It has been over a year since I was diagnosed with rheumatoid arthritis and I am on 3 dmards which have had little effect. I would like to know if I can expect to be in remission anytime soon and also does the pain go away when you are in remission?
10/ 6/09 1:32am
Hi Michelle,
Ellen pretty much touched on every subject. Remission is what we all long for, just a tough item to locate! I too was thinking you should try a Biologic. I just went on a weekly instead of bi weekly dose of Humira and will start Rituxin in November if that does not help. I also take a DMARD, Salagen and pain meds. True remission, from what I have read does mean no real symptoms of RA. So I would imagine pain would go away as well.
Hope you feel better soon! Push your doc for a biologic!
Brad
10/ 5/09 4:01pm
Hi Michelle, and welcome -
I don't know that "expect" is the right word. We certainly work towards that and hope that it happens but there is no guarantee. Some people go into remission with their first drug, and some don't for years, despite trying numerous drugs. Every individual is different. The definition of remission includes something such as "no more than 15 minutes of morning pain/stiffness) and some other criteria, such as no progression in joint damage. Some drugs will lower the inflammation but not necessarily prevent damage.
It's been over a year since you were diagnosed, and the first year is often a roller coaster. Have you responded at all to your medication(s)? Have you had joint damage? This is usually determined by x-rays when you're diagnosed, and then later on comparing current x-rays to the past ones (although you may know without needing an x-ray if things are definitely worse!).
There is also the possibility that, if you had some joint damage when you were diagnosed, that osteoarthritis can then kick in on top of the RA. You can have pain from that, even if your ESR (sed rate/inflammation level) has gone down.
You will need to keep in close touch with your rheumatologist, let him know how you are doing, and ask him what other options might be available to you if your current drug regime is not working. I'm guessing that if you're on 3 DMARDS that you are not on a biologic. It might be time to try one of them (Remicade, Enbrel, Humira) if you haven't already. Or - depending on your medical history, there might be a reason why he/she has not already put you on one of these.
Can you share more about what treatment you are now getting?
Best wishes -
10/ 6/09 12:42pm
True remission happens rarely, but drug-induced remission is very possible. I'd also suggest that you speak to your rheumatologist about the biologics if your current medication is not working. We have a couple of recent posts about remission, what it is, etc. - they are here and here.
Whether the pain goes away once your RA is suppressed depends on the amount of damage. If your RA is well-managed, the inflammation-related pain goes away. However, if the RA has caused damage in your joints you can expect some degree of pain.
From a psychological point of view, expecting remission can send you into a bad place. When you have a chronic illness, you're already fighting issues of feeling that your body betrayed you and if you expect remission, you set yourself up for really hating your body if it doesn't happen. It creates a situation where you start questioning why you don't have remission, maybe you did something to deserve being punished and I know it sounds a little nuts, but this disease can do a number on your head and a big part of learning to cope with it is recognizing a mental/emotional trap when you see one. I'd recommend you pick up a book called The First Year with Rheumatoid Arthritis - it's a fantastic resource with loads of information and some really great tips on how to live well with RA. For review of the book and an interview with its author, click here.
10/ 6/09 5:18pm
Hi Michelle,
Remission is something we all wonder about. I was diagnosed a little over a year ago, and started out on on Nabutome (Relafen) (until my rheumatologist was convinced I had rheumatic disease) for about 4 wks, which didn't provide any relief. He started me on Plaquenil in Aug, and I went thru a pretty rough time (flare) and he started me on Prednisone (5 mg) in early Oct (last year) and within a week, I had relief. When I say relief, it was like I didn't have RA at all. I do get minor aches and pains, especially during weather (barometric) changes and times of heavy stress. Those pains I do get are no where near what I had before Pred, and if anything, they are just annoying aches/pains. When I get up in the morning, I have no joint stiffness for even a minute. Nothing hurts and I feel 100% normal. I hear the dangers of being on Prednisone and how it's not good for me, etc. But good for me is my choice, and now as an RA afflicted person, it's all about quality of life now. If I live 10 yrs less with no pain, then it's worth 10 yrs more with alot of pain.. So, keep in touch with your doc, and tell him when you're hurting.. There is hope ! Hang in there!! ~des
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By Michelle— Last Modified: 12/24/10, First Published: 10/05/09
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Thank you for your well wishes and for sharing your treatment regime. I can hardly wait to go on a biologic as I heard so many good things about them and am hopeful it will give me the relief I am looking for.
Michelle