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.

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 stomach issues I 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.

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?