constant colds

By MJ Monday, April 26, 2010

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My husband was diagnosed with RA 14 years ago. Last October we finally made the very difficult decision that he should no longer work full time. Fortunately for us, I have a good full-time job that provides decent health benefits, so I picked up health insurance for our family at that time.

Currently he takes about 10mg prednisone/day, methotrexate, folic acid, and Rituxin. Before the Rituxin, he was on Enbrel for many years until that seemed to stop working about 2 years ago. While the Rituxin seems to control the RA symptoms, he has had a cold virus since mid-September of last year. It is relentless; we've never experienced anything like this in his 14 years of dealing with this illness. It's hard to say where one cold ends and another begins; he's always sick. And as you probably know, any virus can put someone with RA right into bed, which is where he has spent 80% of his time since last September. It's so discouraging. I want to cry (and often do).

The latest "idea" regarding the constant colds comes from his GP who thinks he should try reducing his dose of prednisone (which I guess can lead to secondary infections) and treating the resulting pain with extra doses of NSAIDs or other painkillers. My husband tried doing this right before Christmas but was in so much pain that he stopped--which I appreciated since we've had a lot of crummy holidays due to the RA! Also, we both agreed that it would be better to try this over the summer months when he doesn't work (he's a speech-language pathologist for a local public school).

I just really don't know what the answer is anymore. His quality of life is so shitty, and I just want to run away most of the time. But I don't because I love him, and we still have two kids at home. I try so hard to be understanding, but it is hard when you're working full-time and taking care of the house full-time even though your husband is home in bed most of the time and you wonder why he can't put the laundry away or unload the dishwasher.

Thanks for this website. I'm going try to check in periodically. It helps to read other people's experiences because no one, absolutely no one, who doesn't have RA or who doesn't live with someone who has RA, can possibly understand the ugly nature of this disease and all that it takes away from the individual who has it as well as those who love him/her.

Mary Jo

Comments (6) | Add comment

Hope

4/26/10 6:32pm

I had the same problem when I was taking humira and meth I always sick for 2 years straight. I actually stopped taking anything for my arthritis for two months so I could finally get rid of what ever itwas that was tring to kill me. It worked but within 4 months it came right back. I stopped taking humira andswitched to enbrel and maybe get one (if that) sinus infection a year now nothing more than that. I have a friend who had the same problem while she took enbrel and switched to humira and that worked for her. Maybe talk to your rhuemy about switching biologicals (insurance permitted that is). It may do the trick. Good luck and I hope you husband feels better soon.

4/28/10 4:17pm

Hope:

Thank you for your response. I'm beginning to think that my husband does need to consider switching to another biologic. He was doing quite well on Enbrel until it seemed to stop working. It's such a struggle. I thank you for your insights.

Ratnapriya

4/28/10 3:17am

Dear Mary,

I am a scientist and also a RA patient for 10 years working full time. Most of the biologics drugs are aimed to target and inhibit the Tumor Necrosis Factor (TNF) and that is why they are also known as anti-TNF drugs. Now TNF is a very important component in the complex network of human immune system. Since RA is an autoimmune disease (which means your immune system has lost control and attacking its own joints), inhibiting TNF will not only reduce inflammation but also supress some network of the immune system. In other words when, you take anti TNF drugs your immune system is compromised to external attack from agents like virus/bacteria/fungus/parasites etc. This could be a reason why your husband is having constant cold. Each human being reacts to inhibition of TNF in a different way which scientifically is poorly understood. Pred also reduces immunity but not known to affect so much when you are having a maintenance dose of 10mg. As for your husband feeling miserable the pain levels can depress us so much you cannot imagine. I hope this helps you

Ratnapriya

4/28/10 4:07pm

Ratnapriva:

Thank you for your response. It is very interesting. My question now is whether it would be a good idea for my husband to consider switching to a different biologic drug. As I mentioned earlier, Enbrel seemed to stop working for him two years ago, and his rheumatologist started him on Rituxin last January. The interesting thing is, he was never this sick while on the Enbrel for eight years. So, do these biologic drugs act differently on the immune system so that it would make sense to try switching to a different one?

As an aside, he was also on Remicade for a very short period 5-6 years ago when Enbrel production was inhibited (I forget why), and he had a terrible allergic reaction to that drug! I just feel so bad for him and for us as a family that he's constantly sick and in bed. It's depressing.

Ratnapriya

4/29/10 3:15am

Mary

Could you talk to your doctor about this cold symptoms and openly discuss the role of biologics. There is a lot of material on them available on the web. Could this cold be also an allergic reaction to the drug itself. An open discussion with his rheumatologist might help. He does need a lot of your suppport at this stage.

Best of luck

Ratnapriya

Lene Andersen, Health Guide

5/ 6/10 12:17pm

To be honest, I would recommend a second opinion. It sounds as if although you have been satisfied with your rheumatologist, you're frustrated that what's currently happening and if you're resorting to your GP instead of your rheumatologist for solution, it sort of sounds like to me as if you may not have a lot of faith in them anymore,, so a different pair of eyes may be beneficial. See if you can find someone who's attached to a teaching hospital - they often have more experience in thinking outside the box.

I would also definitely recommend trying another biologic. I'm a bit confused about why your doctor went from Enbrel straight to Rituxan - it was my impression that this drug is the one you try when all the other Biologics have failed, but I'm not a doctor, so what do I know... However, I was on Enbrel for a couple years and it didn't work well for me, so I switched to Humira, which has done wonders. There are a number of other Biologics as well - lately, there's been a positive flurry. Check out Lisa Emrich's series on the new Biologics and our post on Simponi.

Is your husband having colds or is he having a continual sinus infection? Upper respiratory tract infections are very common with the Biologics and can really do a number on you. You may want to check out my post on managing side effects - through trial and error, I found a trick to keeping the sinus crap down to a dull roar and it may help your husband, as well. You may also consider consulting a licensed naturopathic doctor for help in building up general health.

Please let us know how it goes?

constant colds

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