For years I have had flares and popped in a diclofenac and tolerated the pain until and unless I almost wished the pain away. My job as research scientist made it hell for me for 10 years now. Recently I changed my Rheumy begining of 2011. He was shocked at my high flares and changed my drugs to leflunomide 10mgs/day along with methotrexate 10mg/week continued along with folic acid calcium vitamins etc.
The flare could not be controlled so he put me on 8 mg methyl pred for a month followed by 4mg per day for another month and then slowly tapered over another month. My blood work showed I am in remission. Unfortunately after a month of stopping medrol I had another huge flare which could not be so well controlled by
8mg/day. My rheumy had to reduce the dose to 4mg because of terrible stomach problems. After fifteen days I am down to 2mg for five days and then to be stopped. I wonder why this time medrol was not effective.
I would like to know how you all deal with flares. Taking frequent leave from my lab is sometimes impossible.
Ratnapriya
I'm sorry the prednisone is giving you so many stomach issues, because prednisone is very good at stopping flares. My rheumy prescribed 15 mg a day during my last flare, and now I have tapered down to 5 mg a day. I have read recent studies stating some docs are keeping patients on 5 mg of prednisone a day because at this low dose, they find the benefits outweigh the risks. Perhaps taking something to protect your stomach would help...??? Your doctor can give you a steroid shot that would help and not cause you stomach pain.
Flares are really a mystery to me. They are unpredictable, but there are some things I have identified in my life that ALWAYS cause a flare. Does there seem to be any pattern to your flares?
Honeslty, it almost sounds to me as though your RA is not under control. Perhaps your meds need to be adjusted.
If I were you, I would have a long talk with my doctor. I would tell him everything about the flares and how you struggle to work. It may take a while to get the meds right, but perhaps a medication adjustment is just what you need. Hope you feel better soon!
V
Thank you V for your kind note. Yes I have a pattern with my flares, whenever I am in stress I have a flare. My job, my lab, my graduate students, projects are alll a contstant source of stress. Somehow I react to that stress more favorably because I really enjoy my work. Stresses from other sources are killing. I was in remission for quite a long period but after my father died in December 2009 the flares are quite frequent. My previous Rheumy gave high doses of streroid which he brought down very fast leaving no room for much improvement. However it left me with initial stages of cataract in both eyes. I am 50 years. That is why my present rheumy wants me to be without steroid for some time.
Meanwhile I read that many of you resort to meditation to bring down stress. I have just started it. Let us see how it works. Any other suggestion will be very welcome.
Ratnapriya
Yes, some of us do use mediation to help relieve the stress and consequent flares. Nothing like lack of sleep and stress to make the RA monster raise its ugly head! If at all possible, please try to get an adequate amount of rest. When I am exhausted, both physically and emotionally, I come home and put on classical music and read a book. It is my quiet, recharing my battery time. Sometimes you just need to take a break from the stresses of life. You have a demanding work life, so I know this will be a challenge. Hang in there, and keep trying things until you find something that works. Please let us know how you are doing. Nice to have you here at Health Central!
Blessings,
V
Thanks a lot V. I have started feeling better. Pain in my hands is still there but my legs are much better. Somehow I have started doing something more. That is learning to say no in a very nice and firm way. I have very demanding relatives. I could never say no to their endless demand of favor. Now I have started saying no, with my husband backing me by describing my condition in graphic details to anybody who is about to demand something :-). So less stress in one front is helping a lot.
Ratnapriya
Oh, yes! Learning to say No is a must. Be firm if you have to. You have to take care of yourself. Some relatives never "get it". I was wondering if you are on your feet a lot. If you are on your feet for hours, you will want to invest in some really good shoes, such as SAS. If you have RA in your feet, you might want to consider orthotics. My ankles were turning in and I was walking on the inside of my feet. My ankles, knees and feet were really painful. My ortho wrote a script for othotics for me and this is my second week wearing them. You cannot wear them all day when you first get them. You have to build up tolerance. Anyway, I really like them, and they do help me a lot with the pain and fatigue I was having in my feet, ankles and legs. Here is a tip if your feet are hurting and swollen: Keep a frozen bottle of water in your freezer and take it out and roll your feet over it, back and forth. It is wonderful!
Hang in there, and let us know how you are doing!
V
I will do as you suggest. I do wear mediical shoes which helps a lot both outside and inside. The frozen bottle treatment I have never tried but hot water bottles do not work for me. My feet gets really bad when I have to give Ph.D. course work with one and a half hour classes each. I will try the cold treatment then and tell you how it worked.
Ratnapriya