Recent months have been crazy busy With the wedding (yes, my wedding) in only three weeks, it seems like my to-do list keeps growing at the same time the days are evaporating. Fortunately RA is taking a back seat so my attentions can be placed elsewhere. However, that doesn’t mean that I’m ignoring RA.
Rheumatoid arthritis is a disease which is hard to ignore. When it is flaring, the pain can be enormous. When your joints are swollen, accomplishing even minor tasks can be difficult. Even when RA seems to be in remission on the surface, it could still be causing internal damage. These are just some reasons why getting on treatment and staying on treatment is so very important.
My own treatment choices have been fairly simple over the years. Just after I was diagnosed in April 2007, my rheumatologist prescribed methotrexate, sulfasalazine, and plaquenil. I stayed in methotrexate and sulfasalazine until October 2009 when the decision to switch to Rituxan was made. I still take methotrexate.
Shortly after my first Rituxan infusions in November/December 2009, I began to feel a positive effect on my RA (and my MS). My hands began to feel more loose and limber. My fatigue levels dramatically improved and I realized that I had been living with an ongoing level of pain for years.
Switching to Rituxan was one of the best medical decisions I have made. I am very glad that I researched the drug and chose to mention it during an office visit. My rheumatologist was very open to discussing the pros and cons of switching, as well as the drug’s appropriateness in my personal case.
This past Monday, I completed my 5th full round of Rituxan. My plan was to schedule it before the wedding (but not too close to the wedding) so that RA continues to stay subdued. In the few weeks before the infusions were scheduled, I was beginning to feel stiffness and pain return in my feet and hands.
[Rituxan is a monoclonal antibody therapy administered by infusion in sets of two infusions given two weeks apart, repeated 6 months later or as needed. Rituxan attaches to mature CD-20+ b-cells and causes them to self-destruct, which does serve to suppress a specific part of the immune system.]
Before this round of Rituxan, I came to a realization, which seems so obvious now, but which I honestly had not considered. My knuckles became smaller after switching drugs. The last time I had been in a jewelry store and had had my fingers measured was in September 2009. That was the same number I gave Rob when he asked me for my ring size last year. I made the mistake of not double checking my ring size.
When I went into the jeweler this summer to have my engagement ring resized, I discovered that my knuckle/finger was more than a full size smaller than in 2009. The change in finger size was more significant than what could be caused by normal fluctuations of weather, temperatures, or body weight.
RA had changed my ring size and Rituxan changed it back. I know that there is the possibility that RA will cause more swelling in my knuckles once more. It took me a few visits to the jewelry store on different days to decide what new size I wanted my rings. I don’t want my rings sloppy and slipping off, but I also think that having a little extra space for future swelling is smart. Stories of people who had to have their rings cut off is somewhat frightening.
I’d like to know what your experience is. Has rheumatoid arthritis or drug treatment changed your ring size? Please share your story.
Lisa Emrich is a patient advocate, accomplished speaker, author of the award-winning blog Brass and Ivory: Life with MS and RA, and founder of the Carnival of MS Bloggers. Lisa uses her experience to educate patients, raise disease awareness, encourage self-advocacy, and support patient-centered research. Lisa frequently works with non-profit organizations and has brought the patient voice to health care conferences and meetings worldwide. Follow Lisa on Facebook, Twitter, and Pinterest.