a company and the pharmacy that I HAVE to use for maintenance drugs (which, despite the fact that I take MTX every week and have for three or four years now, apparently this isn’t… ) is… yep yep yep… the one that doesn’t like my MTX script.

Skip forward to yesterday.

Dr called in my refill.  One month supply, 4 shiny little vials (except the doctor thinks she’s calling in two moth supply… blood test to blood test) came from the pharmacy.  Bear and I got into a lengthy text message conversation about the meds.  He said the bottles didn’t look like what I’ve been taking.  They didn’t.  They say preservative free on the vials, so I got a one month supply, half of which I would be throwing out, and the vials are bigger and a different shape than what I use.  OH… and they are twice the dose I use.  The ones I take are 25mg/ml the ones they filled are 50mg/ml.

Now, I’m not a pharmacist or anything, but I’m good enough at math (it was one of the dual minors on my undergrad degree) to know that 50 is kind of a bigger number than 25.

I called the pharmacy.  They don’t carry my script and TECHNICALLY the doctor didn’t say it HAD to be with preservative.  They GUESS (they guess???) they can TRY to get what I take to fill my script NEXT month, MAYBE, but only if the doctor SPECIFICALLY says they HAVE to.  Otherwise they will give me what they like to sell not what I take.

What do I do with the drugs I won’t take?

Toss them they guess, they can’t do anything with them.  WE left the store.

The guy on the phone laughed at me.  He thought it was hilarious that I was calling him about this.

I called the insurance company.  The part of the company that handles the prescriptions.  The part of the INSURANCE company DIRECTLY AFFILIATED with the pharmacy (which is why I HAVE to use them for maintenance drugs) because I was concerned with being laughed at and being told that there is NOTHING they can do until they get a different prescription.

And I had questions about why (maybe the doctor changed what dose she wants me to take even though I’ve been mostly controlled and even though when I was there she verified my dosage) it was 50mg rather than 25mg.

The insurance company showed that 25mg had been billed in Feb and (GHASP) yeseterday.  25… 25… yeah… the right dose.

I was also informed that MTX is apparently not considered a maintenance drug, so I can get THAT filled anywhere I like.  So I’m going back to where I can get what I take without argument or stress.

I don’t understand why they think it is okay to mess up my meds.  And I know it isn’t personal.  They mess up meds for lots of people or it wouldn’t be such a joke.

My MTX… taking twice the strength might make me feel crappier than usual for a day, but it probably wouldn’t do any real lasting damage.  But other people take other meds.  They RELY on pharmacies filling the scripts RIGHT.  They might not realize the dose is doubled.  What then?  Not everyone has a George Bailey looking out for them.  Not everyone triple checks the labels every time (okay, MOST times).  What happens with them.

he he he… ooopsy?

shake my head… you are dealing with LIVES… it’s really not that funny.

Buff Headwear

So… I’ve decided to embrace the fact that I’m going to continue to be on methotrexate for the foreseeable future.  I don’t think buying a wig is really me.  For starters, while I do some how fundamentally “care” about my hair and the fact that I can pull it all back, now, in one of those baby clips, I really don’t care that much.  It is what it is.

I found this at REI.  We went during their recent ‘yard sale’ (where we found squirrel girl an awesome pair of Vibrams Hairless Hobbit Feet) and I saw this.  It’s purple, so I think it is awesome anyway… but it is amazingly versatile and neat.

I may not have fashion sense, but I do think this will make a statement.

Junkie

I am a junkie
I realize
as I draw the methotrexate into the syringe.
as fear grips my heart at the idea that
I won’t be able to get my drugs
as I push the air and ensuing drop
of the Etanercept
off the end of the needle

I am a junkie
I don’t get high
from my drugs of “choice”
I get nauseous
A headache
itchy and bruised
balding
and every time hopeful
That this time my fix
will chase away the swelly pain.

I am a junkie
An RA Junkie
hear my song
I live
from injection to injection
from week to week
The hope of “remission”
an elusive dream

 

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Methotrexate… Missing in Action?

It has been an interesting week to say the least. Went to my Rheumy for my every 8 week exam.  My fingers and toes are rebelling.  3 weeks without meds turned into three months of trying to get back to … Continue reading