RA after RNY X-post

I have lost a total of 150 lbs since my RNY surgery in 5/08.  I am really happy with my success!  Now I have been told I have RA in my hands and feet. This is a complication due to a suppressed immune system.  The RA doc wanted to put me on steroids for the inflammation.  I hate steroids and what they do to me.  Increased hunger, ie weight gain etc.. After many discussions with other professionals, I was told 5mg/dly would not produce the side effects.  I have been taking them for a couple of weeks now. They have not been working! (silly me for even thinking it would help) Now he wants to increase to 15mg/dly and I won't do it! Does anyone know of any other meds that will help with the stiffness and pain??
Thanks! 

Hi Ladybug1211,

Your post got my attention...how did you discover all of this?  I have had some symptoms that I am trying to make sense of and often wondered if my surgery has had anything to do with it.  Every morning it takes an hour or so to "loosen" up my joints.  I live on ibuprofen (which is killing my stomach).  My hands are very weak.  My hands and and arms up to my elbows often ache. 

As for the steroids, I am so sorry!  Steroids are awful, but at times so necessary.  I hope you find an alternative.

Tamara

Hi Tamara!
I have an immune system problem that underlines all my health issues. I go for infusions of a blood product every 3 weeks to keep me healthy.  I takes me forever to recover from sinus problems or infections. That said, I ask my infusion Dr. why my hands and feel were stiff in the morning. (Silly me, I thought it was years of working on the computer 10 hrs a day!)  He sent me to a RA Doc.  After loads of tests, he said it was tied to my immune deficiency.  At first we tried Tylenol RA for a month, then he tried to talk me into steroids. He said a low dose would not produce the ugly side effects I had experienced pre-surgery with sinus problems. WRONG! Now he wants to up my dose and I just wont compromise my weight and am exploring different "****tails of drugs" to help with the pain and stiffness.  I don't believe it is related to my surgery, only that I cannot take NSAIDS as inflammation control.
As far as the ibuprofen killing your tummy, you might want to ask your surgeon about Carafate. Its like a pepto bismol for your pouch.  I have to take it b4 any medication. Its really gritty, but better than ulcers!!  It takes me at least 1 1/2 hours to loosen up in the am.  Today I noticed that my hands were hurting while I was making my mini-muffins. (later in the day) .So its not getting better just steadily worse.  Sure hope I can find some answers! take care and keep in touch! By the way I'm 52. To young for all this crap. I feel like I'm 102..lol
Amy

Hi,

Have you tried  Celebrex?
I have severe  RA, I am 54 years old, and, after I tried Methotrexate, Avara. Embrel and Prednison, (  each of them  made me miserable ),  I stoped at Celebrex . Less side efects and no stiffnes in the morning anymore .
 
I hope this wiil answer some questions you may have .
 

Hello Tamara..

You are describing symptoms that I had pre-diagnosis.  It would often take me about an hour or so to "loosen up" every morning.  My hands and feet were constantly aching.  One day my wrist would be so sore I could barely move it..  The next day the wrist was better - the knee would hurt tho.  I thought I was losing my MIND!!  I didn't say anything to anyone about my "neck hurting, my hands hurting, my feet aching, my back in knots, my hips tightening, etc..." because I was afraid I would sound like a lunatic hypochondriac!  Finally, while having a routine check-up I mentioned all my "aches and pains" to my family Doctor.  He prescribed blood tests and x-rays and referred me to a wonderful and caring Rheumatologist. 

Ibuprofen is a mask - a good pain reliever, but one that could possibly mask an underlying serious illness.  RA has been found to cause serious internal damage as well as life long damage to bones and joints.  Please see your Dr. if you are worried.  A simple blood test and x-ray will let you know if this is causing your hurting.

Good Luck!

Amy:  Sorry to hear about your troubles.  One little correction, RA is actually not due to a suppressed immune system.  It is actually just the opposite.  The immune system is actually over-active, attacking the joints.

Immunosuppressant therapy is required to control true RA.  The drug of choice is methotrexate.  If methotrexate can't be used (such as if you are wanting to get pregnant) then another med such as sulfasalazine should be used.  If these meds don't control it, then the drugs of choice are TNF inhibitors such as Humira, Enbrel, and Remicade.

Prednisone is often used as "bridge therapy" where it is used in small doses initially while waiting for methotrexate or TNF inhibitors get the disease under control.

Good luck!

 I have RA as well. My first choices by my RD were Hydroxychloroquine (Plaquenil) as well as Methotrexate. We tried many other combos, but right now I take the Plaquenil 2 times a day as well as the Remicade infusions. I feel normal again!! No pain getting up, no stiffness anymore. The only thing I still have is a weak grip. Jars tend to fall out of my hands/finger grip.


As stated by this doctor, if I have a flare up of pain, my doctor does a short term "blast" of Prednisone. THIS is the only way I will take the Pred!!


PLEASE find a GOOD Rheumitoid doctor. ALOT say its all in your head. Don't listen to them and find someone else!!


Good luck!!

PS: You need to have an ANA test done to try to pinpoint is this is RA.

 I have had RA for 10 years.Also have a sister which had Still's disease at age of 10.So it is in our genes.Had a positive RF & Positive ANA for Lupus.Was treated with Methotrexate & Salfasalizine which worked fine.Had my RNY in 2007 & had no treatment or pain until 3 months ago.Then it came back worse than ever.Had bloodwork again & this time my RF was negative as well as the ANA but rheumatologist says it is still the RA.I tried Tamadol Tylenol etc & now I am on Methotrexate which kind of works .Doc wants to add Enbrel but I see you say Sulfasalizine can be used.

My question is are we able to use Sulfasalizine post RNY? It is significantly cheaper than the Enbrel but thought I was not suppose to use it after gastric bypass???

Hello Lady Bug!

I am new here and this is my first post!  Anyway..  I have been diagnosed with Rheumatoid Arthritis for 5 years now.  It IS an auto-immune disease which causes the body to "attack" joints, muscles, organs... 

After my diagnosis I was put on methotrexate and anti-inflammatory medication.  All the methotrexate did was cause my immune system to drop to about nothing!  From there I was placed on 50mg of Enbrel injections once a week.  Enbrel has been a miracle for me!  I am still "stiff" in the morning, and when it's cold - but NOT as bad or as long as I was pre-Enbrel.

My Rheumatologist gave me a prescription for prednisone - which I haven't had to take for over 3 years now (since I've begun taking the Enbrel).  The Prednisone is prescribed to help me get through "crisis" points should I ever need it.  Thankfully, I haven't needed it.

The interesting thing about RA - as opposed to Osteo-Arthritis is that the MORE you use your joints the better they feel!  After a round of golf, I feel better than I had throughout the whole day!  So, with proper exercise, proper medication and a good Rheumatologist, I have found that my RA is manageable and that life still goes on!

Good Luck!

 I was diagnosed with RA in 2008. I first began with Methotrexate oral tablets and Remicade infusions. The Remicade did not help. I then went to Enbrel injections 6 months ago and am also still on the Methotrexate oral tablets. Enbrel works wonders for me for the arthritis throughout my entire joint system. I also take 1 packet of Coromega Omega 3 Fish Oil (Orange flavor) on a daily basis. Hope you feel better soon!