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Re: Remission and Biologics [Re: MichaelSean] #281747
10/11/18 04:48 PM
10/11/18 04:48 PM
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MichaelSean Online OP
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I just noticed two small red bumps inside my mouth. With the dry mouth and the loss of taste I'm now wondering if I have a candida infection? I know those on Humira are more prone to infections like that.

I've not been feeling right ALL SUMMER ... I'm beginning to wonder if it's all related and if I have some kind of a fungal/yeast infection that's affecting multiple systems?

Last edited by MichaelSean; 10/11/18 04:49 PM.
Re: Remission and Biologics [Re: MichaelSean] #281749
10/11/18 06:07 PM
10/11/18 06:07 PM
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It's always possible. Why don't you ask your primary about it and whether he/she thinks a referral to an infectious disease specialist is warranted.


It might also be good to ask your neighbors in the apartment complex if they have been having any of the same issues that you are experiencing.

Last edited by SouthernMoss; 10/11/18 06:09 PM. Reason: additional thought

Ginny - 57 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis
unicompartmental knee replacements: right-June 2014, left-Aug 2018
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Culturelle probiotic, Melatonin (as needed)
Re: Remission and Biologics [Re: MichaelSean] #281750
10/11/18 08:09 PM
10/11/18 08:09 PM
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MichaelSean Online OP
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Just got back from my PCP. He thinks it MIGHT be a candida infection in my mouth rather than a bacterial infection of my sinuses. I THINK that may be right? I've had sinus infections plenty of times in my life and this doesn't feel like that. This seems MUCH more mouth based than sinus based.

He prescribed me oral Nystatin and told me to cease taking the antibiotic. He also took a couple of swabs of my mouth to send off to the lab.

It sucks not knowing FOR SURE what this is because if it's bacterial you treat it one way and if it's fungal you treat it another way. Someone on this forum who I believe was a nurse told me once, "Doctor are really just guessing. Educated guesses but guessing all the same." Which isn't super reassuring. But that sure feels true right now as I try to get to the bottom of what the hell is going on with me.

Re: Remission and Biologics [Re: MichaelSean] #281751
10/11/18 08:24 PM
10/11/18 08:24 PM
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I'm glad you let your primary look at it.

I wouldn't call it guessing as much as playing detective. They have to solve the mystery based on the clues we provide. Sometimes the solution is easy (a bone sticking through your skin is pretty easy to diagnose), but sometimes it can be tough as they try to piece together the evidence.

Hopefully the swab will put you closer to a definite diagnosis. Let us know how it turns out.


Ginny - 57 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis
unicompartmental knee replacements: right-June 2014, left-Aug 2018
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Culturelle probiotic, Melatonin (as needed)
Re: Remission and Biologics [Re: MichaelSean] #281752
10/11/18 09:06 PM
10/11/18 09:06 PM
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Just for context:

This is intended to be humorous but I want to share my inside perspective of the healthcare industry since I'm a retired RN. I will say "we" to include myself and everyone working in healthcare. We are expected to "know" stuff but we really don't. Most of it is a guess. Hopefully an educated guess but still a guess.

And later on:

It is difficult and complicated but you need to remember when it started, what changed when it started, what relieves it, time of day when it happens, where it happens, what your BP is when it happens, what you are doing when it happens and on and on. Write it down. Think of it as a mystery and you are looking for clues. The more clues the better the guess.


Dx. reactive arthritis with recurrent uveitis, HLA-B27+ (1993), polymyalgia rheumatica (PMR) added in 2008, trigeminal neuralgia added in 2009

Hx. cataracts (2009), tendon rupture-wrist (2010), HTN with LVH (2011), pulmonary embolism-multiple, extensive and bilateral (2012), total bilateral knee replacements (2015), craniotomy for microvascular decompression of trigeminal nerve (2016), surgery pending for L4-L5 disc bulge, stenosis and severe "degenerative" spinal arthritis (2016)
Re: Remission and Biologics [Re: MichaelSean] #281753
10/11/18 09:21 PM
10/11/18 09:21 PM
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I have been dealing with my own problems for 25 years and I still don't feel like I have any definitive answers to why it happens and what to do about it. I had brain surgery and when the surgeon got in there it wasn't what the MRI showed. After surgery I asked what caused the problem -- the surgeon replied, "ask God".


Dx. reactive arthritis with recurrent uveitis, HLA-B27+ (1993), polymyalgia rheumatica (PMR) added in 2008, trigeminal neuralgia added in 2009

Hx. cataracts (2009), tendon rupture-wrist (2010), HTN with LVH (2011), pulmonary embolism-multiple, extensive and bilateral (2012), total bilateral knee replacements (2015), craniotomy for microvascular decompression of trigeminal nerve (2016), surgery pending for L4-L5 disc bulge, stenosis and severe "degenerative" spinal arthritis (2016)
Re: Remission and Biologics [Re: MichaelSean] #281754
10/11/18 09:24 PM
10/11/18 09:24 PM
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MichaelSean Online OP
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There's ONE other possibility, I guess. And I see a dentist on Monday. But about the time this all started I lost a filling. And I suppose this could all stem from that.

The thing is there's no pain where I lost the feeling. It doesn't FEEL like an infected tooth. But then maybe the Humira is tamping down the inflammation.

All I know is the dry mouth and foul taste in my mouth are getting worse by the day. And each day it gets worse I grow increasingly worried.

Re: Remission and Biologics [Re: MichaelSean] #281755
10/11/18 09:34 PM
10/11/18 09:34 PM
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Here's a prior thread on oral thrush that may help: http://forums.spondylitis.org/ubbthreads.php?ubb=showflat&Number=227780

Re: Remission and Biologics [Re: Winston] #281756
10/11/18 09:58 PM
10/11/18 09:58 PM
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MichaelSean Online OP
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Originally Posted by Winston
Here's a prior thread on oral thrush that may help: http://forums.spondylitis.org/ubbthreads.php?ubb=showflat&Number=227780


That thread is interesting.

I visited my physician four weeks ago and we I had a sinus infection. So he gave me an antibiotic AND prednisone. I wonder if, in combination with my Humira, this led to oral thrush?

I don't know ... I feel like I'm just throwing darts at a dart board full of possible causes at this point.

Re: Remission and Biologics [Re: MichaelSean] #281757
10/11/18 11:00 PM
10/11/18 11:00 PM
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Originally Posted by MichaelSean
I visited my physician four weeks ago and we I had a sinus infection. So he gave me an antibiotic AND prednisone. I wonder if, in combination with my Humira, this led to oral thrush?


If it is thrush then nystatin will treat it. Thrush is obvious once you have seen it and two small red bumps inside your mouth doesn't sound like thrush. Antibiotics are more likely to cause thrush so it is good to stop that. I would wait for the swab results before you start to worry what caused it because it is a waste to worry about it until you know the results. Are you still taking prednisone? Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the natural balance of microorganisms in your body can increase your risk of oral thrush.


Dx. reactive arthritis with recurrent uveitis, HLA-B27+ (1993), polymyalgia rheumatica (PMR) added in 2008, trigeminal neuralgia added in 2009

Hx. cataracts (2009), tendon rupture-wrist (2010), HTN with LVH (2011), pulmonary embolism-multiple, extensive and bilateral (2012), total bilateral knee replacements (2015), craniotomy for microvascular decompression of trigeminal nerve (2016), surgery pending for L4-L5 disc bulge, stenosis and severe "degenerative" spinal arthritis (2016)
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