NRAS
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Holidaying with RA- Sun, sea and Methotrexate

Hi everyone! This is my first post since joining :)

I have had problems with my hands/feet for a couple of years but have only just been diagnosed with RA in Jan this year on my 30th birthday. It was a big shock and has been an emotional time dealing with the fact i will be on this medication for life and how much my life has changed especially since starting the meds. I am currently on oral methotrexate 25mg, Sulfasalazine 2000mg, hydroxychloroquine and now down to 5mg prednisolone. I suffer from extremely bad migraines and other side effects from the medication some weeks better than others. But the inflammation/stiffness in my hands/feet/ wrists etc has started to improve.

My mum and I decided to book a holiday (as it has been such a tough time and she wanted to cheer me up) and I’m a bit nervous due to how vulnerable I am to infection and what if I get poorly abroad or if i get any new side effects. I know my skin has changed a lot already..will I burn more easily? Has anyone had any bad or good experiences from holidaying on all this medication? Or will the relaxation, sun, sea and sand do me the world of good? No cocktails for me of course :( xx

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I got diagnosed about 7 years ago and I’m about on the same drug dosage as you. Luckily it was caught early and thank goodness I’m in what is classified as remission. I still get occasional bad flares when I need a steroid shot, last one was about six months ago. But, touch wood😉, I have a reasonable active life as long as I pace myself.

As far as travel and hot weather. At the moment I’m typing this from a golf resort in Portugal. Temperatures are moderate about 20 degrees. In late December though I was in Abu Dhabi for a week and then Melbourne Australia where it got up to over 30 degrees 😳. That was brutal, but my wife’s fault as she wanted to go to the Australian open tennis 🙄😂. So advice? High sunfactor spray or cream. Hat. Loads of water. Cover up with light clothing. And if in doubt, leave your wife watching the tennis and head inside the air conditioned cafes or shops😉.

Enjoy yourself because a good restful holiday and sun makes you feel so much better.

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Ahh thankyou for a lovely reply. I must say I am looking forward to some time off work and some sunshine. Can I ask (if you dont mind) how long did it take for you to get into remission?

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Probably about six months before things properly settled down. Maybe 18 months before I got back to a ‘paced’ living and getting back to some fitness level. I’m 63 now, so we are not talking marathons or climbing everest😉. But some golf, walking and not impact gym type work. But, like I always say, I’m one of the lucky ones that had no side effects from the drugs.

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That is lucky and great that you are in remission. I think i’ll give climbing everest a miss too 😉 but getting back in the gym would be great...at the moment my hands and feet swell at the sign of any exercise. Walking to the train station every morning is hard enough- worst part is if I dont get a seat! :)

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Cheers. I had to give up playing squash, as the impact on shoulder and elbow, which was where my RA was worse, would cause damage. And in the gym I can’t use rowing machine, or anything that puts too much strain on my shoulders or elbows. And luckily, even though I travel a lot in my job, it’s not commuting. So mostly booked train seats or flights😃.

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Just go and enjoy yourself. Take reasonable care with hygiene and be careful of the sun, but otherwise enjoy!

I'm on metoject and am off wild camping in May. Can't get more bug prone than that! I'm just taking soap, and hand gel. :)

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Haha thankyou! Wild camping is that in the UK? Enjoy :)

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Scotland. I'll be eaten alive! One way of losing weight :)

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I'm also diagnosed 7 or 8 years and on same triple therapy as you are. It took maybe a year to feel that the drugs were working fully and another year to get into remission. So a slow process.

And yes I am much more sun sensitive. Factor 50 sun block, hats, loose long sleeved clothing and good quality sunglasses are vital. Eye drops might also be helpful if hot and dry. But it's not stopped be having holidays in hot places - I'm currently in south of France and it was 27 degrees today.

Swimming is good, relaxing is also good. But steer clear of holiday alcohol.

In 8 years on this combination I have had fewer colds, infections, viruses etc than my non-RA husband. Methotrexate only has a slight compromising effect on your immune system and if you take basic precautions then you should be fine. So wash your hands very regularly, and carry hand gel for moments when you can't wash your hands.

And enjoy your holiday!

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Thankyou so much and for being so positive. This is all so new and scary for me. Enjoy your holiday too! :)

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Yeah. It is new and scary. Been there had that when I was diagnosed. But patience, take professional advice. Pace yourself. And DONT GIVE UP! 😉.

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Thankyou x

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Hiya Harvey0279. That must indeed have been a shock, I'm sorry, but you're diagnosed now & on your treatment so hopefully you can look forward to being better controlled.

I think that's a lovely idea going away. It's true a side effect of both MTX & HCQ is photosensitivity, or sun sensitivity , so some care needs to be taken for the first few days where the sun shines brightest, you don't need reminding it's different. It depends on your skin too, how prone you were to burning before being diagnosed & starting your meds. It might be an idea to go up a few factors from your normal sun screen, just until you know how or if you react. Be mindful too at reapplying it if you're likely to be in & out of the sea or pool. Even be mysterious & beguiling, treat yourself to a wide brimmed hat! Oh & sunglasses too, lots of lovely ones out there at the mo. I always wear Ray Bans, the quality of the lens is important I find, a throwback from a side effect of HCQ.

I was diagnosed in Spain, people in the sunnier climes also have RD & take the same meds. Mine whilst there were HCQ & MTX plus NSAIDs & steroids & whilst there may something in that their skin may be more accustomed to the sun you'll still find this time of year they layer their clothes & wear lightweight cotton clothing to cover up in the hottest part of the day. HCQ did give me light sensitivity so needed to wear sunglasses more or less the whole year, no great deal there! MTX gave me no issues at all, even when getting my prescribed Vitamin D top up, no sunscreen for 20 or 30 mins depending on the time of year. Again though it could well be in the previous 6 years living there before diagnosis my skin was accustomed to sun most of the year, that & that I tan easily so don't have an issue burning. That is until I returned to the UK, the first summer I sat out in the sun on my iPad & burnt my legs, the first time ever I'd burnt. You can be sure I slap on the sunscreen now, even here.

Regarding being vulnerable to infection, no need to go overboard on DMARDs, it's more if you go onto anti-TNF's or biologics where more care should be taken, though some is still needed. Just be sensible, buy bottled water because you don't know where the tap water originates from, although in some places often it comes from the mountains & can be lovely unless you're used to it it can give you a gippy tum. Avoid buffet-type food, you don't know how long it's been out, especially if uncovered & particularly if the restaurant isn't very busy, though if it is the food turnaround will be quicker & so less likely to be carrying any bugs. It's just common sense really.

I take it you'll be buying holiday insurance? Just be sure it specifically covers all you're diagnosed with & any other medical history. Your EHIC too, always best to have that tucked away, could save a load of hassle if you should need medical attention. Hospitals in the more common holiday hotspots tend to be good nowadays, you'll probably find most speak English or if not will provide an interpreter. But you won't need to know that I'm sure. Many pharmacists, particularly in Spain, are higher qualified than ours able to treat common illnesses & prescribe as necessary so if there is anything you're concerned about it's always a good place to try first. Don't forget to take enough meds to cover your hols plus a few days extra just in case. I,d take the outer packaging too, even if you just pack them flat & band them all together, just in case you need any you can take the box to a Pharmacy, many meds are available to buy without a prescription.

Most of all enjoy, the warmth of the sun does you the world of good as does just being away relaxing. So do just that & relax. You'll be fine as long as you're sensible. Where is it you're jetting off to?

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Thankyou so much for such great advice. I just hope the migraines dont cause me to be bed bound whilst im away...but I guess laying in bed at home or a sun lounger makes not alot of difference. I am off to visit some friends with my mum in tenerife el medano a lovely quiet town so will be relaxing. Trying to keep up with work whilst starting all these drugs has been tough so no doubt a little break will do me good. As I keep seeing on here being positive helps ALOT with everything so trying my best to be. Its crazy how much my life has changed x

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Hi. Im on same meds as you except just been put on 7.5mg steroids for 6 months as still not in remission and diagnosed 18months ago. So im pleased it hasnt taken you a year to get on those meds.

Everyone on here is so supportive and very knowledgeable as you have read from the others on here.

Have a smashing holiday. 😎😎😎

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Hi I am a old but I have suffered very badly We hands feet legs etc I was only diagnosed 12years ago medication does help , but I find dry sunny weather aboard does me the world of good providing I use very high sun lotion, shower and plenty body lotion after , (as skin thins with this horrible R/A ) we wish we had moved to the sun years ago to later now , we never be able to afford healthcare, make sure you have good health insurance before you travel , good luck I feel for you , but don’t let the bugger get you down

Love Elizabeth (liggie)

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Thankyou Elizabeth for the positivity and great advice :) My skin is very thin too bruise so easily and everything takes forever to heal. I love a sunny holiday am now looking forward to it. Thankyou so much xx

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Hi, I am on MXT injections for 2yrs now, have been on a few foreign hols and have been fine, plenty of sunscreen, and you should be ok, don’t overdo sunbathing. The sun and warm should do you more good, so go for it.

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