Here we go again. . .

It's all coming back to me. The war on this myopathy* starts with PILLS. Not very exciting, but there you have it. 

THE ARSENAL

Methotrexate: An immunosuppressive agent which knocks out overactive immune systems like mine. Takes a couple of months to get going.

Prednisone: Also discourages the overeager immune response but jumps into action more quickly than methotrexate.

Pantoprazole: Keeps the prednisone from tearing up my stomach.

Sulfamethoxazole & trimethoprim: This antibiotic combo helps prevent infections while the immune system is being suppressed.

Probiotics: To counter the effects of the antibiotics. (But also, look how great they are!)

Folic acid: An inexpensive over-the-counter supplement but it's sorely needed since methotrexate keeps the body from being able to use folate

Calcium and vitamin D: To try to boost calcium levels since prednisone inhibits the absorption of calcium in the body.**

THE PLAN

Hold the course, take the pills. Bloodwork in a couple of weeks. If CK has not started dropping at that point, we'll pull out the bigger guns.

Next up, if needed: Intravenous immunoglobulin (IVIG) and rituximab. Stay tuned!

* “Myopathy” means muscle disease in Greek (myo- “muscle” + pathos -pathy “suffering”)

**Related: I'm now taking alendronate to try to restore some of the bone mass lost in part due to my last round of long-term prednisone in 2020. Thanks a lot, prednisone.