Saturday, March 25, 2017

WEEK FOUR OF MTX TREATMENT

Okay, this one is a little late, normally I would have posted this right before taking my fifth weekly dose, but I am halfway into week five now.

This last week reminded me that I am still not all the way back (and who knows if I will ever be). I didn't have a flare like in the past, but my knees weren't feeling almost back to normal like they were before either. Three runs, including a race, and skiing during the course of 10 days was a little much. They regressed a little bit, not to the point where it hurt going down stairs or anything, but I couldn't bound down the stairs joyfully either.

When I took my fourth dose, Thursday, my "shit" day, was actually pretty good. I barely felt nauseous and didn't experience any increased fatigue. However, the Thursday after dose five... about halfway back to the worst it had been. A little crummy feeling and tired the next day. And then on Friday I started getting a sore throat. Very low level, but annoying. So ugh. Not feeling quite as positive as before.

Anyways, one good chunk of news is my mysterious sleep issues have seemed to disappear. I'm back to sleeping much better, so I'm very happy about that. If we can just get the Thursday to near normal, and they seem to be slowly trending that way, I would be a pretty happy camper. I hope this sore throat dissipates quickly. Again, it is very low level, doesn't hurt to swallow or anything, it's just annoying. Maybe once my body is in "rhythm" with the methotrexate these sorts of minor things will be less common. I did have about three solid weeks without anything though.

Again, this is midway through the fifth week. The full effect of the drug is usually reached at 6-12 weeks and people say it can take months for the body to get used to it and have reduced side effects. So, the real question will be how I am feeling in June. I'm on the path to recovery but I still need to be cautious and take it easy.

Monday, March 20, 2017

2017 SHAMROCK RUN 8K RACE RECAP

This year's 8k route, a giant out and back, no frills.
I didn't end up doing a preview for this race, I thought about it, but when I'm just running for fun and not much else there isn't much to say. I signed Brandon and myself up for this race a few weeks back. Some people might dislike the Shamrock Run, but I freaking love it. Fantastic event that kicks off the racing season in Oregon! I gave Brandon the option of doing the 5k or the 8k and to my surprise he choose the 8k. So regardless of how I did, I was going to PR this race!

Normally the weather at Shamrock Run is terrible. I remember last year being ridiculously cold and windy. Katie and I went together and it was an all together miserable experience (including being trapped trying to get out of the parking garage for over an hour). Anyways, this Sunday was fantastic. Sunny blue skies, perfect spring weather! I even had the foresight to put sunscreen on beforehand so I wouldn't burn. Anyways, Brandon's first Shamrock experience was looking to be a positive one!

At the Shamrock Run the 8k is one of the last races to go off, at 10:10am. Very nice! Allowed me to get decent sleep, pick up Brandon, and meander to the start line without much issue. We took the MAX and that was really slick. We arrived about 45 minutes before the start and watched as Alejandro finished the 15k in something like 56 minutes, which is low 6-minute miles. Crazy. After congratulating him we worked our way to the start line and settled into the 10 min/mile+ corral by choice (usually I get stuck back there trying to arrive right before it starts to avoid freezing).

I wasn't really nervous at all. I had been able to run four miles non-stop in a few practice runs around home. It was hard, but doable. I figured the race day adrenaline could get me another mile. Brandon was pretty upbeat too. He used to be almost afraid at the start of races but he has embraced running lately as a tool to improve his soccer game and overall fitness. So I think we were both excited to see what we had in us! Beforehand we had arranged a meeting place at the finish line so he was able to run ahead - I didn't want to hold him back.

Heading to the start line, Brandon pondering how much he is
going to "shred" my by.
The gun went off and off we went! I was a little frustrated at first because the masses were moving a little slow. A lot of people were doing like a 12:00/mile and I was more thinking of a low 10 minute mile. Anyways, I did some bobbing and weaving and tried to find a hole. Even though I was just running this for fun, I still wanted to give it a good go. Eventually the sidewalk opened up and I spent much of the first two miles or so on the sidewalk as it was slightly less crowded.

Overall the race went really well. I had no idea what my pace was as I had given my watch to Brandon. I was tracking the run on my phone with Endomondo but that was in my FlipBelt. So ignorance was bliss! I just tried to settle into a pace that was as fast as I thought I could keep up for five miles. The Endomondo tracking with my phone was not very accurate so I didn't get great splits. However it looks like the first few miles were of the 11:00/mile-ish variety (no doubt due somewhat to the crowds) while the final couple miles were more around 10:00/mile or just under. My official overall pace was 10:21/mile, but it was probably more along the lines of 10:10 if I were able to run a good line.

The race reminded me a bit of the Portland Marathon in that it was just a giant out and back along Natio/Front. The whole course was actually part of the marathon route. One of my least favorite parts too, haha. I actually enjoyed it though, it felt good to be out there running in the beautiful weather and the energy of the race was infectious. I was able to get to the turnaround, the halfway point, still feeling pretty good. At this moment I was pretty certain I would be able to finish the race without walking. That wasn't a sure thing in my mind when I started.

Longest race ever and the desire for more! Yay!
Side note: he did not complete the Portland
Marathon, just in case you were wondering, haha.
Shortly after the turnaround I was surprised by a tap on the shoulder. It was Brandon! Turns out he had to poop! So while he had darted a couple of minutes ahead, he had to wait a little bit to use the bathroom and then actually go. So all together he probably lost five minutes. He was pretty bummed that his race time was going to be impacted. I let him know that was a running right of passage and to not let that get him down. He then went ahead again and finished ahead of me by about a minute and forty seconds. I know he wanted to crush me so that was probably a little disappointing, ha.

The sun got a little hot on the way back. The beanie and gloves that I had worn at the beginning were now in my pockets and my sleeves were also rolled up. It was only in the low 40s, but when that sun is right on you... it's hot! Nothing too uncomfortable though. By the time I finished I was ready for it to be over. I could have done another mile no problem, but I would by lying if I didn't say I was tired. I was thrilled with how it went though, to be able to run five miles, and run it faster than I thought I could, was a definite victory. I can't dwell on how much quicker I used to be, I can only control what is happening now, and I was quite pleased with the result!

I met Brandon at the finish line and we headed to get our free soup. I skipped the beer this year (huge line plus kid) and we headed back to the house. Overall we both had a blast. I really do miss doing these races. I hope my knees can hold up and I can get back to running semi-regularly. Brandon has expressed the desire to do more races and longer distances and I would like to help facilitate that. Overall, this was a positive first step in that direction.

Hmmm, what race next???

Official Chip Time: 51:31, 10:31/mile. 2177/4153 overall, 1134/1730 male, 178/256 M30-35.
Brandon's Time: 49:50, 10:01/mile.

Wednesday, March 15, 2017

WEEK THREE OF MTX TREATMENT

From Mt. Hood Meadows last Sunday. Beautiful day for skiing! Love swooshing down the mountain!
Another week of improvement on methotrexate. I would say my knees are down to a 2 or 2.5 out of 10 now. I think three additional weeks from now I'll hopefully be at a 0 or 1, which I was hoping to achieve by going on the treatment in the first place. If I can be pretty much back to normal, that's huge! I'm getting more and more confident that I'll get to that point. Once I am there, hopefully I can maintain a normal level of activity and feel good.

The issue I have now when I do anything is sore muscles. I got so out of shape by not doing any sustained exercise for nine months. Imagine that! So I'll have to get back in shape. I'm not going to go back to full activity right away, I am going to kind of ease into it as the weather turns. I'm not a gym rat, I like to run outside or play tennis, catch the football, stuff like that. So hopefully I can ramp things up as the weather turns.

As for winters, it is hard, I never liked running in the rain and the cold. One thing I do love though is skiing and I went last Sunday with Alejandro and his friend. Every year I go skiing, think of how much I like it and how I should buy my own equipment... and then don't do anything about it. Repeat every year. And that'll probably happen again. However, since I probably won't be as hardcore of runner in the future maybe skiing would be a good way to stay active in the winter. If I were to get a season pass, I'd have a lot of motivation to go up and and maybe even work out of the Clackamas office and take off at 3pm some days for some night skiing. Who knows.

Lastly, on the side effect front, my sleep still isn't quite back to normal. Still waking up, I typically only remember waking up around 5 or 6am, so I think I have a solid chunk of sleep, but I might just be forgetting waking up other times. It would be nice to have one of those watches that tracks your sleep here! But I don't feel any more tired than I usually do, if anything I feel more energy. That just might be a placebo effect of feeling like I can move around again though. Thursdays are still rough in the energy department and feeling crummy in the tummy from the dose the night before. Hopefully that'll get better with time. Overall I can easily accept the issues above for protecting my joints and being able to act my age.

Wednesday, March 08, 2017

WEEK TWO OF MTX TREATMENT

Today is the 14th day after my first dose. I'll take my third dose weekly dose tonight. How did week two go?

Things started off a bit rough after taking my second dose, I felt like crap and very tired again the next day. My cold that I had developed right after taking the first dose was still plugging me up and I was pretty miserable last Thursday. I was pretty down on the whole thing. I felt like I was poisoning myself and wondering if this all was really worth it.

However, Friday through today have been awesome. I'm really starting to feel the therapeutic effects of the methotrexate. After my "bleh" day Thursday, I woke up Friday feeling spunky and my cold starting to clear. I started noticing little things I could do again, like:

  • Get in and out of the car without pain and hoisting myself up using the door handle
  • Stairs were no longer the enemy, either up or down
  • Wake up in the morning feeling rested and not being stiff and sore
  • Noticeable reductions in inflammation of my knees, jaw, and upper back
  • The ability to jump without pain
  • Getting out of the bath like a normal person and not a 80 year old
  • Knees aren't stiff after periods of sitting or inactivity

All in all it has been a really huge change. Things aren't completely better obviously, but if the old baseline was 7/10 with flares being 10/10, I'd say I'm at a 4/10 now. The best I've felt in a long time. There is certainly something still there, but I have many more weeks of treatment before I reach the "full effect." So I'm feeling pretty positive about things! The cold has mostly gone away (tiny amounts of residual flem) so we'll have to see how often I get sick in the future.

The key now will be to see if the side effects greatly lessen or disappear. I'm hoping after a few weeks Thursdays won't suck so much after taking the MTX on Wednesday night. From what I'm reading on the internet, most people had their side effects noticeably reduce after some time on the treatment. The main side effect is gastronomical discomfort, and that has been minimal for me, so hopefully that's a good sign.

One side effect I've been having is waking up when I'm sleeping. I'm not having trouble going to sleep, but I seem to be waking up in the middle of the night. I'm usually able to fall asleep again super quick, but waking up randomly can't be good for energy level. I'm not seeing this listed as a side effect, so I don't know what's up. I've been having some really vivid dreams though and that's weird. Normally I sleep like a rock and don't remember any dreams. I *think* this is getting better, last night I only really remember waking up once, so hopefully with some time I'll be back to my normal deep sleep.

Overall I'm feeling much better about things this week. 

Tuesday, February 28, 2017

WEEK ONE OF MTX TREATMENT

I'm basically giving my immune system ritalin and hoping it
will start paying attention in class.
I thought maybe I'd start posting weekly updates with how I'm feeling. The medication I'm on (methotrexate, herein referred to as "MTX") usually takes a few weeks to start being effective and about six weeks before it's in full swing, so I think recording my status on a week to week basis might be a helpful exercise to look back on later.

The main side effect of MTX is digestive distress. Upset stomach, cramping, that sort of deal. From what I read it was mainly in the first 24-48 hours of taking the medication. In some people it is bad enough that they switch to an injectable form of the drug to avoid this side effect. In some people they just have a slightly upset tummy once a week. And in about a third of people they don't really experience anything. So I was feeling pretty cocky when after two days of taking my first dose I didn't have any stomach issues at all. Maybe a slight rumble the night I took it but nothing super noticeable at all.

While I might have avoided tummy issues, you have to remember that MTX is an immunosuppressant and what do you know, I come down with a minor cold a few days after taking it. Nothing major, but annoying. And then yesterday, as I still had this cold, I felt like complete shit. Just no energy or anything. Yesterday, after feeling like complete garbage, I was a little discouraged. However, today I am feeling much better and I can tell my cold is starting to clear. Just in time for another weekly dose. Hah.

I think my immune system has always been "supercharged." The last time I remember getting sick enough to miss school or work was 8th grade when I had whooping cough. Otherwise, I've gone 7.5 years of my professional life without a sick day. Sure, I've gotten colds and stuff, but I've worked through those. Food poisoning a couple times, really bad diarrhea from Mexico... but overall, I remain pretty healthy. I've always credited that to a good immune system. But, my immune system is hyperactive and bored and starting to attack my own body now.

I'm hoping taking MTX will knock it down to an immune system of a normal person. So maybe I get sick a little more often, but in exchange my psoriatic arthritis (PsA) more or less goes into remission. That would be a fair trade off that I could accept. I will not accept being one of those people who is constantly sick, especially during the winter. So hopefully once my body adjusts to the new normal with MTX I won't be a constant sniffling mess. I don't think I will be, but after getting hit by a truck yesterday I'm putting it on notice.

As for my PsA, I don't know if this is a placebo effect at this point or what, but it feels like it is getting slightly better. I swear I am able to sit up from chairs without hoisting myself with my upper body like before. I can bend at the knees and pick stuff up easier. I don't feel as creaky and stiff in the morning or after sitting for a period of time. It's still definitely there, but I want to say this is the best I've felt in regards to the PsA since initially seeking treatment. I know the drug isn't really supposed to kick in for a few weeks, so maybe this is just me being optimistic. I'll keep an eye on it.

Wish me luck tomorrow. Hopefully I don't curl into a ball from G.I. distress and then follow that up with the flu.

Friday, February 24, 2017

REPORT BACK FROM THE RHEUMATOLOGIST

Snapped this picture of the waiting room while I was there.
Well, it turns out my web sleuthing was correct. I do appear to have psoriatic arthritis. It’s funny how I started down this road, it was all sparked by a TV commercial for a drug treating psoriatic arthritis. As soon as I heard those words there was a spark in my mind that led to reading all about it and pretty much diagnosing myself. Of course, I also diagnosed myself with a tight hamstring as the cause, so my batting average is still pretty shitty.

I would have eventually been passed along to the rheumatologist. I think the orthopedic doctor would have tried a few more things before referring me along, but I basically told him to do the MRI before the end of the year just in case (that sweet, sweet deductible) but then to pass me along because I had this hunch and he agreed. So off I went to into the world of auto-immune joint inflammation.

First of all, I was the only person younger than 70 in the waiting room. So that was a huge confidence boost right there. Not. Eventually I see the doctor and she asks some questions, does some poking and moving of joints, and comes to the psoriatic arthritis diagnosis. I’m not a classic case, but she still was pretty confident that’s what it is based on all the other work I’ve had done and the way my body was reacting.

Overall, at the moment, my case is milder and I don’t have some of the symptoms of when it can get really bad. So that’s good. No sausage fingers for me. It’s also early enough where my joints haven’t likely suffered long term damage. Also good. With treatment, I should be feeling back to close to normal. She wasn’t willing to say I’d be 100% normal again, but that is where some people can get. Almost like a remission of the arthritis. You can’t cure it, but you can treat it. So I’m hoping I can get to that point.

She also agreed it wasn’t triggered by the running, rather, this was something that was going to happen regardless of that whole deal. When I first was seeking help, the running made sense, the dual marathons I did, the sore knees, etc. Unfortunately, that kind of sidetracked my treatment for a while as we were looking for a mechanical issue to diagnose and fix. However, I think you have to go down that road first to rule it out regardless. It just sucks it took almost a year to get an answer. And let’s hope this is the final answer! I think it will be though.

Until a cure is found (aka probs not), I’ll have to take a prescription for life if I want to keep it at bay. So that kind of blows. However, it is better than the alternative, which is the disease progressing and me being unable to walk by the time I’m 50. By taking treatment, I can pretty much proceed as normal and my joints should be no worse for the wear other than the typical aging effects.

The drug I’ll be taking is meth. Jay kay. It’s methotrexate. It’s the most commonly prescribed drug for arthritis. In large doses it can be a chemotherapy drug, like 100x what I’m taking, so if you search for it on the internet the results can be really scary. However, in smalls doses it’s pretty safe as evidenced by its huge user base. While it usually treats rheumatoid arthritis, it also treats psoriasis and psoriatic arthritis very effectively. So I’ll be taking a pill of that once a week! The most common side effect is gastrointestinal distress when you take the pill, however, I had almost zero discomfort on my first dose so hopefully I won’t experience that. One bonus is that it also treats psoriasis, so the little patches on my scalp that I do have should go away.

Sweet, sweet pharmaceuticals... that's actually what
they look like though!
The drug takes many weeks to reach its full effectiveness. I should have “relief” three weeks in and by six weeks the drug should reach its maximum effect. So hopefully, by mid-April, I’ll be feeling like a new man. If not, they can always tweak the dosage or try a different medication. If I’m also feeling awesome they can try to lower the dose a little and see if I could have the same result on a lesser dose. So I’ll be visiting with the doctor every three months or so to check in and adjust if necessary.

Overall, I am just happy to finally have an answer I truly can believe. All the other times I’ve just been like “okay, that makes sense, let’s try that” but never really was convinced we had the root problem nailed. I feel differently this time. I have a sense of hope because I think we’ve figured it out and there is relief in sight! It sucks to have to take a pill, but hey, overall it’s not so bad. It could be a lot worse and I should be grateful for being alive and generally healthy, minus this little deal.


I’ll let you know how I’m feeling in the coming weeks! I decided to sign up for the Shamrock 8k with Brandon in three weeks, so that should be interesting. I think I can run about four miles right now without stopping, so I’m close to being able to shuffle along for five that day. We’ll see!