Reactive Arthritis

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Bev
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Reactive Arthritis

Post by Bev »

I had a knee replacement in August. I was taken off Asacol because of it's blood thinning properties. I was on injectable blood thinners. As a result, I developed Reactive Arthritis in my foot. It's hard enough trying to walk again with a knee replacement, but adding the reactive arthritis makes walking & knee recovery even more difficult. This is the second time I've had it in the last 8 years. I'm now on Sulfasalazine and it has improved, but it's still painful and hard to walk. Also, from what I've read, Sulfasalazine is hard on the system.

Has anyone else had this problem and if so, what did you do to make it go away?

Bev
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tex
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Post by tex »

Hi Bev,

Sorry to hear of those problems. I don't recall anyone else here ever mentioning that they had reactive arthritis, but it's possible that I missed it, or that someone had it but didn't post about it on the board. In fact, I'd never heard of it until you mentioned it. Very few members have taken sulfasalazine, also, because as you say, sulfasalazine can cause problems of it's own. Many of us can't take sulfa drugs.

I would assume that it's been prescribed to you because of your somewhat unique situation. As you probably know, when the body metabolizes sulfasalazine, the metabolites are sulfapyridine, (which can cause undesirable side effects), but which has anti-arthritic effects, and 5-aminosalicylic acid, which is the active ingredient in Asacol and other mesalamine-based medications.

Looking at the symptoms, it seems to me that reactive arthritis could also possibly be associated with an MC flare, for someone with the HLA-B27 gene.

Sorry I couldn't be more helpful.

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Bev
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Location: Snohomish, WA

Post by Bev »

I think I was tested for HLA-B27 and there wasn't a problem. I'll check on that again. I've only gotten reactive arthritis when I stop the asacol. I never had it before I developed diarrhea (11/02) and was put on Asacol... I've been tested for a variety of bacteria, C. difficile, and a few others - all were negative. (It's really a plot by P&G to keep me on their over priced drug - just kidding)

I'm now going to try a combo of sulfasalazine & asacol. If that doesn't do anything, I'll have to include more prednisone which I really don't want to do. Egads!
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Post by Lesley »

Bev,

Egads indeed! The side effects of prednisone are awful, and weaning off it is worse. The pain is excruciating so it's not worth it, especially since the effects only last as long as you take it. I have done it 2x, and, even if I am dying, I will NOT do it again.

I am one of those who cannot take sulfa. Makes me very sick.

Therapist in me taking over now. Knees are awful, and getting an arthritis attack is adding insult to injury! No fair!
I am assuming you are warming pre exercise, icing post exercise and as much as you can, elevating, wearing pressure stockings, using a CPM etc.

Do you have access to a pool? If you do, using it for exercise is the best thing you can do for both your foot and your knee, AND the rest of you. Things WILL improve quicker if you can do this.
If you don't, do you have a bathtub with enough depth to submerge your leg? If you do, get in it and start to gently move your leg and foot, flexing and extending both your knee and your foot. ICE AFTERWARDS! Very important.

BTW - do you have equipment to help you do everything you need to do?
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Bev
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Post by Bev »

The knee is doing great! I knew what I was getting into - had the other one done in 2007. I'm really glad people only have 2 of them!! It's still a little swollen & warm, but nothing I can't deal with. It gets stiff sitting in the same position too long, but I can always go for a walk at work - coworkers are way understanding. I'm looking for a gentle yoga class. I've done yoga off & on for years, but I just don't do well getting off the floor or kneeling anymore.

It's the bloomin' reactive arthritis that hurts so much. It started in my ankle (same side as the new knee) and has moved around. It's been centered at the base of my 2nd toe for the last 2 weeks, which makes walking difficult. I work at the U of WA which is a large campus. If I've got a meeting, it seems like it will always be 1/2 way across campus. Oh well, I hobble along.

I'll start the asacol w/ the sulfasalazine tomorrow. I'm really hoping this will knock out the ra.

Thanks for your input!!
Bev
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Post by Lesley »

LOL! I am always glad we only have one back! And had I designed us our joints would allow us to reverse front for back when either is tired.

The ra - also needs heat, movement and then ice. Also, elevating will help. I know it's painful. Is it cold where you are? Can you wear a shoe? Does a sock or shoe put pressure on it?
I know they are dichotomous, but rest and movement, warmth and cold are key in keeping pain down.

I lived in Seattle for 3 years and loved it.
Snohomish, cold and wet? Yes? Bad for arthritis. Keep warm.

I hope you feel better soon.
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Bev
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Post by Bev »

I like that reversible joint idea! Next time I'm down at the UW Med Ctr, I'll check in orthopaedic research & see if they can't come up with that for us - in the near future of course.

I have two pair of shoes that I can get into. My foot swells during the day and my shoe is pretty snug by the time I leave. I don't mess with it until I get home. Then I stretch out on the couch & don't budge until I go to bed. Since I get up at (groan) 4:00 AM and I don't get home until 6:00 PM, I don't get into projects, etc. The foot is at rest before the rest of me.

Snohomish is 40 miles NE of Seattle - the convergence zone = more rain and a little colder. I only get tired of 'dreary' & 50 degrees in May & June. I'm from SE PA, moved here from Colorado, moved to Colorado from Alaska... weather is a relative thing. ;)
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Post by Lesley »

That is a LONG day! WOW! Too much for anybody. No wonder your body is rebelling. You don't think it's telling you something?

Can you get a bigger shoe for the bad foot? Too give it some room to swell?
How much do you have to walk during the day?

Very relative. I now live in what one of my son's terms "weather heaven", and it is.

Up till the last year or 2 at least you didn't get snow. Now even that claim has gone north.
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