Thursday, April 27, 2017

MY FIRST INJECTION

Hey look, this is what I did.
Felt like a total druggie on my bed with all the needles and vials and stuff. Haha, but seriously, it wasn't bad at all! Let's start from the beginning though.

So my insurance rejected the injectable methotrexate. I'm assuming they want people to take the oral tablets because they are cheaper. However, there are plenty of reasons why people may need to inject, including the GI side effects. Anyways, I was prepared for a fight. But then the pharmacist is like "but we just ran with the group discount card and it comes up to $8.64 without insurance." So one month of the tablets, covered by insurance, was $15. One month of injectable, not covered by insurance, was $8.64. Our healthcare system in a nutshell.

Anyways, I also had to buy some needles and some alcohol swabs. Both are really cheap, so all together it is cheaper than taking the tablets and with no insurance help. Anyways, at the doctor's office they gave me a quick demonstration of how to inject myself. It seems easy enough, so I was pretty confident I could do it when I got home.

I was a little scared, I'll be honest, but I just started doing all the prep and whatnot without trying to think about it. Swab my thigh with the wipe, swab the top of the bottle, insert syringe and inject air into the bottle to replace the medicine I was going to take out. Draw the medicine out. Tap the syringe to get rid of air bubbles, push until I have just the right amount, remove needle...

...shove needle in leg. Okay, so I paused a second. Palms sweaty, Mom's spaghetti. I had my left thigh pinched (plenty of real estate to work with there). I knew I just needed to shove it in there at a 45 degree angle. No need to hit the muscle or a vein, you just inject into the fatty layer. Honestly the easiest injection possible. I did pause a few seconds though and then just grimaced and plunged it in. And honestly, I felt nothing.

Instant relief. That didn't hurt at all. I honestly didn't feel anything. Maybe that's why they have you pinch your big fat fucking thigh up? Idk, but anyways, I then just slowly pressed the liquid in. It burned a little, but not bad at all. I just did it nice and slow. Once it was all in, I quickly removed the needle. No pain there either. Not even a drop of blood, just a microscopic red dot where the needle went in. Honestly, super painless and easy. And today none of the nausea I would often get with the tablets. Haven't had the fatigue yet either. So I'm feeling good about this method of delivering the methotrexate.

Now I just need the results I'm looking for! It'll also be interesting to see next week how much I freak out. Because even though it was pretty dang easy this week, I know next week I'll probably be freaking out again.

Tuesday, April 25, 2017

FOLLOW UP APPOINTMENT

Alright, had my follow up appointment with the rheumatologist this morning. Due to my condition getting slightly better overall but nowhere near where it needs to be, we are going to try the following:

  • Switch to injectable methotrexate
  • Increase dosage to 20mg a week from 15mg
The injectable form of methotrexate is fully absorbed unlike the oral dose, so really my doctor said it was like 22.5mg of the oral tablets. So I'll essentially be increasing my weekly "smack" against the inflammation by 50%. The injectable form will also get rid of the nausea I would often feel the day after taking it. So that's good.

One negative is that I have to give myself shots! I don't know how to do that! A nurse walked me through it and it's simple enough, but popping pills is a lot easier. Oh well. I'll just have to not be a baby and nut up. Not a fan of shots but also not someone who totally freaks out - just the ol' grimace and never look at what's happening method. Not sure I can do that here.

Oh yeah, give me the good stuff.
Some other notes... the doctor thinks I can get back to feeling more or less normal once we get the dosing correct. So I'm hoping that can be the case! If the increased amounts of MTX don't do the trick, then they can introduce another drug into the mix. Hopefully it doesn't have to come to that. The end of the road should be relief though, so just got to keep chugging along. Since my case is relatively mild we shouldn't have to use any of the hard hitting drugs.

I also mentioned my colds and sickness. She seems to think these weren't related to the MTX. A little side eye there, but hopefully it was just an unusual occurrence and I won't be sick 35% of my life moving forward.

Two weekends ago (aka 9 days) I scrubbed my deck to get it ready for wood treatment. I was out there for three to four hours bending over, kneeling, scrubbing, etc. And that pretty much hobbled me all week. The knees have not been very fresh feeling. So it's not just impact activities that are making them angry, it's simple things like that. I remember when they blew up after using the elliptical. So onward for answers we search.

Monday, April 17, 2017

I'M ALIVE

So that cold really sucked. All told I was sick for 15 days and hacking out stuff for a couple more. I'm back to normal now enjoying it very much. Not being able to taste... feeling like you were drowning in snot... not fun. Worst sickness in many, many years.

Anyways, I would say the progress on my knees plateaued. I've been on a couple runs since being healthy again and my knees are reacting somewhat. Not inflaming to the point where it hurt to walk down stairs like when it was really bad, but enough to hobble for a few steps and remind me that they are not normal. So I don't think the current set up is going to give me the results I'm looking for. Right now if I wanted to just exist and walk around it would be okay, but currently I can't ski, play tennis, go on a long hike, etc without bothering my knees.

I'll mention this at my next rheumatology appointment, which is in a week or so. Ugh. I'm guessing she'll just want to bump up the MTX dose (they can go up to 25mg, I'm taking 15mg) but I'm not sure if that'll fix it or if I want to take that much! I know MTX is the cheapest treatment out there because it's old enough to have plenty of generics... but I also wonder if there is a newer treatment I could take that is more effective. I'm open to whatever though. Who knows, maybe 25mg will end up tamping the inflammation all the way down.

On a funny note, the way I can tell how my knees feel is to just imagine jumping in the air. I can be sitting, laying down, whatever, I don't need to be standing or anything. Just the way my body physically reacts to this thought lets me know how my joints are. When it's bad, I almost cringe. When things are good, it's no problem. And when things are meh, like recently, it sounds doable but painful at the gut level.

Silver lining, I can probably get a medical deferment for the upcoming war with North Korea, so there's that. Maybe the nuclear fallout will be good for joint pain?

Friday, March 31, 2017

NEAR DEATH

Okay, not really. I am just being a dramatic male getting sick, but this last week's cold was horrible! As you may recall in my last update:

"...[O]n Friday I started getting a sore throat. Very low level, but annoying."

Well, that ended up turning into a doozy. Really bad cold. Kept me home from work for three days this week. I was able to work from home, which is a great option to keep up on everything without infecting my teammates and save precious PTO. It started getting better Wednesday just in time for my next dose and now I just seem to be hacking out the remains.

Another point where I was feeling down on the whole situation though. While I can't say for sure the methotrexate caused my cold, that is now my second cold in four weeks. Normally I get like one or two a year. So if I'm going to have twenty colds a year, this is not going to work out. Again, it's early, there is no direct correlation, so I'll take a wait and see approach.

Unfortunately, that means no running for the last eight days. Just as I was excited to pick things up and try to get out there two to three times a week regularly I get smacked down with this cold. I hope to be back running by Monday at the latest. Still need to see how everything holds up with increased activity. My knees feel about the same this week, about 2/10, but my Thursday actually went pretty well. Almost no negative reaction to the medication. So that was one positive.

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.