shellbones

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  • June 4, 2012 at 7:39 pm

    Bny,
    I am glad you are feeling better! Would you believe as I write this I am fighting a cold too? Started on Friday – I have been using zinc lozenges and drinking gallons of tea but having a lot of sinus and ear pain setting in- trying to avoid antibiotics . On the plus side, since I have been on the Imuran although I am a bit more prone to colds I no longer have major relapses when I get sick . Dick S I love your quote about the dog and the hydrant – I needed that today!

    June 3, 2012 at 12:01 am

    I am sorry to hear you are struggling right now! I share the concern of previous posters that if there are any issues with breathing or heart rate you should seek medical attention immediately- I have been where you are and had many relapses due to colds/infections – some I was hospitalized for as I would get short of breath and rapidly lose ability to walk and some were dealt with as outpatient getting 5 day loading doses of IVIG ( in addition to my maintenance IVIG) not fun! Also one time I had a relapse we were traveling in Jackson hole and Yellowstone ( with a cool 3 wheeled wheelchair no less) and I used a high dose prednisone taper as an emergency rescue. I do not tolerate the side effects well and do not want to use long term, but it works very quickly for me and is helpful in a pinch- – have your doctors tried you on prednisone or solumedrol ever? I am thinking of you and wishing you well.

    May 16, 2012 at 11:35 am

    Add me to the list ! I have mixed connective tissue disease, lupus, bechets vasculitis, and CIDP.

    May 14, 2012 at 11:39 am

    To add to the stories of atypical tests, my normal nerve conduction studies did not reveal demyelination but when they did nerve root testing, they found the conduction block ( evidence of demylenation) – it was because it was high up in the proximal nerve root that is was missed on testing of the lower part of the nerve. Not all neurologists are able to do this apparently requires special training and it is very painful to have done! Aslo like MarkEns pointed out , inflammation is a huge component and in fact if any of you have had MRI looking at your nerve roots, you can see the swelling and this is used as one of the criteria to support diagnosis. Fred, I am glad to hear you are responding to therapy!

    April 26, 2012 at 11:55 am

    I am so glad you had a good response to your treatment- it is a long day- I can only go to 60 ccs/ hour. Luckily my infusion center is only 20 minutes drive . My reflexes are pretty normal now – the only time I lost them is when I was first hospitalized/ diagnosed with GBS at this point I was essentially paralyzed from chest down could not move legs and could not walk- since then have never gotten that weak again ( have been treated for relapses) and have not lost reflexes again. My neurologist jokes that my reflexes are mocking him. In terms of skin I do get weird rashes from time to time. Don’t forget your skin is your largest immune organ and people with autoimmune disease get all sorts of weird rashes . Add to that the meds which can cause rashes- I get something called solar urticaria which is like hives from the sun . I feel like living with autoimmune disease including CIDP is like a the line from Forest Gump- its like a box of chocolates- you never know what your are going to get! Hope your good days keep coming.

    April 20, 2012 at 11:40 am

    I had treatment yesterday too! I hope the new schedule helps- how are you tolerating treatments?

    April 20, 2012 at 11:37 am

    Thank you for sharing- I was diagnosed in 2008 and am in the process of slowly weaning down ivig dose ( currently on every 10 days) next step every 2 weeks. Spent last night in bed with terrible migraine after IVIG yesterday and would love to be free of it! I am also on an immunosupressant ( imuran) – Did they try any immune suppressants in your case? Keeping fingers and toes crossed for you!

    April 17, 2012 at 8:48 pm

    I am glad to offer my experience in the hope that it helps others! I am glad you are getting more frequent IVIG- Hope it helps – keep your eye focused on the long game even if it means you have more stuff to deal with in the short game- you are trying to prevent long term or permanent disability and this is the goal of aggressive treatment and it can be done – CIDP is a tough opponent but don’t go down without a fight- my doctors have always laid out a goal of normal or as near normal function as possible not a goal of fair or moderately disabled – it sounds like you have a good team who are listening to you – it is an art form and requires good two way communication.
    I had terrible abdominal pain and cramps from cellcept, stomach pain , nausea , dizzy and terrible insomnia like the worst I have ever had- absolutely exhausted but unable to sleep (not usual for me)- I stuck with it 3 weeks but side effects were not going away
    Plaquenil causes increased sun sensitivity which can be both rash, itching and burning
    I think getting IVIG offsets immune suppression from Imuran a bit – it gives you some passive protection from infections ( not all but some) keep the questions coming!

    April 17, 2012 at 11:54 am

    Hi there- hope you are feeling better and sorry to hear you are still having ups and downs- It took very aggressive IVIG for that pattern to stop for me ( weekly) – to answer your questions about imuran, I was still getting weekly ivig for the first 10-12 months of treatment and my symptoms did slowly improve but also helped stopped pattern of relapses. I did try cellcept but did not tolerate it due to side effects in my case. I don’t stay out of the sun per se, but live in the great lakes region and we don’t get a lot of sun here- when I am in the sun I wear a hat and sunscreen – more for the plaquenil than the imuran. Don’t apologize for your questions- the more you know the better! Take care

    April 13, 2012 at 12:24 pm

    I fought going on partial disability for over a year and after my third relapse I finally realized that I was not doing myself a favor by trying to to “everything” – I think many women have this mentality of doing it all- I also love my work and spend many years in school to be able to do what I do- I finally came to the realization that I was hurting myself and indirectly everyone who depended on me by putting myself at risk by not really honestly dealing with the cidp. Fortunately my work disability policy has a partial disability clause so I could continue to work at reduced hours and the policy fills in the missing income. My policy did require that I stayed out on total disability for 6 months before being eligible for partial disability ( weird huh?) Many policies are written that way. At first I was like a lost puppy, but then I actually started to heal once I gave my body the rest it needed and was able to engage in physical therapy etc. I think it is worth exploring for you –
    In terms of Imuran it did not kick in until about 9-12 months – I work around sick people all the time on Imuran so far no major issues but I am on a low dose – I do get sick when my kids are sick however but can’t avoid that! Hang in there !

    April 1, 2012 at 1:37 pm

    Hello again- to try and answer your questions I started Imuran about 18 months after my initial dx of CIDP due to needing IVIG every 7 days it was very difficult to maintain that schedule and I was still getting relapses – the hope was the imuran would stop the relapses and allow me to extend ivig- after 1.5 years on Imuran I can say that I went a year without major relapse and am now getting IVIG every 10 days- I do have a lot of fluctuation of my symptoms with good days and bad days for sure- at some point I will probably try to go every 2 weeks with ivig- not sure when .
    you mention feeling callous on your fingertips that can def be from raynauds – typically scleroderma causes swollen tight fingers that they call sausage fingers. I don’t know if I would call myself a success story as I am not cured but I am living with it and able to lead a fairly normal life – I have not given up hope of cure but for now I am not a candidate for stem cell as I am not weak enough – I am interested in sq ivig to get better control of symptoms – I might pursue trial being done in NYC at weill medical center – not sure if I am a candidate as my other autoimmune stuff may eliminate me –
    When I first got diagnosed and started treatment the CIDP dominated my life physically, emotionally – now I still have to deal with it but it no longer dominates me- it is just a part of my life that I have to deal with and I refuse to let it win- you will find balance in time and I hope they find a regimen that works for you with the least impact on your life
    I did get the biopsy for celiac ( done through an upper endoscopy of the stomach) which in my case was negative.
    I feel for you with young kids- my kids are older now teen and pre teen – I don’t know how I would have handled toddlers! I cannot emphasize how important rest is- Do you have a disability policy through work? Many policies have partial disability that let you keep working and make up for lost income from reduced hours- not sure if doctors can give note you your employer to say you can’t work overnights? I fought it for awhile but eventually went on partial disability- now work about half my previous hours and I wish I had done it sooner- it really helps to be able to self care. Hang in there!

    March 30, 2012 at 9:35 pm

    ps- I have a port too- love it ( as much as you can love a port!)

    March 30, 2012 at 9:33 pm

    hi there- I am so glad you got in to see a Rheumatologist- I have been on plaquenil for about 6-7 years- I was taking it for possible bechets ( an autoimmune vasculitis) and inflammatory issues which were not fully characterized – then cidp started almost 4 years ago ( as with you considered atypical) saw neuro and rheum at Mayo clinic at this point only on ivig – this past year at my follow up at mayo I was found to have high ANA and RNP antibodies- along with joint pains and new raynauds- so now rheum has dx with mixed conn tissue disorder which is an overlap syndrome with features of many autoimmune diseases such as lupus, Rheum arthritis, sjogrens and scleroderma. I don’t know how this ties in to my cidp except that they are all autoimmune and that my cidp responds to IVIG- so I am currently on IVIG 20 grams every 10 days, Imuran 50 mg per day, plaquenil 200 mg per day and fish oil and a few vitamins. It seems my immune system is just looking for trouble- the plaquenil is very safe and side effects not bad and does not make you more susceptible to infection- helps the joint pain and fatigue a lot! I feel for you as you are going through so many of the things I did- I am still here and living a decent quality of life – pay special attention to getting rest ( not easy with kids I know I have 2) sleep deprivation is the worst and a natural food diet helps too- try gluten free sometimes that helps people feel better as well- I will go back to mayo for follow up this fall for both neuro and rheumatology- let me know if I can answer any more questions!

    March 24, 2012 at 3:36 pm

    Hi Lori- in answer to your question I don’t know what the endpoint is for me as far as Imuran is concerned. Remission to my understanding is when disease is no longer active but not on any treatment- If you are on treatments like IVIG or immune suppressants, then you may have controlled but active disease if still requiring treatments. One can either go into remission on their own or with the help of remission inducing agents like Rituxan. I have been told and read that ivig is not considered a remission inducing agent due to the mechanism of action in blocking the effects of the so called ” bad antibodies” produced against peripheral nerve myelin, but does not limit the production of these so called ” bad antibodies”. Immune suppressants actually work on decreasing the production of these antibodies. I do not believe I am in remission as I still have symptoms and require regular treatment. I believe the plan for me is to slowly wean down on ivig and if I ever get to a point where I am off completely , a decision would be made about what to do with Imuran at that point. It is hard to balance trying to live one day at a time and considering the future and all of the implications there.

    March 22, 2012 at 6:13 pm

    Hi Lori- Hmm you raise a lot of good questions- I have so far only seen case reports of PML with azothioprine ( Imuran) and usually when used with other immunosupressives – I don’t believe it carries a specific warning by the FDA but theoretically can cause – I also looked up info about the blood test- it was developed for patients with MS who go on an agent called Tysabri which is associated with PML- it is a blood test to look for antibodies to see if you have been exposed to the PML virus ( called the polyoma virus) that can become active when you are immune suppressed- they use it in patients who are considered at high risk of this before starting Tysabri – it was just approved by the FDA and not sure if available yet . the plot thickens yet again! I have a friend who is on Rituximab finishing a protocol of every 3 month infusions and also received cytoxan for a hematologic disease and has done very well works full time no issues except occasional sinus infection. I learn so much from everyone on this forum-