Arthritis and the Fine Art of Germ Avoidance. ll

Posted on 20 May 2010


Sick Anyway

Okay, so what if you overcame your needle phobia and got the flu shot, alienated all of the shunned sick people in your life, scrubbed your hands scaly, lived like a well-nourished hermit and you get sick anyway?

Hey, it happens. None of us are bulletproof, especially those of us with ignorant immune systems.

And those of us with the aforementioned immune systems need to take extra care when we do get sick. Many felonious bugs elude scientists and refused to be identified, so for practical purposes, I’ll divide the next section into caring for colds and flus. First of all, which do you have?

May include some or all of the following symptoms:

* lasts 2-14 days
* nasal congestion/sneezing
* sore throat
* dry cough
* mild fatigue
* slight fever

May include some or all of the following symptoms:

* can last up to 2 weeks; fatigue can last for several weeks
* nasal congestion
* sneezing
* sore throat
* dry cough (more severe than with cold)
* aching muscles
* severe headaches
* extreme fatigue

There is a commercial that illustrates the difference between a cold and a flu with images of a gentle rainstorm (cold) to a hurricane (flu). Even so, medical advice is pretty much the same for both:

* Drink plenty of clear fluids.

Dehydration can occur more quickly than you think, especially if you have a fever. Drink more water than you think you need and avoid caffeine.
# Rest.
Rest is an ambiguous term (there was a time when I would interpret that to mean cutting back on one of my three jobs), so I’ll let the medical establishment spell it out: STAY IN BED AT LEAST ONE FULL DAY. Those of you still living in the real world with troglodyte bosses and mortgages to pay are sneering, so I’ll amend that to: AT LEAST GO STRAIGHT TO BED AFTER WORK. There…is that better?

# Use OTC meds for comfort…carefully.
Tylenol and its ilk are a godsend for various aches and pains, but please be careful. Even the most benign-sounding drug is still, in fact, a drug and should be respected as such. If you are taking prescription medication for your arthritis do not take anything without your doctor’s permission! Think I’m being paranoid? Okay, how about this: there is some evidence that ibuprofen should not be combined with methotrexate. Apparently, ibuprofen can raise the level of methotrexate to toxic extremes. Make friends with your doctor’s nurse and call before you take anything not approved by your doctor.

Inhale hot steam.
A nice hot bath or, better yet, a steamy shower will relieve your nose and head congestion, which may accelerate the healing process. Humidifiers and vaporizers work, too, but there is some controversy that bacteria can become trapped within, which could actually make you sicker. Ask your doctor.
# Avoid tobacco.
All of you smug (albeit, smart) folks who have never smoked are probably saying, “Jeez, this chick has a gift for the obvious.” True. But as non-practicing tobacco junky (I won’t say ex-tobacco junky because I still want to smoke. Sheer willpower and blackmailing children prevent me), I understand what it is like to crawl on my hands and knees from the sick bed to an ashtray. If you can’t stop completely, at least try to keep it down to 5 or less a day.
Okay…Real Sick, Now

There is some controversy as to whether methotrexate leaves you more vulnerable to colds and flus (of course it does, you scientific nitwits!); however, there is no question about the dangers of Prednisone, Remicaide and other cytotoxic drugs. If you are taking any drug that suppresses your immune system, never ignore persistent symptoms. You are more susceptible to infections—especially of the lung—and the same drugs that help you function can impair your ability to heal. Don’t ever be afraid to “bother” the doctor with seemingly minor symptoms. Studies show that “good patients” (friendly, compliant, hesitant to speak up or complain) have poorer prognoses than pain-in-the-butt patients who advocate for their rights and their health. Don’t be an arthritis wimp…raising a little hell may keep you out of the hospital.

(Note: the following advice is intended for healthy people…those with dysfunctional immune systems should report troublesome symptoms even sooner).

When to Call the Doctor


* if it lasts longer than 2 weeks
* if you have an earache
* if you have sinus pressure
* if you have a fever over 100 degrees Fahrenheit (could be an indication of infection)


* high fever
* chills
* yellow-green mucus
* difficulty breathing
Please, please don’t ignore this symptom, particularly if you are taking methotrexate and Remicaide. Both drugs make you more vulnerable to pulmonary disease…and people still die from pneumonia in this country. To illustrate my point, my doctor (after chiding me for not reporting a month-long bout of the flu) told me about another “good patient” of his who ignored a persistent cough for a few days because she didn’t want to use up her sick leave at work. She ended up having a nice, long vacation under an oxygen tent. It was months before she was well enough to take care of herself and she may have breathing difficulties for the rest of her life. You’re not being silly, you’re not a hypochondriac and it’s not your imagination: if you are having persistent symptoms—especially any type of chest pain or impaired breathing—call your doctor.

The Tao of Dealing With a Recalcitrant Immune System: A Modern Metaphor

I’ve noticed many similarities between my wayward immune system and my teenage daughter. They’re both moody, capricious and cause me a great deal of anxiety–and yet, they are not without their good days. As with raising teenagers, we of the weak immune systems have to perform a balancing act of knowing when to restrain and when to let go.

Let’s just hope that my immune system makes better grades and doesn’t try to date Goth stoners with bad personalities.

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