View Full Version : Flare??

05-14-2008, 09:02 PM
I am newly diagnosed...I have my ups and downs. I think i had a major flare up last week, I could now lft my arms the pain in my hands, wrist and elbos was the most intence pain I have ever felt, It hurt to move, lift or do anything. It went on severly for about 4 days started to calm some, and again the pain in the joint and muscle in and around my elbo is insane. I take vicodine, soma and tehy had me on meloxicam(lupin) and then switch me to diclofenac sodium 75 mg 2X daily. The pain seem to increase after i switched to the diclofenac so i went back to the the meloxicam but neither of these seem to help...i go back to the rheum on Friday of next week any advise to what I should ask for???

Also, what is considered a high ANA test?? mine was 1:2657

05-15-2008, 10:09 AM
Hi Sheila;
I'm going to give you a breakdown of the types of medications that are used to deal with the various pains caused by Lupus. These include non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (pain relievers). They help you to feel better by reducing the amount of discomfort that you experience, but they do not inhibit the disease process itself. These formulations typically take a few days to a few weeks to control pain effectively.

Pronounced “ensayds,” these drugs help reduce pain and swelling in the joints while decreasing stiffness. When a low dose is taken, NSAIDs control pain, but higher doses are required to reduce inflammation. The problem with NSAIDs is their side effects. Taking more than one NSAID at a time increases the possibility of heartburn and severe side effects such as ulcers and bleeding. NSAIDs inhibit the blood’s ability to clot properly and may therefore interact with blood-thinning medications such as coumadin. Kidney disease has also been reported as a side effect.
Most NSAIDs require a prescription, including naproxen (Naprosyn®), nabumetone (Relafen®), indomethacin (Indocid®), diclofenac (Voltaren®), piroxicam (Feldene®) and sulindac (Clinoril®). Other NSAIDs are available over-the-counter; these include ASA (Aspirin®, Anacin® and others), and ibuprofen (Motrin IB®, Advil® and others.)

COX-2 Inhibitors
This is a recent sub-class of NSAID. The most frequently prescribed Cox-2 inhibitors are celecoxib (Celebrex®), rofecoxib (Vioxx®), valdecoxib (Bextra®) and meloxicam (Mobicox®). Unlike standard NSAIDs, Cox-2 inhibitors do not inhibit proper blood clotting. Recent evidence, however, strongly suggests that Cox-2 inhibitors have the same degree of negative side effects as standard NSAIDs—including contributing to kidney failure—and may increase the risk of heart attack and other cardiovascular problems.

*Important News Release September 2004
Vioxx®, the cox-2 inhibitor made by Merck, has been pulled from the market because of severe lethal side effects due to heart attack and stroke.

Acetaminophen (Tylenol®, Panadol®, Exdol®, and others) is often prescribed to relieve mild to moderate joint pain. Acetaminophen is not an anti-inflammatory drug and may therefore usually be safely combined with an anti-inflammatory medication to relieve pain. (Please consult your doctor or other health care practitioner regarding medications that are appropriate for you.)
While acetaminophen can bring relief for joint pain, it does not help the underlying cause of the condition. Overdosing can cause liver damage. (If you are taking acetaminophen on a regular basis to control pain, you should make sure that other over-the-counter medications such as cold and flu remedies do not contain enough acetaminophen to constitute an overdose.)

Cortisone is a steroid that is naturally produced by the body. It reduces swelling and inflammation and can help regulate the immune system. Corticosteroids are man-made drugs that closely resemble cortisone but have a much more powerful effect on inflammation. The most common form of corticosteroid is called prednisone. Oral prednisone is usually considered when the symptoms of systemic lupus erythematosus (SLE) are not being controlled by other treatments, and there is concern about an imminent flare-up, or when the disease is severe and perhaps life threatening. Prednisone use needs to be carefully monitored because of its many side effects, and the drug must never be stopped abruptly.
Side effects from long term use of corticosteroids may include cataracts, high blood pressure, sleep problems, muscle loss, bruising, thinning of the bones (osteoporosis and osteopenia), weight gain, immune suppression and increased susceptibility to infections. The goal with these drugs is to find the lowest effective dose that will avoid as many of the side effects as possible.

Anti-malarial medications help to managing the fatigue, skin rashes and joint pain associated with lupus. Chloroquine (Aralen®) and hydroxychloroquine (Plaquenil®) are examples of antimalarial medications. They may take several months to take effect.
The most common side effect of anti-malarial medications is stomach upset. A more serious, although rare, side effect is loss of vision. This may occur if anti-malarials are taken in high doses over a long period of time. If you are prescribed an anti-malarial, you will probably be required to have an eye examination before starting the medication, and have regular follow-up eye examinations.

Cytotoxic drugs are often prescribed to control inflammation by suppressing the immune system. For this reason, they are also known as immunosuppressive drugs. You may be prescribed these if your symptoms are difficult to control with prednisone alone or if you are experiencing side effects from prednisone. Cyclophosphamide (Cytoxan®), cyclophosphamide (Procytox®) and azathioprine (Imuran®) are commonly prescribed cytotoxic drugs.
Serious side effects include decreased blood cell counts, increased risk of infection and a risk of developing certain types of cancer. If you have lupus and you are taking cytotoxic drugs, you should have regular blood tests and be monitored closely by your doctor or other health practitioner.

Nutricol®, available as Recovery® in many pharmacies and health retailers, is a food-based non-drug supplement proposed to improve quality of life*.

Nutricol® (Recovery®) may be safely combined with other lupus medications or taken on its own to help improve quality of life*. It does not produce unpleasant side effects. Since this product works to modify your body’s responses, it may take up to six weeks for you to experience relief, with most people noticing benefits within a month.

Perhaps you can use this information, when you visit your doctor, so that you and he can discuss which pain relievers you feel will work best for you. Let us know how it goes.

Peace and Blessings

05-15-2008, 02:31 PM
Hi tootiredtoplay

Sorry to hear you're flaring...gentle hugs to ya. I'm still playing the nope not that one game with medications. But was didn't work for me might work for you...so you'll have to be patient and keep trying.

Besure to ask you doctor how long it should take before you know if the drug is working for you or not. Then get back to them after that time has passed if it's not working.

I've done this several times and there is always a detox period to get the old drug out of my system before I start a new one.

Good luck :)

05-15-2008, 07:39 PM
Thanks for all the information, I will take it with me next week. :lol:

05-17-2008, 02:37 PM
Sorry your 'flaring' tootiredtoplay. NOT fun....it will pass - lupus is a whole series of 'ups and downs!' Hopefully, the docs will find the right medication 'cocktail' for you. It's trial and error, I think, in many cases.

Hope reading the posts here is helpful to you. Welcome to the group!

07-15-2008, 09:27 AM
im new to lupus also but shouldnt you go to the hospital? those are some of the symptoms i experienced my first flare. they kept me in the hospital for 2 weeks, then they put me on 60mg od pred, mobic, skelaxton, vicodi didnt work so they gave me morphine and so on... i was pretty druged up so i felt better even though i couldnt barely move but when the drugs wore off.....it was war again. I know that keeping in touch with your rhumy is very good!