Thursday, May 31, 2012

Question Regarding Weight Gain w/Remicade

By cbrown Friday, August 14, 2009

I started taking Enbrel about 6 weeks ago.  I noticed that pants I could fit in prior to taking the meds are now too tight.  Today when I went to my Rheumy, I learned that I've gained 15 lbs. in 6 weeks.  As we all know, weight gain is not good for people w/RA so I definitely can't have this.  As it turns out, the drug didn't work for me because I'm still in a great deal of pain.  I can't stand for more then 5 mins before my ankles and hips hurt so bad that I want to cry.  MY Rheumy is now trying to get approval from my insurance company to put me on Remicade.  My question is this, has anyone experienced weight gain w/Remicade? 

 

Also, I curious about prednisone.  Can someone share some light on the benefits of taking the prednisone?  My Rheumy has never mentioned it, but I've been diagnosed over 3-1/2 yrs. and I'm still in pain & stiff daily.  I can deal with the achiness, however, I'm talking pain that when I get up from a 30 mins lunch, I have to stand for 2 mins before walking because I will resemble someone 90+.  Also, my ankles, hips and back hurt so bad that I spend most my time during in the evening in bed or on the couch.  I've been forcing myself the past couple of weeks to workout regardless to how I feel, but when I finish I feel cripple.

 

Has anyone else had similar experiences where it took quite some time to find the right mix of drugs and if so, what is that mix?  Today while at my Rheumy, I requested a copy of my medical records be sent to a new doctor to evaluate.  I am scheduling an appointment with her in the next couple of weeks to see if she has some miracle trick she can pull from her bag because I just don't feel my doc is taking me or my pain serious.  In fact, he told me my tolerance level for pain is just low and that's why I'm not have any success.  That really made me mad in that I won't take pain meds until I'm almost in tears.  I played a whole softball game about 7-8 weeks ago after rolling my ankle warming up and never complained.  I got hit in the head by a man throwing a softball to throw me out at a very high speed and after recovering from the dizziness, I contineud to play ball.  I even tore my ACL and continued to play softball for the remainder of the summer before having surgery, so to me, that was a insult to basically say I'm a cry baby.  His solution to my pain is to just keep increasing my methotrexate.  I was diagnosed 3-1/2 yrs ago and started at 3 a week and within 3 months was at 9 a week.  Today he suggested I go to 10 or 11...NOT!!!  My hair has thinned emough.

 

Looking for support!

8/15/09 10:23am

I recommend you read Lene's comments about controlling pain. She says if your Rheumy is not helping you than you should consider finding another one. Which sounds like your doing. If you are concerned about weight gain (which I am too) Prednisone is one of the worst. You should take some time to read up on that medication. It does help control inflammation...but there are many side effects and since it is a steroid weight gain is common. Im sorry I cant answer your questions concerning Enbrel since I have yet to try it...Lene has some good information on that. Injections are my next step. I have had trouble finding a medication that works for or that I can handle the side effects of. I have tried methotrexate,planquenil,and arava with no luck. Almost all RA patients have to test out different drugs till they find the one that works for them. I know its frustrating...I suffer from that as well. I thank-you for sharing and wish you the best of luck! You will find something that works for you! Innocent

8/16/09 3:27am

Thanks for your input.  The more I think about some of the comments my Rheumy made during my visit, the madder I get.  I talked w/a couple friends about what he said and they all agree that he is showing no sensitivity or compassion.  I'm looking forward to talking with someone else to see if they have a better solution then me increasing my metho.

8/18/09 11:17pm

Hi CBrown,

 

Well, you definitely want a doc who listens and takes your symptoms and degree of pain and stiffness seriously, so getting a second opinion sounds like a good idea. 

 

Methotrexate is a first line drug, and docs will often do as your doc is doing and gradually increase the dose until the RA is under control, or side effects dictate that you can't tolerate a higher dose, or its determined that the drug isn't working.  At that point an alternate med or a second drug like Enbrel is usually tried, and if it fails, when a different drug, etc.  Unfortunately it is a bit of a trial and error process to find the right med or combination of meds.  

 

You don't mention your labs.  Is your sed rate normal or still elevated?  If its elevated then inflammation is not under control and you need to keep working closely with your doc until the sed rate falls into the normal range.  Some docs will use prednsione as a bridge therapy until the right combination of anti-rheumatic meds is found.

 

Prednisone does frequently bring on weight gain due to water retention, stimulation of appetite, and its effects on fat metabolism.  However, weight gain can often be kept to a minimum if you are very strict with your eating.  Not everyone gains weight while on prednisone, but many people do.  An ADA diet is often helpful for anyone going on prednisone.  Prednisone is an extremely effective anti-inflammatory, and often gives excellent relief of pain and stiffness cased by the inflammation of RA.  If you do take it, keep the dose as low as possible to control symptoms and get off of it as soon as you can.  If you are on it for very long who will need to taper off slowly and it can take awhile to get completely off of prednsione.

 

If you do have active inflammation as indicated by an elevated sed rate, I would avoid strenuous sports until the inflammation is under control.  Joints that are inflammed are much more prone to injury.  Stick to something gentler that keeps you moving and gently takes your joints through range of motion.  Tai Chi for arthritis (Dr. Paul Lam) is particularly good, and can even be done seated if need be.

 

Best Wishes,

 

Josephine

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By cbrown— Last Modified: 09/04/10, First Published: 08/14/09