Newly diagnosed with RA

[Ash600]

Check to see if there are any NHS Stop Smoking services being provided in your area as then, instead of paying full price for these products, the most you'll have to shell out for would be the standard prescription charges. However, if you are eligible for exempt prescriptions, then you won't have to pay as it'll be treated in the same way. Also, in the initial stages, you should be given one week's supply at a time but you should be receiving counselling/support to help you to abstain from the cigs.

That can happen when commencing treatment with DMARDs. Hopefully they will have given you sufficient counselling regarding the use of the one which you are taking, the do's the don'ts, 8-12 weeks response time for beneficial effects to kick in, what side effects to watch out for etc and of course I assume you will be receiving regular monitoring in the initial stages.

Also, I hope they have recommended you take the seasonal influenza vaccine as well as pneumonia vaccine (pneumovax) as your are now on DMARDs.

Hope things settle down for you and the DMARDs will help to ease things up for you.

 

[Pennylane-]

Eek! Basically he told me to stop smoking and have an eye test before I picked up my prescription.

I had the eye test and picked up three months worth of the DMARDS and three months worth of Meloxicam. He didn't give me any further advice or suggestions about the meds. He just said he'd see me after my chest scan. I already have a terrible cold maybe I should have waited before taking them?

I think my GP may give me a prescription for the patches, sadly I'm not exempt. The consultant told me to ask my GP. The consultant got stuck in traffic this morning and was half an hour late and so behind with his appointments so he rushed me through.

Do you think I should ask my GP for some further advice?

Thanks again for your time and advice Ash

 

[Pennylane-]

I have googled them to death, I will have another look in the morning, shattered, thanks again

 

[Ash600]

PennyL, here's some general advice regarding DMARDs

https://patient.info/health/rheumat.../disease-modifying-antirheumatic-drugs-dmards

More drug specific advice either I can pull out the info for you, or your dispensing pharmacist should be able to do it.

As you already have a cold, contact your GP, let him know what DMARD you're taking, he may recommend you suspend treatment temporarily until you have recovered. Also, your doc may wish to prescribe you a course of antibiotics/antivrals.

Naturally of course, you won't be offered the influenza or pneumococcal vaccine until you have recovered from your URTI. But as already mentioned, it would be prudent to get it done, either from your GP or pharmacises that offer these vaccination services. Additionally, depending on your area , the CCG may have comissioned smoking cessation services via pharmacies. Again, check with your local pharmacy and if there are any available, then they should be able to signpost you towards them.

As you've also been prescribed meloxicam, I was wondering if you have also been prescribed meds for gastro-protection ie PPIs (lansoprazole, omeprazole etc0? as it is actually recommeded.
Mentioning that you pay for your meds on prescripton, depending on the amount you get during a 3 month/yearly period, it may be worth thinking about getting an NHS pre-payment certificate:

https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/prescription-prepayment-certificates

Right, I need a beer now:p

Take care

 

[Pennylane-]

You're a superstar Ash thank you, will get a call back from my doctor this morning and pop in to see my pharmacist this afternoon.

I don't think I should probably take anything else just yet, to be fair I got my tablets from a Boots in the city that I don't normally use, if I'd used my local one I'm sure he would have had a chat with me, it was silly really but as it was right next to the opticians I just thought I'd get it out of the way.

Have a good day, cheers again

 

[Ash600]

No worries PennyL, you're welcome.

Hopefully your doc and pharmacist will be able to clarify things for you and be able to supply you with NRTs.

Have a grear day yourself, and let us know how you got on.

 

[Pennylane-]

Just an update: I waited two hours for a call back from the doctor yesterday, I'm not complaining as such it just meant that I was at work when she called and forgot half the stuff I was going to ask, and so it culminated in her telling me not to start the DMARDs until I've had my CT scan. She said I should start the Meloxicam straight away though.

I popped in to see my pharmacist in the way home to ask whether I should be taking anything else with the Meloxicam and whether it was safe to start whilst I was still smoking and she said that as I didn't get my prescription filled out there that she couldn't answer and I should call my doctor. Lol.

I'm not going to get a chance to do anything much today as I have a long day at work and so I think I'm going to leave it all again until Monday?

Or should I start on the Meloxicam? I'm still smoking :/ still full of a cold.

The doctor I spoke to yesterday was a temp and will probably have read on my records that I've given up as the last time my doctor asked me I had. I told the consultant I was smoking though

 

[Pennylane-]

An update on my bro: he went for further chest x-rays and blood tests on Monday, they called him in Wednesday and said he needs to go for an ultrasound on his liver next week.

 

[Ash600]

It should be ok for you to start the Meloxicam, be sure to take it with or just after food so as to help reduce any gastric irritation. But if you are going to be on it long term, then as mentioned before,it would be wise to be prescibed a gastric-protective such as a PPI. I'm not sure if you're on any antidepressants, and please forgive me for asking, but if you are and they are SSRIs, then it is highly recommended to be prescibed PPIs as SSRIs combined with NSAIDs can increase the chances of gastric irritation.

Hope you're recovering well from your cold PennyL, and thoughts and wishes are with you and your brother.

 

[Pennylane-]

Thank you Ash,

I'm not taking any anti-depressants, I haven't started the Meloxicam yet either as my cold turned a bit nasty and I've had Vertigo for the past couple of days, so I just didn't dare take anything other than painkillers. I think I'm probably Anemic as in true 'me-style' I've been living on caffeine, cigs and pot noodles for a couple of weeks

I've called in sick today just to make life for my future self even harder

Do you mind if I ask why you've been in the hospital recently? Tell me to bugger off if I'm praying, is everything okay in your world?

I'm really annoyed at myself for not going in today, I'm freelance and really couldn't afford a sick day, I've worked in management or head chef positions since I was 26, but left my latest one in August of last year as my body kept packing up on me and I thought it was because of the long hours.

I can't afford to be ill. I know that no-one can. Especially at this time of the year.

Thank you for your advice again and your kind best wishes, sorry for rambling :/

 

[Ash600]

The way your cold has turned doesn't sound good. I'm guessing that the vertigo is being caused by nasal or sinus congestion? If so, a steam bath (hot NOT boiling water in a bowl and inhale the steam) can help or you could try a saline nasal wash such as Sterimar which is quite effective. Also, unlike other topical decongestants such as Otivine, they don't cause rebound congestion if used for more than 7 consecutive days.

The thing is, I can understand how frustrating it can be by not going into work, and how it can make things harder by not doing so. But sometimes it may help to try to be a bit pragmatic and try to look at the bigger picture if you can. Taking a few days off allowing yourself to make a good recovery and getting your strength up could be a better option than trying to go in half conked and trying to muddle through and therefore possibly risking making things worse, and having to take even more time out from work.

I wish you as speedy recovory as possible Penny.

Do you mind if I ask why you've been in the hospital recently? Tell me to bugger off if I'm praying, is everything okay in your world?

That's ok, you can ask. Basically I had to go to Moorfields for an assessment on my eyes. I've been diagnosed with a condition similar to glaucoma, called Narrowing of the anterior chamber angles which could actually lead to glaucoma. Put it bluntly, there is a problem with the drainage which could lead to an increased introcular pressure. So they've booked me in sometime next year to drill a hole in each eyeball to help improve the drainage and so reduce pressure.

Thanks for your kind words, and I wish you well.

ps you're not rambling!

 

[Pennylane-]

Thanks Ash,

Sorry for the tardy reply the vertigo got worse but it's easing off now, now I'm just left with the cold.

Does the problem with your eyes cause you much pain and discomfort? Does it effect your work? The operation sounds scary but is it a ray of hope?

I hope you have a good day, wrap up warm, it's freezing!

 

[Ash600]

Hi Penny, glad to hear that your vertigo is easing off now, hopefully the cold is starting to ease up as well.

No, at the moment there isn't any pain or discomfort with my eyes. There's no visual disturbances either so it doesn't affect my work. The danger though, is that there could be a sudden increase in pressure in the eye(s) which as well as being incredibly painful, is deemd to be grounds for immediate emergency treatment.
The op from what I've been told is relatively straight forward, they just use lasers to knock a hole in the iris and so create an additional drainage channel for the aqueous humour to flow through. It does normally do the trick in solving the problem, so I'm hoping for once this will be a straight forward procedure.

Thanks for your kind words

My day was ok thanks, hope yours went well too.
It might be cold, but there isnt much need for me to wrap up warm as they always whack the heating units on at work right up. It can be like the tropics working there sometimes

 

[Pennylane-]

The operation must be a worry for you, hopefully it will be straight forward, my partner had a serious operation on his eye a few years ago and had to stay awake for it, I can't remember exactly what it was as we weren't together at the time but he talked about a needle? It was a complete success, he can't sing their praises enough, hopefully yours will be the same.

I only went back to work this weekend as I got a nasty chest infection possibly from the cold I had, hopefully the kitchen will already be nice and hot when I get in today

Still smoking but completely off the codeine, I had some nasty withdrawal symptoms, I won't be using it again if I can avoid it. Still no chest scan appointment, I'm just going to put my head down and work as much as possible whilst I'm well to make up for the past couple of weeks.

Thank you for your advice and kind words Ash, they're always appreciated and I hope you're well

Brrrr it's bloody freezing

 

[Ash600]

Although it's a relatively straightforward procedure, with any operation there's still potential for something to go wrong. So sometimes, there is a slight worry, if only because there has been a bad run of luck regarding ops running in the family over the years. I won't bore you with the details, but it can occasionally play on my mind. But it needs to be done sooner rather than later or else risking a sudden increase in ocular pressure which could arse things right up.

Hope you've fully recovered from your chest infection and not rushing back too soon so as to avoid any risks of suffering a relapse.
As you havn't heard from anything regarding your chest scan appointment, personally, I'd chase it up incase you've been lost in the system. Best to do it soon if you can what with Xmas coming up where quite often, from what I know, the propensity for things to be arsed up is greatly increased.

Hopefully the kitchen has been nice and warm for you, and all has been running smoothly at work.

 

[Pennylane-]

Just an update: Feeling much better and completely off the codeine, I got a copied letter from my consultant to my doctor saying that my anti-CCP levels were very high and that he'd started me on the DMARDs straight away, eek!
Would have helped if he'd told me to start them straight away when I saw him! Started taking them yesterday and now I'm stuck on the loo and have to go to work.
Still no appointment for the CT scan, patches ordered, giving up smoking with my bro from January 1st

 

[Pennylane-]

Some really good news: Taking my son to the Philippines with us, we've been walking every night for two weeks now, he's starting the process of coming off his meds next week, it's been five years and he thinks he's ready, he's going to learn to dive! )))

 

[Ash600]

Hopefully over time, your body will get used to the DMARD which you are taking and the diarrhoea will subside. But see if you can chase up the appointment with the CT scan. You might've been "lost in the system" so thay might need a nudge for them to pull a finger out and get you booked in. Maybe even ask your GP to chase it up on your behalf as obviously that will or should, carry more more weight.

Great news that you're off the codeine and are feeling better, good luck with giving up smoking and hope you both enjoy the trip out to the Philippines.

 

[Pennylane-]

CT appointment has come through, 4th January, my brother's ultrasound is booked for the 7th.

Taking meds sporadically, determined to have a routine implemented by New Year.

I can't help thinking the scan will show that my lungs are much worse. I'm just hoping for enough time to ensure my kids are going to be okay.

 

[Pennylane-]

CT scan of my chest tonight, I don't imagine I'll get the results for a couple of weeks. Fortunately I'm having a flare up in my shoulders, my chest, my hands and my knees. Maybe something will show on my scan?
Taking meds regiously at last with milk, seems to stop the stomach upset but still makes me feel shattered.

My bro's ultrasound in on Monday, my son's nearly at the end of the first month of cutting down his meds. He's ordered some CBD oil as a failsafe as he feels he may need 'something' just incase. Really proud of him, he never shirks on our walks and is opening up to myself, my partner and my daughter much more