mama whose curiosity knows no bounds

Archive for January, 2015

CellCept – not yet

Last December, I saw a new rheumatologist. He is a professor of very prestigious university and usually we don’t get to see him. But thankfully, I had another option available through my employer. My employer subscribes to Personal Medical Guidance doctors service. This service let’s the employee and their family see or phone a doctor and help understand the situation, or if needs arise, secure referral for the second opinion. The doctor I consulted clearly saw the need for a second opinion or switch the rheumatologist, as I continue to suffer. It’s incredible to see such a prestigious doctor in 3 weeks wait. I know seeing ANY specialists take at least a month, if not more. Let alone the famous one! I’m very happy that my employer has this service!

Of course seeing the well-known doctor has it’s drawbacks. First, the wait time was awful. I waited for about an hour to see a resident physician, then wait another 40 minutes to see the doctor. And even though I need to see him in a month, there was no opening. So he found a sole opening slot in the RESIDENT’s schedule, in a different campus where he doesn’t see patients directly and only teaches. This means that I need to drive an additional hour for the next appointment, but I think it’s worth it.

For the first time, I felt that all my concerns are legitimized. He didn’t minimize, or make a comment like “it’s all stress!” So I felt very validated. AND HE TOUCHED ALL MY JOINTS AND CHECKED THE MOBILITY! My 3rd rheumatologist touchd all my joints, but even she didn’t check my mobility.

Anyway, he decided that my methotrexate is not working – at least not in a way it should. I still have flare up about once a month and background joint pain is always there. I was taking 15 mg/week of methotrexate, and when it was raised to 20 mg, I felt much better but my liver wasn’t happy and showed in the blood test. So the new rheumatologist prescribed CellCept – an immunosuppressant that is usually used in post-transplant patients to prevent organ rejection. He told me that it has side effects like nausea so that the dose needs be slowly increased. I started at 1000 mg/day, a week later, 1500 mg/ day and then a week later, 2000 mg/day, the supposed working dosage. 

I did have nausea and it somehow kicks in 3 days after starting the certain dose. As I started on Wednesday, I suffered nausea for the last three weekends. But it wasn’t too bad. What was worse came from stopping methotrexate. By the second week, I had all the joint pains coming back, and this time, unlike any flare-ups, the pain doesn’t go away. Similarly, I had rather rough fatigue and inability to focus. But my inability to focus may be from another reason, which I plan to write in a separate blog.

Just to be functional, I need Vicodin now. I hate to take it, so I limit to 2 tablets a day maximum and if not needed, I do my best to rest. Therefore, I need to use it wisely. I usually reserve one for the evening as pain when I try to sleep is really awful. During the day, I try to distract myself by doing lying meditation or watching videos. Not having a consistent routing doesn’t help, either. Thanks to polar vortex part 2, the school barely opened for the new year. Although S is mature enough to leave her alone in the home, I still need to check in at least every few hours. And I don’t want to drive on icy road while on vicodin, although the medication doesn’t make me drowsy or high at all. This is just a safety precaution. Now I can type only because I’m on Vicodin. Otherwise, I can’t really do anything.

Since now Cellcept reached to the full dose, I expect the effect to kick in soon. But immuno suppressant seems to take days, if not weeks or months, to kick in, based on my experience with methotrexate and Plaquenil.  I hope it’s not the case for CellCept. I can’t wait to see the effect. It’s not an easy medication as it needs be taken in an empty stomach and having two more empty stomach medications (synthroid and Fosamax) is not very helpful. Now I take it with synthroid and I’m not sure if that is the problem or not. Pharmacist didn’t have the definitive answers, either. I do plan to ask the rheumatologist at the next appointment about 10 days away, though.  I might change the way I take if it doesn’t kick in soon. Ugh.


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