Fairly new RN with newly diagnosed RA

[lilpsychRN2017]

Hello everyone!

Quick introduction before I go into my question-I have been an RN for just over a year and a month now (4 months of med-surgical and then transferred to mental health which I am currently working). I absolutely love it despite some of the issues we are having lately on my unit such as poor morale of some and chronic understaffing, but this is where I wanted to be and I am not going to let anything stand in my way of finally being happy and comfortable where I am at. =)

Ok so if I am so happy and thrilled, what brings me to this forum? Well, a couple of years ago I noticed that I was abnormally tired and feeling a lot of chronic pain in my joints (mainly my hands). Honestly looking back it should have been a red flag to get at least some testing done as RA and Psoriatic arthritis run in my family but yet I always had some excuse..."I am working a lot and I am just tired." "I am in nursing school and working, of course I am sore and tired." "I don't want to be a hypochondriac." "I am on night shift, my body just hates me and can't adjust." Well, after being in my current position on 2nd shift and having a somewhat normal schedule (3-11) and being comfortable, I finally ran out of excuses and was finding that these symptoms were not going away but getting worse. I finally got myself a doctors appointment with a primary care provider who was awesome and listened to my concerns and agreed to test me for RA and other issues. Turns out blood tests came back positive for RA (rheumatoid factor and other indicators) and off to the rheumatologist I went a few weeks later (about 3 weeks ago). I was put on oral methotrexate and meloxicam and by x-ray was found to have signs of bone erosion in my hands (I am almost 29 years old for reference). I am struggling to get this medication to a point where I can tolerate it with minimal issues but I know that is going to be a few weeks and to where I can actually see results as far as pain goes.

So now knowing all of that information, I was wondering if you guys had any advice or tips that work for you as far as keeping comfortable at work. I work on a pretty busy psych unit with patients that keep me moving so any tips on finding relief would be appreciated. Thanks!!!

[poppycat, ADN, BSN]

I was diagnosed with RA just over 6 years ago at the age of 54. The rheumatologist first put me on methotrexate but I had bad side effects from it so I was taken off it after only 3 weeks. At that point she put me on Plaquenil & Enbrel. Currently I take Plaquenil & Orencia as well as Meloxicam.

My best advice is to listen to your body. I still have a lot of fatigue so I rest when I need to & don't push myself to try to get everything done at once like I used to.

[Tiffilynn1]

I could not tolerate oral methotrexate at all. I had better results with the injectable. It might be an option for you to try. If that still causes side effects that aren't tolerable change to a TNF or biologic. Get this wildfire under control. Gentle hugs to you. ❤️

[Me2kuul, ASN, BSN]

Hi! I'm 30, and have had RA since I was 11. How do you like psych nursing? Is it easier on your body? Night shift, and PCU nursing almost killed me. Pediatric ICU was easier on my body, because the children usually weighed less than adults, but working 12-14 hour shifts was ruining my joints, and most of the parents were abusive. Oral methotrexate had worked for me until I turned 29. The Rheumatologist placed me on Enbrel for a while, and I developed every respiratory infection you can think of. lol Then I tried Cimzia. Cimzia restored my energy, and I did not even feel like I had RA. Then, I had blood in my urine, bilateral leg edema, and a total-body super fungal infection. The Cimzia had caused an acute kidney injury. Hopefully, you can find a medication regimen that works for you without too many side effects.

Tips to survive as a nurse with RA:

1) Remember to pace yourself.

2) Sleep as much as possible.

3) Sit down as much as you can during the shift.

4) Night-shift is not your friend, and will probably make your symptoms worse.

5) Your meds and your disease will make you immunosuppressed, so always get your flu vaccine, and wear a mask when possible.

6) Ask for help when lifting objects or moving/restraining patients.

Over the past 6 months, I started eating less red meat, and fatty snacks, and I started consuming ginger, vitamin C, garlic, elderberry, fish oil, vitamin D, b12 complex supplements, and the occasional mutli-vitamin. My doctor was shocked at my most recent lab values. It seems like my dietary changes have thrown my disease into remission. When I eat like crap (burgers, potato chips, McDonalds) my RA flares. What works for me may not work for you, but try slowly incorporating some of the supplements into your diet that I mentioned. Good luck!