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1) I have never been told to fast before any Actemra infusion.
2) I have never had any activity restrictions after any Actemra infusion.
I have no restrictions at all with Actemra except maybe Actemra being held for any infection. There are frequent monitoring labs that should be done when Actemra is initiated but those labs aren't done very often anymore.
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I had a pulmonary embolism that was called extensive, bilateral, multiple and "unprovoked" when I was on Prednisone. I wasn't completely clueless because I did admit to being slightly more short of breath than usual. Otherwise I thought I could go home.
Instead of going home, I was sent to the intensive care unit for 2 days. I was seen by a hematologist, a pulmonologist and other -ologists but I wasn't sure who they were. Nobody could explain with certainty what happened but "prednisone" was frequently mentioned. A "cascade of blood related events" was the determination of the hematologist but no clotting abnormalities were ever found.
"Warfarin for life" was initiated to prevent any recurrence of another pulmonary embolism. At the time there was no end in sight to my long term Prednisone use.
Maybe it was just a coincidence but warfarin was discontinued when Actemra allowed me to taper off Prednisone. The risk of me having another pulmonary embolism was less. My PCP was reluctant to stop warfarin but the PE incident was revisited when Eliquis was being considered. Now I'm off anticoagulants for the first time in more than 10 years.
https://www.sciencedirect.com/science/article/abs/pii/S0049384816300378
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Very similar. Thank you. Only difference I was never short of breath or had any symptoms. The CT scan that showed the Pulminary Embolism was done at 8:30AM and I was sitting in Starbucks in Mayo Clinic waiting for 1:00PM RA doctor appointment when they called me and told me to go right to ER. Had my appointment been later I would have been at LA Fitness working out.
My guess is caused by Prednisone, which they raised back up from 10 mg to 20 mg with slower taper planned.
Have Hematology appointment on 8/20 but my guess is caused by Prednisone also because I have no clotting history. They put me on Eloquis and told me Hematologist can do more tests to determine how long I need to stay on it.
Im back to exercising vigorously with no effects.
Ive postponed scheduled flu shot. Told I can get it while on Acterma and that its a little too early. I ususally get in mid September.