I am a teacher and I need to work for financial reasons. I have lupus, sjrogren's, fibromyalgia and unmanaged ra. My doctor put me on actemra (in addition to the plaquenil and sulfasalazine I was taking already, as well as periodic prednisone injections, and I had been on methotrexate until it was no longer effective and making me sick). Every time I took actemra I would get bronchitis or pneumonia. I got really sick but my joints were getting some relief. So, we switched to orencia. Unfortunately, I still get infections after treatments, but they are not as severe (sinus and bronchitis) but the effectiveness is also not as great. I am becoming reluctant to take it because I am so sick of being sick, but my disease is progressing too. Any suggestions for for reducing risk of infection?