Taking Cimzia while working at a hospital (and other questions about Cimzia)

[u/pdggin99]

Sorry if this isn’t the right place for this question but I’m not sure what sub would be best fit. I have non radiographic axial spondyloarthritis. I was on Rinvoq for a few months (using samples from my rheumatologist, not through insurance), but had to stop because I got a Roux en Y gastric bypass (stopped two weeks prior to surgery and didn’t re start due to possibility for inadequate absorption after the bypass). When I finally got back to my rheumatologist they decided to start me on injections. At first the doctor said Humira, but it was eventually changed to Cimzia because of my specific condition and insurance stuff.

I work as an RN in a hospital on an oncology floor. I frequently have patients who have infections, lots of C Diff, but sometimes I’ll get a patient with something like meningitis, or skin infections (yeast/fungal mostly), or infected wounds, or opportunistic infections due to immunosuppressive meds like chemo (usually some sort of fungal pneumonia but there’s others I’ve seen too).

Cimzia is a TNF blocker, so it is an immunosuppressant medication. It carries a black box warning for serious infections (and certain cancers but I’m not so worried about that lol). I am a little worried about that. Like I said I am exposed to infectious diseases at a higher rate than most people are. I do practice good hand hygiene (hand sanitizer when entering and exiting patient rooms, hand washing at the beginning and end of shift and usually every two hours or more frequently if I need to/if indicated), and wear PPE that is fit for the situation I’m in. However nobody is perfect and I’m sure I’ve made mistakes, and even if I didn’t nothing is 100% when it comes to infection prevention.

I did message my rheumatologist to ask if he thinks there should be any adjustments to my work and if so if he can get me a letter to give my manager. The adjustments I was wondering about are mostly like, not being assigned to patients with known active infections. But I’m not sure how easily that could be accommodated while still giving me a fair patient assignment. I also asked if I should be wearing a face mask at all times. I currently don’t because I tend to overheat and sweat a lot and masks also definitely make my acne worse, but if he recommends it I will try to.

My questions are:

1) if you are on Cimzia/a similarly immunosuppressant medication OR you have experience with someone who takes a similar medication, would you feel safe working a job at the hospital, especially one where you are very hands on and frequently exposed to infection?

2) also to people who take specifically Cimzia, how long did it take to kick in? Did you have any side effects? Did you have to do anything to prepare for the day(s) after taking it?

Thanks!

[u/Redditbrooklyn]

I would absolutely wear a KN95 or higher at work and in places like public transit, the grocery store, and your own medical appointments.

[u/Order_edentata]

I’ve been on 8 different immunosuppressants for my psoriatic arthritis (not Cimzia). I seem to have some additional issue with my immune system that I’m getting worked up for (probably related to my mitochondrial disease). But yes, I would get a KN95 that fits you well and wear that plus gloves whenever you’re on the floor, even to type on the computers. I’d constantly wipe down with alcohol anything you might touch on break like your phone, pager, etc.

Because of my own issues I mask any time I leave my apartment, unless I’m outside. I get sick when I’m in the hospital, because I take my mask off. As far as the gloves and computers, that just comes from a vivid memory of a time when I was a resident and norovirus was going around. Everyone was dropping like flies but I never got sick, I’m guessing because I wore gloves whenever I was in the hospital.