Now that Cimzia appears to be working fairly well against my RA symptoms, I’d say I’m 60-70% of “normal”, various corners are being turned. TNF blockers like Cimzia don’t work for everyone or even over the long term for those who initially find relief from them (Enbrel stopped working for me). If I’ve learned anything from RA, it’s that change is inevitable. But for the time, I’m content with progress and I can say that Cimzia has given me a semblance of normalcy.
About a 1 ½ years ago, I started taking the lowest therapeutic dose of Celexa (20mg) (citalopram) for seasonal affect disorder. This is fairly common in Seattle given the 8 months of clouds/rain and the fact that the farther north you go, the less daylight there is in the winter (the converse is true in the summer…sun up at 5:00 a.m. and twilight lingers until 10:30 p.m.). Within four months of starting Celexa, I was diagnosed with RA. It seemed wise to stay on the Celexa during that stressful time. I also learned later that an increase of cytokines in the body from RA contributes to mental changes including brain fog and depression (see earlier post). For me, it seems that Cimzia is keeping RA cytokines in a state of check allowing for a decrease in both physical and mental RA-related symptoms.
The long term plans were always to get off Celexa within a year or so. Now that RA symptoms seem stabilized due to Cimzia, my doctor and I agreed that it was time to drop it. I’ve also made it a priority to drop as many medicines as possible…RAers are notorious for their long lists of medications and I hate being a walking pharmacy.
Unlike many other medicines, selective serotonin reuptake inhibitors (SSRIs) like Celexa, Prozac, Paxil, etc. can’t just be stopped immediately because they are believed to impact neurotransmitter chemicals in the brain. Thus, a slow tapering down is necessary. It took about a month to get off it completely. But the battle wasn’t over until my body made final readjustments. Once it started clearing from my body, the week from hell ensued and included insomnia, brain fog, nausea, migraine headaches that lasted for days, brain zaps, and constant dizziness. I knew this might come as there are studies documenting these discontinuation symptoms.[i] But, like the experts stated[ii], things got better after a week or so and it is great to be free of one more medicine. Another corner turned in the battle against RA.
Another series of many small turns were made this President’s Day. I took the kids snow skiing. This was only the second time I’ve attempted to ski since the RA diagnosis (see earlier post). The skies were blue, the snow fluffy, and a blast was had by all. By mid afternoon, my right knee was making it clear that it had enough turning for the day. An MRI several months ago revealed torn cartilage on the interior side and the outside part of the joint is also now hurting. I suspect that a knee replacement will be in store someday (as does my orthopedic surgeon). But I’m not going to let that slow me down now. And I’m hoping that an artificial knee will be even stronger on the slopes!
Who knows what other turns life will bring? Whatever they are, it will be an adventure.