Treating RA: Starting Duloxetine
Lets talk about mental and physical heath and well being shall we?
I have to admit, I almost didn't write this. I almost talked myself out of sharing my experiences. I thought about the pros and cons and the cons almost won. Why? Because talking about health can be so taboo in this society, still! However, my health has made leaps and bounds in the last year or so because I refused to accept that I would always be in pain. There is a stigma attached to taking care of yourself mentally and struggling with physical aliments. I'll admit that I once wasn't as understanding as I am now. "Why do you have to talk about it like that?"..."Why can't they just handle it quietly?"..."I can't help them, so why should it bother me?"..."You don't hear me complaining, just suck it up and get over it"...I'm sure we've all either had those thoughts or had someone think them about us. It sucks. So I'm going to share because I know speaking up helps. Because I would have greatly benefited from someone sharing with me, helping me, believing me and more information. Empathy and education, those are things that I think we all need more of.
I was diagnosed with Latent Tuberculous and Rheumatoid Arthritis last year. Whoa. It was scary. But I'm glad that now I have the answers and a plan (and the proper support) to feel better.
Now that I've got the TB cleared up, it's time to address the RA. It's more mild than my initial tests showed, because the TB amps things up. But the chronic pain was still there even after I was cleared of TB, because TB wasn't the root cause, it just made things worse. My entire left side from shoulder to ankle aches with this deep sharp pain. All my joints hurt, and the pain radiates out to cover the entire mass of me. Not. Fun. I've become so good at ignoring the pain that I wouldn't realize how bad it had gotten until something would put pressure on my muscles/joints or I would stretch and the pain would morph into something I couldn't ignore. When the pain changes, it pops back into focus. When I walk, I can feel each step with a fresh ache. It is a quiet pain that will envelop me and steal my attention at night, it gets hard to sleep. It's a kind of pain that is hard to describe. I can't pin point it, it's everywhere. I can't get to the pain to massage it away, it's deep, it is hunkered down inside me and it refuses to let go.
My doctor started me on Vimovo (which is a glorified ibuprofen in my experience) which barely helped for a little while, and then it stopped working. So I've now been switched to Duloxetine, a nerve pain medication and antidepressant. A common brand name for it is "Cymbalta". At fist I was little thrown off that it was an antidepressant. My gut instinct was to say "BUT I'M NOT DEPRESSED! I don't want that" Why? Because it's an antidepressant and we've been conditioned to think that means I'm 'less than' some how, not as good as someone who isn't on it. But it's also used for chronic pain and bone pain like mine. One of my best friends, Rachel, is living with Alex and I and made a good point of "If it makes you feel better, then why does it matter that it's an antidepressant as well as a pain management medicine?" She was right, I was letting some arbitrary judgement get in my own way. I want to feel better, and this is a step in that direction. Not to mention, patients with RA have an increased chance of being diagnosed with depression. It makes sense, living with chronic pain and eventually not being able to move well or function like you want to can be so defeating. I needed to accept that I need help in order to live comfortably and happily.
Full disclosure, it took me a few days to get over the "it's an anti-depressant" issue. Because while I have not been diagnosed with depression nor do I feel like I am at risk for it at this time, hey, I have bad days, we all do. I'm lucky enough to not be clinically depressed but I hurt like hell and I want to feel better. Anti-depressants like this (Selective serotonin re-uptake inhibitors-SSRIs) help a lot of people, why not me? I did have a good giggle when reading the side effects "may cause an improved mood"...of course it 'may', that is part of it's job! And I thought, "well I'm probably going to be in a better mood when I don't hurt as much!" And that sounded wonderful.
Day one was tough, I took my pill in the morning and had a bad case of nausea all day, so bad that I had to leave work early. That was to be expected according to my doctor. So the next day I took it at night with a snack and ever since then I've been ok. Some decreased appetite in the morning but nothing crazy. I have to build up the medicine in my system before we can see any real results. It's 1 pill a day for 2 weeks and then 2 pills a day from there on out. So now it's just a wait and see game. I see the doctor again in a few weeks to see how things are going. But for now, I have a plan: Take my meds, keep up with physical therapy and self care. Thank goodness I have my husband Alex and my roomie Rachel to help keep me on track and listen to me vent and work through things. They are both saints, I couldn't do this without them. I have Alex to pamper me when I need it and Rachel to kick my butt and make me get over the slumps.
I honestly can't believe that I almost didn't want to take the medicine because I didn't want to be labeled as 'depressed'. I didn't want that pressure on me I suppose. But I rather be pain free, so I'm going to take the meds, and I'm going to talk about it. In case there is anyone else out there that needs that reminder that you deserve to feel better, even if you don't want to admit that you need help to do so. Even if I was/am/will be depressed, Depression isn't a defect. You are not being punished for needing help. It isn't something to be ashamed about. You didn't do this to yourself, your body is just built this way. Humans don't come with an instruction manual or even a trouble shooting guide. Living is about trial and error. So listen to your body and advocate for yourself. You deserve that. If you can manage physical and mental wellness without the help of medicine, good for you! But I've tried that and it wasn't working for me, so it's on to the next idea.
So talk about it, how you feel, both physically and mentally. It may be tough, but it could also save you from a lot of pain and suffering.