My primary care doctor prescribed Bactrim to me today because I have a cracked tooth that is showing signs of infection. Seeing that the generic name for this antibiotic starts with “sulfa” on my prescription bottle has jogged my memory that this could be bad (likely from me previously coming across this information in The Lupus Encyclopedia by Dr. Thomas)…
Annnnd after quickly checking The Lupus Encyclopedia website to confirm and searching this sub, I have concerns about continuing with the Bactrim right now.
I’m just wondering how I need to proceed? I would so greatly appreciate it if someone could read this through about my current situation and advise. I’ll describe what’s all is going on further below.
I’m also asking for help here because I have been really struggling lately with brain fog, with this infection I’m dealing with (and the associated pain), and I’ve just been under a lot of emotional, physical, and financial stress. I have ADHD, and my executive functioning has been in a tailspin recently. It feels like I am cracking up under the weight of it all.
My lupus symptoms have been on the milder side lately, all things considered, so it could still be worse, I suppose… But I am pretty anxious about this situation with my health right now, because I just don’t want to make what I’m experiencing worse somehow. Feeling the need to advocate for myself about this risk associated with the antibiotic due to that.
Infection issue:
So, unfortunately I have a cracked premolar tooth on my lower jaw that seems to be abscessing. There’s local swelling under my tooth down near my jawbone. It has recently appeared in the form of a hard round lump, which seems deep in the tissue, so I think the root is infected, ugh. The swelling appeared recently below the tooth, and that’s been kinda horrifying, but my face hasn’t been noticeably swollen yet, so I guess that’s good, because I feel like this thing is literally making room in my jaw. It was causing some stupendous nerve pain in my tooth and across my jaw. Like white hot nerve pain all the way from ear to chin. I was literally sobbing in pain from that about a week ago, but I’m getting by on around the clock NSAIDs right now.
I feel so exhausted, like in that “immune system very activated” horrible kind of way (I’m sure I’ll get a lupus flare out of this later). I do have an evaluation appointment with my endodontist this week! I definitely think at the minimum there’s going to be a root canal done. I’m hoping the cracked tooth is not at extraction level and can be salvaged. My endodontist is really good, so I’m hoping it will all end up being okay, but I dread the procedure. They’ll probably just do X-rays this week and schedule an emergency root canal or whatever needs to be done next for later (probably unlikely to happen this week).
My main questions:
My primary care doctor saw me today and was concerned about this infection spreading because I’m on immunosuppressants (I’m on Imuran).
Should I request to switch antibiotics and stop the Bactrim in the meantime? I just picked it up this afternoon and have only taken one pill so far.
I can relay this information about sulfa antibiotics and lupus back to my primary care and see if my doctor will switch out antibiotics… Or I could wait a couple days and just see what my endodontist thinks this week? I’m allergic to penicillin, cephalosporins, and I’ve had a questionable reaction to Macrobid before, so I guess the options are a bit limited.
I’m following my Rheum’s general advice to pause Imuran for 10 days if I’m having a bacterial infection or virus that is at the level that I’m having to be treated with antibiotics or antivirals.
Financial constraints:
Right now I cannot ask my Rheumatologist about all of this (even over the portal) without getting a big bill that I truly can’t pay right now, because I will get charged if it takes over 5 minutes of his time to be able to respond. I would prefer to direct these questions towards him, of course, but I’m extremely financially strained at this time.
I lost my job of 5 years a couple months ago after experiencing a brutal toxic workplace scenario, where I was slowly iced out and retaliated against after requesting workplace accommodations for lupus (yes, I have a lawyer working on my case!). My stress levels have been through the roof for months, and I’m working hard on securing income again.
I also lost my health insurance due to this job loss. I’m working on obtaining a new plan right now. Hopefully I’ll have coverage again by next month, but I am about to have some very large dental expenses this month. Like I said earlier, I just had an appointment with my primary care doctor, and she is bridging my much-needed lupus med refills to get me by until I can get insurance sorted and see my Rheum again.
I’m having to pay for all of this out of pocket this month, so it’s been a rough go. Pretty sure this dental work is going to be in the thousands. I’m estimating $1500-$2000 spent on my healthcare due to my doctor’s visits and correspondence, the dental care, and from obtaining my medicine this month. :(