Tips for Managing Infection Risk

Patient Expert

We live in a time when there are more treatments for RA than ever before. Biologics offer more hope of symptoms going into remission for many more people. These treatments, however, come with a downside. Since they suppress the immune system, they also increase your risk of infection.

What can you do to manage this risk? Here are tips that can help protect you, leaving you free to make the most of your life.

Get vaccinated. Get a flu shot, a pneumonia shot and a tetanus shot. These three vaccines can greatly reduce your risk of illness and infection. Keep in mind that when you take Methotrexate or one of the biologics, you should not get a live vaccine.

Use hand sanitizer. Thanks to increased awareness of preventing the spread of flu and colds, it no longer seems weird to carry around and use hand sanitizer. Using it after shaking a lot of hands or touching dirty surfaces (see #6) can help reduce the risk of contagion.

Pay attention. If you get a cold or flu, pay attention to your symptoms. If you start feeling wheezy or your cough sounds like a car that won't start, see a doctor. People who have RA can be more sensitive to developing pneumonia and when you're on immunosuppressants, the risk increases. The same goes for infection in a wound. If you have a scratch that starts getting red, warm or swollen, see a doctor. If your cat or dog bites you and breaks the skin, go to the ER immediately and ask for IV antibiotics. This last one applies to everyone, even healthy people. Animal bites can become very serious very quickly.

Educate your loved ones. Talk to your family and friends about the consequences of being immunosuppressed. Develop a "don't visit me if you're sick" rule. Tell them you're more likely to pick up viruses and that if you do, you will have a much harder time fighting it then they do. There's no such thing as "just a cold" when you're on an immunosuppressant. It may take a while for them to understand, but keep trying.

Take care in the kitchen. To prevent contamination from raw foods that could lead to food poisoning, use different cutting boards for meat, fish and vegetables. After you have dealt with raw meat or fish, clean the counter and cutting boards (and your hands) thoroughly with soap and water.

Don't touch public surfaces with bare hands. According to a study by Kimberly-Clark, some of the dirtiest public surfaces include gas pump handles and ATMs. If you think about it, it stands to reason these are rarely washed. Keep a pair of gloves in your car to use when you pump gas, and press elevator and ATM buttons with a key or a finger covered in a tissue. Use your own pen for signing credit card receipts and forms.

Use gloves. Invest in a box of vinyl medical examination gloves some people are allergic to latex which are available in most drugstores. Use them when repotting houseplants, cleaning the litter box, picking up after your dog and doing other tasks that involve getting your hands into substances that carry germs. If you're a gardener, wear gardening gloves.

Buy masks. Keeping a box of surgical masks in your house is also a good idea. Hand them to people who don't respect the "don't visit me if you're sick" rule. Carry a few with you for situations where the risk of contagion is higher than normal, such as a doctor's office or on an airplane.

Know what to do if you get sick. Talk to your rheumatologist about what to do if you feel yourself getting sick. Some doctors say you can continue taking your immunosuppressant as long as you don't have a fever or infection, while others want you to skip the meds entirely when you're sick. Also, stay away from immune system boosters, such as echinacea or goldenseal, which can cause autoimmune diseases to flare.

Relax. When you first hear the word "immunosuppressant," it can make you very anxious. For most people, the increased risk of infection can be managed by a common sense approach without becoming hyper-vigilant.

Remember that the point of taking these drugs is to get better so you can get back to your life.

Lene Andersen writes the award-winning blog The Seated View. She's the author of Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain.