I’m feeling much better after a few days on Prednisone, and in fact yesterday took my last dose of it. I touched base with my Rheumatologist, Dr. L, like Dr. C asked me to do on Wednesday. His nurse called back Thursday morning with his recommendations and what he wanted to me do. My results from the last round of testing had also came back, I’m cleared to begin Imuran. Except, I’ll be starting it NOW, not in May, like originally planned. He feels this is warranted after my flare-up due to getting the immunizations Monday.
He also doesn’t think the adjustment in my Plaquenil dose from 400 mg to 200 mg has anything to do with my worsening symptoms but I find it rather curious that I had an almost immediate worsening in my joint pain and rashes after I dropped my dose to 200 mg.
I attempted to pick my Imuran up from the pharmacy Thursday evening but the pharmacist but it wasn’t in. I was told to return the next day after 4 and they should have it ready. I did just that, and sure enough. There was my new med. Waiting for me.
So this is it, I really started this med. This is one of the big guns, It’s one of the ‘serious’ medicines used to treat Lupus. I took my first dose last night with dinner, and I took my second dose with breakfast this morning.From here on out I’ll take them with breakfast. I’m really taking an immunosuppressant now. I’m still trying to wrap my brain around that. I’m reading online and educating myself about this medication. I already know it’s going to interact with my anticoagulant, and that poses some hefty risks. If my blood isn’t adequately anticoagulated, I am at an increased risk for blood clots, which is the main feature of my other condition, Antiphospholipid Syndrome. I’m scheduled to see Dr. C Monday afternoon to have my INR checked, so I can alert him then to this quick additional change my Rheumatologist sprung upon me when I called him at the request of Dr. C. Hopefully the lab orders Dr. L wants me to have Dr. C run every 4-8 weeks will have arrived in the mail by then as well. Yep that’s right, This new med requires even more lab tests be ran. They have to keep a check on my blood cell count and on my liver function tests. I am on a med that could cause Leukemia or Lymphoma, BUT it could also be the key to making me feel better, it won’t cure Lupus, but it can improve my symptoms. Hopefully it doesn’t give me cancer in the process. Wrap your head around that one. Really the risk of cancer, is very low. But it was a risk they had to make me aware of before I took the medicine. Back to my INR appointment that’s scheduled for Monday though, here’s the problem, I was on Prednisone for a few days, that is known to interact with Warfarin, my anticoagulant and cause INR increases, which require decreases in Warfarin doses, if that happens. Imuran on the other hand is known to cause decreased Warfarin levels in the blood, which means lower INR, which means larger Warfarin doses. See where I’m going with this? Just call your Rheumatologist and give him a heads up about what’s going on Dr. C said, mmmhmm. Buckle-up Folks, we are in for a ride!