Tom's Story and Brand Name vs Generic Minocin

[Guest guest]

I have been a long time member of this chat list since being diagnosed with RA

in 1998 and a lurker only posting a few messages or the 10 year period. I was

diagnosed with RA in the fall of 1998. Since I new nothing of this disease I

searched the internet and came across the rheumatic.org website. I was convinced

that RA was due to an infectious agent since I had multiple joints affected -

both shoulders, elbows and wrists, in a very short time. I am also a large

animal veterinarian so being expose to a vast variety of infectious bacteria was

a daily occurrence. Thanks to the website my family physician, who was also a

client, agreed to subscribe minocin 100 mg twice a day, as well as voltaren an

anti-inflammatory. I was also referred to a rheumatologist in Newmarket Ontario

but had to wait 3 months for the appointment. Over the next 6 months I had

multiple joint injections of cortisone in both shoulders, elbows and wrists to

reduce the inflammation and relieve the pain. I also had to leave large animal

practice due to this depilating disease and returned to university to get an

MBA. Over the next two years I was able to gradually reduce the daily

anti-inflammatory pills to the point of stopping them and decreased the minocin

to 100 mg daily. By 2000 I considered myself in remission with my RA factor

being slightly above normal. From 2000 to 2008 I would see the rheumatologist

once a year and would vary my minocin dosage until I found that 100 mg Monday,

Tuesday, Thursday and Friday was as low as I could go before feeling mild

stiffness.

Last year I went through one of my worst flares since being diagnosed which

affected my feet - something that was new for me, and my right wrist. I went

back on anti-inflammatory - Celebrex, and increased the minocin to 100 mg twice

a day for over 2 months with little change to the inflammation and pain in my

wrist. The rheumatologist injected my wrist twice with cortisone, once in

October and again in December which provided 90% relief. In January 2009 it was

mentioned on the list about brand name minocin being more effective than

generic. This topic comes up at least two or three times a year on the list. I

had not opened one of the capsules for years and after reading this thought I

would check. I was very surprised to find a yellow powder in the pill not the

small time released capsules that I had seen years before. The colour of the

pills had not changed - purple and orange. I went to the pharmacy to renew my

prescription and was told the my wife's teachers health plan only covered the

generic and that the brand name minocin would cost me about $20 more than the

$120 generic. The other choice was to have the doctor make out the script for

minocin saying " no substitution " which is what I did. I also found out that the

change in my wife's health plan happened in late 2007 and that I had been on the

generic minocin since Feb 2008 which seemed to coincide with my flare last year.

I started the brand name minocin 100 mg M-F the end of January 2009 and within a

week my right should flared up. The shoulder joint was extremely swollen and

painful. I booked and appointment with my rheumatologist this past week and he

drained 40 cc of fluid from my shoulder and injected it with cortisone. He sent

a sample of the fluid away for culture and cytology. At this time it is 90%

better. I have increased my dosage of minocin to 100 mg twice a day which I will

stay on for a few weeks and then gradually decrease the dosage again. I am also

taking 200 mg of Celebrex twice a day and will stop this in 7 to 10 days.

I believe that there are five factors that are involved with RA and other

autoimmune diseases and even cancer. First there is a genetic susceptibility. I

remember my grandfather's hands being some what deformed and he walked in pain.

I was told that he had rheumatism but that was common for someone who was 84.

Second I believe there is a nutritional component. While in large animal

practice for 14 years I ate daily at a drive through restaurant - Mcs,

s etc and had an irregular meal schedule. Definitely far from a healthy

diet. Third I believe there is a toxic component to these diseases. The toxins

can come form the food we eat, the air we breath at work or at home, my smoking

a pack of cigarettes a day (I have since quit smoking since 2002) and being a

vet I was constantly exposed to a variety of chemicals that would spill on my

hands or potentially inhale - vaccines, antibiotics, hormones, organophosphates

etc. Fourth I believe that there is an infectious component to these diseases

such as viruses, bacteria, protozoa, fungus or mold. And last and probably the

most important is stress. Any stress lowers the body's immune system

capabilities to fight off infection. In the later years of practice I was on

call every other night and had every other weekend off. I was also the owner and

had to manage the practice and employees. In 1996 two years before being

diagnosed with RA I broke my right ankle while working and was off work for 6

months. The ankle required surgery to repair - maybe an opportunity for an

infectious agent to enter my body. I believe that these five factors are like a

balance beam. If one factor is tremendously out of line - extreme exposure to

infectious agent (common flu at work), stress etc or many of the factors are

slightly out of line our immune system is somewhat incapacitated allowing a

disease that may have always been there to progress and show signs.

I am very thankful for the rheumatic.org site and this group and always promote

the use of antibiotics for the treatment of RA to family, friends and new

acquaintances.

Tom Armstrong BSc(Agr), DVM, MBA

Alton, Ontario.

Canada

[Guest guest]

Thanks, Tom, for sharing your story and insights

I hope you will continue to improve

Take care,

Ute