Always adjusting

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Taking Zantac continues to tamp down the nauseating side-effects of the Plaquenil I’m now taking for my rheumatoid arthritis. This is good.

There’s another side-effect, however–it’s a greatly decreased appetite and, I’m discovering, a decreased capacity for food. Not only do I not particularly want to eat (I’m simply not hungry), but when I do get hungry and eat, more than a little causes a vague queasiness that makes me wary of eating much next time.

I’m on the fence as to the good or bad of this particular side-effect. And it definitely is a side-effect: I was not experiencing any sort of appetite dampening (except that which I could effect by will-power alone) before I started taking Plaquenil.

Thus, while I’m pleased to announce that I’ve finally (!) dropped my weight into the 160s (!), I’m a little concerned about general nutrition in the process. The bottom has dropped out of my caloric intake. This is … good. I think. But it’s also, inevitably stressing my body. I had an appointment with a VA dietician the other day. She told me that to lose weight, I should be eating approximately 1,400 calories per day, preferably in complex carbs, lean protein, and lots of vegetables, and that I should resume walking at least a half-hour per day. While I haven’t counted my actual caloric intake since I started the new medication, I’m very doubtful that I’m even reaching 1,000 calories per day. (Achy hips, either from rheuma or bursitis, have been an excellent excuse not to walk, too.)

And even so … hello, 160s. I can see the 150s beckoning hopefully in the near future.

Of course I’m ecstatic to have finally broken that miserable 170s plateau, the one I’ve been stuck wandering up and down for months and months now, in spite of mostly mindful eating. (“Mostly” may well be the operative word, here, of course.) But I’m also well-aware that my body needs to be filled with the best, high-octane fuel I can give it. To that end I’m eating no “bad” foods. Everything that goes in is good stuff, food that my body can use the most efficiently. Now I just need to work out a way to force a little more of it into the tank.

I think I’ll switch to six small meals each day versus three larger ones. Perhaps my irked tummy will accept smaller quantities a little more often. It should work. The other hurdle I need to overcome is appetite. This is unfamiliar ground for me. I’ve never not had an appetite; being hungry didn’t matter. Now, I’m finding it hard to eat at all.  Not only am I not hungry;  the thought of food is utterly unappealing and nothing “sounds good.” But I’m working on that. My body is a complex engine. It cannot function on water and air alone. I can do this.

In the meantime, I’m very pleased that my clothes feel loser again, and that I can actually feel my hip-bones through the slowly thinning layer of fat that pads them. My behind is smaller. Most of my shirts seem to have grown a size larger overnight.

I’d like to be able to say that the rheuma has taken a powder along with the pounds, but so far, nothing has changed that way. It’s early days, though. Plaquenil can take months to show any real effect, so I’ll be patient. I’m grateful that, for the moment, my daily flares are staying mostly at the low end of the pain-scale; the few that reach into the middle of the scale are very short-lived. I want to believe that all of this due to the lower inflammation levels in my body brought about by a couple of years taking Arava and sulfasalazine daily.

Hope springs eternal. I’m enjoying this new, slightly increased lightness on my feet. I believe I can fix my current eating/queasy stomach issues. Now I just need to convince myself that my wee buddy Finny and I should take a good, brisk walk today. A half-hour’s worth. Surely my stupid hips can handle that.

12 thoughts on “Always adjusting”

    • Cathy — I really want the 160s to become the 150s, then the 140s, and then the 130s … and then? It would be nice to get back to the 120s, what I weighed in my 20s. 130 is my goal, though. It seems very reasonable. As for my present lack of appetite, if it is a transition, I almost hope it will last a while. Almost. Being healthy is more important in the long run. So we’ll see.

      SO glad you’ve been feeling so much better! I hope that continues for you, too. You have the nicest smile! 😀

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  2. I hate to admit it but I am almost jealous of your reaction to the Plaquenil. I have never been so “fortunate” to have even the ones that claim weight loss as a side effect actually do that.

    With that out of the way- I know it is miserable to have your tummy not welcome the sight of food at all. My sister recently (in April) had a gastric bypass. Though the idea is to lose weight (she’s down 82lbs!)-she is also at the point where the thought of food makes her queasy. To insure that she is getting her nutrition- she has been doing protein shakes every morning for “breakfast”. She has been taking supplements- and she has been doing just what you suggested- eating small meals throughout the day focusing on proteins through beans, eggs- anything that will give her the most protein per ounce. She supplements it with veggies and things like V-8 when the solids are not going to make the journey.

    If you don’t get any relief-email me and I will ask her for her tips beyond what I just mentioned. I hope beyond hope that the plaquenil kicks in soon so that you can at least have that to show for the journey.

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    • Jules–
      I’ve never had this reaction to any meds before, either! NSAIDs made my stomach hurt if I took them without eating first, but eating first generally worked. And I, too, am ambivalent about not having an appetite. On the one hand I’m delighted — it will make losing these last 40 pounds a lot easier and, probably, quicker. On the other hand I’m a bit worried. Rapid weight loss is unhealthy, and it’s also almost inevitable that I’ll put it back on, fast, once the nausea goes away.

      Thanks for the info about your sister. It’s wonderful that she’s losing that weight, but I sure feel for her, being queasy all the time. I’m glad that small meals, packed with protein, is helping. I feel better about trying this myself, now.

      My best wishes to you, my friend. I hope you’re able to work a little less and enjoy life a little more these days!

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  3. Hi Wren, I know just how you feel. I had this appetite loss thing with methotrexate and thought, ‘Oh well, at least I’ll lose some weight’. Alas, for me it was a transition phase, and didn’t last. Then again, you don’t want it to last if it means you’re not eating AT ALL! That’s NOT good!!! :o(

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  4. Well, congratulations on the weight loss. Some side effects can have benefits. Here’s hoping that your body adjusts to the new regimen soon and allows you to feel well enough to eat AND exercise! That’ll help those pesky pounds stay off. (I think I found them during my recent trip to LV…) All the best.

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  5. Hope the Plaq. works otherwise for you and that the appetite comes back. I don’t have those problems with it unfortunately! I do have nausea almost every morning but that is from stopping taking decongestants which appears to be helping with blood pressure but no fun upchucking every morning. I started Plaq. this summer. It seemed to be doing very well for me for a while. I even had a period where I did’nt wear my splints. But that changed over the last week or so. Weather was probably part of it and i had aching in many joints, but then wrists started feeling weaker and inflammed again. And getting that pain when you barely bump your hands against something is back. So we’ll see how it goes. I did read something not long ago that said perhaps Plaq. should not be taken after 5 to 7 years of being on it. Will have to see what develops from that.

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  6. Hey Wren:
    I had the same side effect with the plaquenil. I lost about 15 pounds — and kept it off while on the drug — but my appetite leveled off after a month or so. I was still rarely hungry, but the idea of food didn’t make me want to run and hide anymore either. So, hopefully something similar will happen to you!

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  7. I’m at the other end of what you have just started and if you can learn anything from my experience, I’ll share it. I have psoriatic arthritis with spondylitis. Mine affects mostly my left side and spine. Last fall I was also hit with trigeminal neuralgia which is a nerve condition in your face (the eighth cranial nerve). The meds for arthritis have never caused those side effects for me but I’ve been on sulfasalazine and methotrexate. Then I started topamax for the trigeminal neuralagia.

    The side effects for me were exactly as you have described. Not only was I not hungry but food didn’t look good, smell good or taste good. In the beginning it was hard to eat because of the pain in my face. Still food repelled me. I didn’t try hard enough to make myself eat because finally I was losing that weight and I thought it was going to so great for my joints. Then I became anemic and my labs got really out of whack. My rheumy really talked to me about what I was eating and nutrition. I promised to try harder. Now both he and husband are worried about me losing too much weight. And, my labs are still out of whack. And the side effects are worse. In addition to not wanting eating, I’m having diarhea if I do. My rheumy is getting me in to a new neurologist because he wants me off the topamax. If I had taken better care and worked harder to at least try to eat small meals, I might have avoided some of these things.

    Although we needs these drugs for the arthritis (and in my case a new condition), we need to really take care of ourselves overall so we can enjoy life and be there for those who depend on us. I forgot that for a time and was rudely reminded. Today I have honestly not been able to eat for the sickness it causes me. I can’t simply stop taking the topamax because it you don’t wean off of it, it causes seizures and I would return to the horrible trigeminal neuralgia pain. I hope to hear from my rheumy tomorrow with a new appt with a good neurologist to get this figured out.

    Please take care of yourself and discuss all these side effects with your nutritionist and rheumy.

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  8. I know what you mean about the nausea and heartburn with Plaquenil. I hate it and my vision issues but I have an appointment with my rheumy tomorrow and I will bring this up. I am not sure about the decreased appetite but then again, I was taking Lyrica up until recently, which made me gain weight. Don’t worry too much about nutritional if you are taking vitamins and folic acid. Our meds don’t help with weight loss and gain unfortunately but in my case, I have become less active but I am trying to get moving again. It is a challenge with pain but good for you with the weight loss. Good luck with the new medication regime.

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