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Anyone know about latent TB and immunosuppressive drugs Options
gogs
#1 Posted : Saturday, November 23, 2013 4:19:36 PM Quote
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Does anyone know anything about latent TB, i.e old scaring on the lungs from exposure to TB earlier in your life.
I understand that there is the potential to re-activate the TB from this scaring when on immunosuppressive drugs.

Gogs
Paul Barrett
#2 Posted : Saturday, November 23, 2013 5:01:11 PM Quote
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This site talks about it.

Although it describes secondary TB as a potential for re-awakening in the previously infected and immuno-suppressed, the article does not even mention it in the risk factors section. Is that because the risk is so low as to not merit a mention? Who knows. Another one for your rheumy team / GP perhaps Gogs?
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
gogs
#3 Posted : Saturday, November 23, 2013 7:46:12 PM Quote
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Thanks Paul - it comes from the consultant this latest.

I looked at the site you found and it does mention latent TB, although as you say the word immunosuppessive
isn't in the writing. I understand that if I have been exposed to TB in childhood (not necessarily had it!) then if I test positive
it produces more problems relating to drug management.

I've just started Leflunamide slightly under three weeks ago and have had no side effects. I was so delighted after my past
drug experiences, I understand this could affect what they can give me, and perhaps needing to stop the steroids and immunosuppressive'sThumbDown

Gogs
Kathleen_C
#4 Posted : Sunday, November 24, 2013 7:38:25 PM Quote
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Hi Gogs,

I do know that before going on to a biologic therapy you have to have TB immunity - they simply test you. If you aren`t immune, there is a course of medication they can put you on, but I`ve forgotten the name. Someone I met at my rheumy clinic had this happen to her.

Kathleen x

gogs
#5 Posted : Monday, November 25, 2013 6:35:42 AM Quote
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Thanks Kathleen.
This game is one step forward and ten back!Sad
I'm going to the chest clinic today for review and will put the question to them, I'm also due another lung function and high resolution CT scan (HRCT)
so that should hopefully help to clear things up a little.

I was certainly exposed to TB as a child although don't remember actually having it.
The memory I have is of going to a hospital. The building was shaped like a boomerang, one ward up and another down on each side of the shape.
In the main door was a corridor on either side with a central office. All the beds were in cubicles off the corridor. The other end of each little room
there were patio doors and these opened out onto a concrete terrace - and this was were the fun started!LOL

All the children would be pushed out in their beds, wrapped up in coats and hats with mackintoshes over their beds to keep the snow offSmile
I remember jumping over or on the beds, playing snow ball fights and generally having a great time. Nurses I think would come out complaining
the beds were getting too wet etc. As someone who wasn't in a bed I had the advantage of hiding under the beds when someone was throwing at me.

That was TB, it was fun! Who took me there, how I got home afterwards, I don't remember, but the fun was amazing.BigGrin
Gogs
Kathleen_C
#6 Posted : Monday, November 25, 2013 4:14:13 PM Quote
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Ah, but they didn`t have "elf n` safety" to contend with in those days!! No snowballs now - far too dangerous!!


Hope your clinic visit was OK.

Kathleen x

gogs
#7 Posted : Wednesday, November 27, 2013 7:28:15 AM Quote
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Hi Kathleen,

So true - no 'elf' and safety in those days, ahhhh what blissSmile

What a day at the chest clinic I had!! First the consultation and a long chat about latent TB, Then off
to lung function who agreed to test me that day (nice of them). Then blood test for TB and finally back to
the consultant for another discussion. Three and half hours in total!!

The upshot is my lungs have shown a slight deterioration from last year (I knew that). The walking test showed
reduced oxygen after 6 minutes. The blood test results will take two weeks to come through, any possibility of TB
and I will have to have six months of treatment and sadly perhaps change the drugs I am on (no probs with them)Sad

He also mentioned a further scan in six weeks, and the possibility of a lung biopsy.

So I'm in the lap of the gods at present, but the outcome could still be favourableThumpUp

One of my present drugs is Leflunomide which I think causing a rise in blood pressure - more treatment!!

This is a laugh a minute if you don't weaken.

Gogs xx
gogs
#8 Posted : Sunday, January 26, 2014 4:09:40 PM Quote
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Hi Everyone,

Just back from my sunny holiday -and looking tanned!!!!!LOL
It was great for R&R, but due to the fact I developed a slipped disc just before going away,
for which I was in a lot of pain, it meant that we couldn't do as much walking as usual.

I was initially having physio at my local hospital - but it was less than helpful. I'm now going to someone
private who appears to be very good at her job - but I do need her to reduce the pain in my neck and I'm on
a very short fuse with the constant horrid pain!!Sad

I resurrected this thread as I have now had it confirmed I need treatment for Latent TBThumbDown
That's a bit of a blow as I'm only on sub-optimal RA treatment at present and will have to stay that way
for the next six months. Both these drugs are hepatotoxic - Isoniazid and Leflunomide.

Normally I'm full of life when just back from holiday and buzzing with energy - not now. I'm totally fed up and despair
at ever being pain free. Driving the car with my stiff and painful neck is horrendous, and there's only me as I'm
my husbands carer.

I'm feeling really sad and fed-up with everything.

GogsSad
Paul Barrett
#9 Posted : Sunday, January 26, 2014 4:21:59 PM Quote
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Sorry to hear that you are feeling low and that you have slipped a disc and need the latent TB treatment. What a catalogue - poor you.

But pleased to hear you have had some R&R. Where have you been?
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
gogs
#10 Posted : Monday, January 27, 2014 11:10:38 PM Quote
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Thanks Paul,

We went to the Canary Islands, it was my first time and I thought it was lovely.
We went to La Palma.

I spoke with my consultant yesterday and she suggested I up my steroids for three days just in case there's some RA in my neck.
It means I have to wait to start the TB therapy, what she didn't say was - if the steroids are effective then do I stop them again to start
the TB therapy!!Confused

Gogs
Kathleen_C
#11 Posted : Tuesday, January 28, 2014 2:59:40 PM Quote
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So sorry to hear this Gogs - you really didn't need anything else to contend with. I'm glad you had some heat on your holiday, and hope the extra steroids help your neck. Hopefully the TB treatment can follow.

Take care,

Kathleen.x

Angiecha
#12 Posted : Tuesday, January 28, 2014 3:58:33 PM Quote
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Deary me - you don't do things by halves do you Gogs.

Really sorry to hear of the added troubles but so glad you had some much needed R&R. It's lovely just being away from the everyday activities and in the sun. Extra vitamin D!

Love your story regarding your TB experience as a child. I've seen reports of that treatment but never encountered anyone that's experienced it. Children can make the most of things can't they. If only you could bottle their resilience. Make a fortune.

Hope you get sorted sooner rather than later and look forward to your updates.

Angie Tongue
Be yourself - everyone else is taken. XX
gogs
#13 Posted : Tuesday, January 28, 2014 5:05:37 PM Quote
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Thanks so much everyone for your support - desperately needed.

I have been taking the increased steroids now for two days and the neck pain has reduced by about 50%Smile
Guess that means I have RA in my neck. I went to the physio again yesterday and she once again reiterated that I had
a really nasty neck that needed handling with great care - which she does and did. Today when I went out in the car to the Opticians
I found I could turn my head without shouting out in pain - boy did that make me happyBigGrin

I will contact my consultant again on Thursday to ask her what I should do next i.e reduce the steroids and start the TB treatment
or stay on the increased steroids and start the TB drugs as well.

Thank you all again for your very kind support, I do get very low and despairing some days, then tell myself offHuh
Then I come on here and get supportLove

Love Gogs xx
Paul Barrett
#14 Posted : Tuesday, January 28, 2014 8:13:00 PM Quote
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gogs wrote:
I have been taking the increased steroids now for two days and the neck pain has reduced by about 50%Smile
Guess that means I have RA in my neck. I went to the physio again yesterday and she once again reiterated that I had
a really nasty neck that needed handling with great care - which she does and did. Today when I went out in the car to the Opticians
I found I could turn my head without shouting out in pain - boy did that make me happyBigGrin


It might actually be wear and tear rather than RA. Your symptoms sound very much like mine from 3 or 4 years ago. I had a prolapsed disc at C5/6 and another at C6/7. The pain from it was excruciating, and the muscles in my neck and head would go into spasm as a way of protecting the joints. I overcame it by having an ACDF operation to fuse the joints, since when I haven't looked back, or rather I can now look back without it killing me. BigGrin

So you might need a neuro-surgery consult rather than a rheumy? You might want to have a chat with your GP about it.
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
gogs
#15 Posted : Tuesday, January 28, 2014 11:11:12 PM Quote
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Thanks for your alternative view on this neck problem Paul.

I do have prolapsed discs at C3/4, C5/6 and C6/7 but was given to understand that pain killers and physio
would resolve the situation. The initial physio was as I previously said - useless. My present physio is great, I've
seen her only four times, three the first week then after my holiday I again saw her yesterday. I also was given a cocktail
of tablets off my GP which though zonked me out really controlled some of the pain, but these were essentially for the prolapsed disc at L3/4

I had last October mentioned to the consultant did she think it might be RA in my neck, but she said no.
But then the same as all of us I suppose she had a re-think, especially as it has gone on for so long, and the back has almost cleared up in six weeks!

Thanks again Paul for your input, I'll keep it in mind but I doubt if anyone would consider anaesthetising me at present, nor would I
want to embark on anything else.

GogsThumpUp
Angiecha
#16 Posted : Wednesday, January 29, 2014 9:06:26 AM Quote
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Gogs/Paul

Are the prolapsed discs anything to do with RA or are they from other activities/health issues?

Angie
Be yourself - everyone else is taken. XX
Paul Barrett
#17 Posted : Wednesday, January 29, 2014 9:51:09 AM Quote
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Angiecha wrote:
Gogs/Paul

Are the prolapsed discs anything to do with RA or are they from other activities/health issues?

Angie


They may be linked to RA but they are osteo based.
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
Paul Barrett
#18 Posted : Wednesday, January 29, 2014 2:56:28 PM Quote
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Hi Gogs

OK so if you want to use a physical therapy route to treat your prolapses you should talk to your physio about traction. Mine recommended a device that sounds a bit like something from the chamber of horrors but actually was very beneficial. It is a home traction device. Basically there is a hook that fits over a door. You sit in a chair with your back to the door. A harness goes on you head and is attached to a thin rope that goes through the door bracket and back down to your hand. You apply traction by pulling gently on the rope. It stretches your neck and reduces the pressure on the prolapses. It sounds horrid but is very effective. You do it a couple of times a day for about 10 minutes a time.

It works well and is a source of amusement for other people in the house.

But as I say - something to talk to your physio about to make sure they are happy for you to do it.
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
gogs
#19 Posted : Wednesday, January 29, 2014 10:34:33 PM Quote
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Many thanks for that info Paul, I will certainly talk with my physio about it.

I've just had an email from my consultant who said she would phone me at home tomorrow. When you mentioned wear and tear on the neck
Paul I would agree that will be there as well, but one thing is certain - steroids have no effect on OA that's why they are not used for the wear and tear
arthritis, only RA is affect by the use of steroids. It was that that made me think there is also RA in my neck.

And yes Paul, I will speak with my GP next time I see him.

Many thanks

Gogs
Paul Barrett
#20 Posted : Thursday, January 30, 2014 11:23:59 AM Quote
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gogs wrote:
... but one thing is certain - steroids have no effect on OA that's why they are not used for the wear and tear
arthritis, only RA is affect by the use of steroids. It was that that made me think there is also RA in my neck.
Gogs


Perhaps there is some secondary tissue inflammation that was causing pain that the steroids reduced? I don't know, but I do recall my entire neck was sore right up the back of my head, down into my left shoulder too, and it also caused pain and tingling down my arms and into my hands and fingers. It was a surprise (unpleasant) to me just how far the effect of two small prolapses extended. Sad

No sooner had I had the op to sort it out than the RA kicked in with not dissimilar symptoms. For a while we thought the op had failed - but no 'twas a separate condition.
Paul Barrett

Hexham - Northumberland - Loads of spectacular walks - all I need now are the joints to go with them! :)

Enthesitis (2012)
Ulcerative Colitis (1990)
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