LIFE ON LEFLUNOMIDE

Remember when I was getting PT for arthritis? Ha!

I'm writing this post mainly to help anybody out who might find this blog via searching for running with psoriatic arthritis while taking methotrexate or leflunomide, etc, etc. I can only share my experiences, but I did detail my journey with methotrexate pretty extensively and I feel like I've been ignoring this drug switch a little. Anyways, running wise there is nothing new, I am still running at least twice during the week and then a long run on the weekend, so full steam ahead there. It's very challenging to stay motivated with the cold and the dark but that's why a race like Miami is so beneficial. Gives me motivation to get out there!

Long story short, I am loving leflunomide so much more than methotrexate. Like orders of magnitude more. It's like one of those Magic Wave ovens... "set it and forget it!" Instead, in this case, it's "take it before bed and forget it!" With methotrexate I was always conscious about the fact I was on it and it was affecting my body. Now, in terms of symptom relief, it was amazing! Essentially full remission of psoriatic arthritis. The price I had to pay though was steep... feeling like shit one day a week after taking it, constant bruising, dreading the next dose and constantly thinking about it, ridiculously prone to sunburn, etc. The side effects weren't going down and the thought of taking that for decades to come was very depressing.

Also in the "try again!" hall of fame.

I'm so glad I made the switch. When I complained at my rheumatologist appointment she presented leflunomide as an alternative but really didn't expect me to agree to it so easily. She was basically like "You don't have to decide now, you can think about it and if at your next appointment you are still struggling with methotrexate, we can switch." And I was like "No, let's switch it now." Very glad I pulled the trigger, if I hadn't, I would still be taking methotrexate. Just writing this post and thinking about it is genuinely making me nauseous.

With leflunomide I just take my daily pill before bed. It's a very small pill and the only side effect sometimes is a rumbly tummy. Sometimes I don't even feel it. Sometimes it's annoying for about 15 minutes. Never is it too bad. Probably has something to do with the last time I ate. Other than that I have noticed zero side effects. The potential side effects are similar to methotrexate but I haven't experienced any of them. The sunburn one will have to wait, but otherwise I feel back to normal. When I was first taking methotrexate I had problems sleeping too, that is no issue here.

As for symptom relief... I would say it's almost on par with methotrexate. I don't think it's had a fair shake yet, right when I switched I got a little more serious about running to train for the Holiday Half and just now it has built up to near full efficacy. There also was a chance at a small flare as the methotrexate worn down and the leflunomide built up. I think I did experience this a little... I had some slight jaw and upper back pain a couple weeks ago. And my knees felt a little funny. It's hard to tell with them, whether or not they are just a little worn from a run or if they are feeling some inflammation... at super low levels it's tough to distinguish. Regardless, at this level it doesn't effect my ability to run or do anything at all.

Onward! My long awaited return to Corvallis this spring!

The jaw pain and back pain is basically gone again and my knees feel pretty good. I want to say maybe like 95% of the way to where they were with methotrexate, but that also might be me being picky and concentrating on them so much trying to compare and contrast. Regardless, in the grand scheme of things, they feel AMAZING compared to this time last year. I can run and maintain half marathon shape without a doubt. Pretty confident they can handle a full marathon too. I still don't know if there is a speed or distance barrier I am going to hit with them, but I'll just keep plugging along and see what happens.

Overall, I am thrilled with how things have turned out. It was the relief I was hoping for during 2016! As for my plans in 2018... a return to the marathon is in the cards! I already tried, and failed, to get into the Chicago Marathon. My next attempt will be the New York Marathon lottery in January (results in February). That has a < 20% acceptance rate, so probably not a good bet that I get in. I will then try the Marine Corp Marathon, which apparently has an ~85% acceptance rate. Should that fail, I'll just sign up for some less popular race, location TBD.

CHRISTMAS UPDATE

This was unintentional, I swear. Although, I might have to expand (heh) on this in a later run...

Sorry for the lack of updates! The week after the Holiday Half I didn't accomplish very much. I took the beginning of the week off to recover and then felt under the weather toward the end of it. I did accomplish one run on Thursday and then was planning to do 8 miles or so on the weekend. By the time it rolled around the weather was terrible and I still didn't feel too well. So I just skipped it. No harm taking one week after the race a little easy.

I did make it a point to go out there and get it done this last week though. My "slacker" week almost tainted me to the point where I was going to be lazy and start skipping runs again. I could see it all snowballing downhill! I ran on Monday with Matt at PRC and my body felt really slow and lethargic. I felt run down most the week actually. It's been really cold too so it's been hard to be motivated to get out there. So much easier to just sit inside. A few weeks of slacking couldn't hurt, right?

Anyways, I was able to find some time on Wednesday during my lunch to do a short run. I decided I needed to kick things in gear, so I went out and did a tempo run. Now, my focus is just getting back to regular running, so I haven't been focused at all on speed work, but I figured now was a good time to challenge myself and see where I was at. I ran three miles and gave it 100%. 7:58, 8:06, 8:04. First mile under 8:00 since the arthritis diagnosis! Felt good too. Definitely a hard run, but not impossible, and my body responded really well. So that was encouraging.

Thursday it was so cold outside the thought of running through the dark was really bothering me. I have to get past that. Instead, I went to the gym and did four easy miles on the treadmill. Dramatic of me, but whatever, I got my run in. And then today I accidentally run a phallic shaped route of 10.5 miles. I went off on my own around 9am and let me tell you, convincing myself to get out of bed to do that should have earned me an Olympic medal. But I did it! And I ran 10.5 miles at 9:49/mile pace. And my body felt good.

So I feel strong again! It is still very hard to get motivated to go out in the cold. That will continue to be a struggle, but I have to just keep fighting through it. I want to continue to be in shape for Miami at the end of January. Everything arthritis wise still feels fine. The leflunomide appears to be keeping it at bay, which is awesome. No more nasty side effects and continued joint relief. Here's to an awesome year of running in 2018!

2017 HOLIDAY HALF MARATHON RACE RECAP

Lined up with about a minute to go until the race. Beautiful weather!

My alarm went off at 6:30am Sunday for my own personal "Breaking2" attempt. I was out of the house by 7:00 and parked near the event at 7:30. I met up with Sunstone to take some pre-race photos. I wasn't really nervous at all this time around as I knew I was trained and I knew I could finish. While I really wanted a time below two hours it wasn't critical. Just the fact I would be out there running around two was a victory.

The weather when the race started was sunny and clear and 30 degrees. I wasn't too cold before the race as there were enough people to block the wind. My outfit was pretty warm too; I wore a beanie, warm gloves, a short sleeve tech shirt on top of a long sleeve tech shirt, long basketball shorts, and high black compression socks. It ended up being just about perfect... I took the beanie off about two miles in and then was comfortable the rest of the race. Not too hot, not too cold.

THE FIRST FIVE (8:45, 8:31, 8:50, 8:59, 8:51)

Before the race with Sunstone.

My goal pace going into the race was 8:55/mile. I was preparing for running a long course (which was good, as my watch clocked 13.2 miles) and the desire for a bit of a cushion at the end. To run a sub two half marathon you technically need a 9:09/mile pace, but you should always shave 5 seconds or so a mile for a long course. I then shaved another 10 seconds to have a two minute cushion to finish in 1:58 if I managed to hold pace.

Anyways, as you can see, I didn't pace myself too great. It partially wasn't my fault though! After starting, the roads were very packed and it was hard to move. I wasn't quite able to get to the "under 9" corral so I was running with people who were going a little slower than I wanted. I ended up popping up onto a sidewalk and slowly passing a lot of people. Every time I looked at my watch I was going to fast. I'd slow to correct myself, but by the next time I checked my watch I was going too fast again. Probably letting the energy of the race get to me. My splits weren't tragically fast though so I wasn't too worried.

After those first miles that were too fast, I settled into the appropriate pace. It felt good - like an appropriate half marathon pace. I was able to enjoy the sights and sounds of the race. Lots of people dressed in wacky costumers, carolers along the course, residents with bluetooth speakers blasting Christmas music. It was good times! Like I mentioned, I had to take the beanie off, but otherwise my outfit was perfect for the cold but clear conditions. The sun was shining and it was just the perfect day for a race. This was a moment when I was so glad to be back running!

THE MIDDLE SPRINT (8:38, 8:34, 8:40, 8:45)

So, as you can see, I started to pick up my pace again? What happened? Well, I was feeling good. My body seemed to naturally keep going a little faster than the target. I didn't want to spend the whole race staring at my watch either, so I only checked it every so often. The pace felt perfect, like a half marathon should, so I wasn't too worried. I figured I might slow down a little at the end, but with the way I was feeling I knew I wouldn't blow up and now had a decent cushion on my two hour goal.

Another factor was some very gradual downhill. I figured I should take advantage of it a little bit, so when my times kept coming in under the 8:55 target I wasn't too upset. The course was very flat, much more so than I expected, so none of this was very significant. There were even some slight uphills portions here. I think even at times it might have looked downhill but was flat, or vice versa. Anyways, I was trucking along and felt good. I could tell my legs were tiring somewhat but with just four miles to go I knew I could survive.

HELLO NINE, MY OLD FRIEND (9:04, 9:11, 9:08, 9:18)

The only significant hill of the race was contained in that 9:04 mile ten. It was probably only about a city block in length and I didn't want to tucker myself out on it, so I took it easy. When I hit the top I resumed my 8:55 pace. When my watch beeped with a 9:04 mile I thought "Dang, that sucks. Would have been cool to have all my miles below nine." Ha. Little did I know, my miles would only get slower from that point.

I was working just as hard, but my pace seemed to naturally be 9:10ish now. I had experienced this before, especially in marathons. You feel like you are going just as fast, you are certainly working just as hard, but your pace drops. It sucks! It's because your legs are tiring and you aren't quite springing the same distance forward as before. Anyways, I knew at this point to speed up to try and chase a certain number would be a bad idea, so I just kept my effort consistent and knew the finish line wasn't too far away.

As you can see, my mile thirteen was the slowest. Oops. The too fast start was catching up with me. I wasn't in shape to run a half marathon at 8:40, which I apparently was attempting to do. Luckily, with a half, you can get away with it for the most part. Marathon would be a different story. But with a half, you just need to hang on for a few miles. I knew I had built up quite the cushion and that even 10:00/mile at this point would likely get me into the finish under two.

FINISH

A "flattering" shot of me right after finishing.

When we were just under a half mile away a woman saw me look at my watch and asked "How much further?" Haha. I feel you. I told her it was only fourth tenths more. We both agreed that was nothing and we would finish no problem. And it wasn't! In fact, I ran the final quarter mile at a 7:40 pace. So I wasn't completely clobbered. Felt good to sprint strong through the finish line. I knew I had gotten my goal but the 1:56 on my watch was a surprise. Didn't expect it to be quite that fast! Awesome!

After finishing I wandered around and got my food and beer. My legs were tired but not tragically so. I was still able to slowly climb stairs without too much effort. Unfortunately, the finish line was a crowded mess and I didn't spot any one I knew. So I chowed down on my free soup and beer and then headed home. A warm bath and day reclining and watching football was calling anyways.

Shaved another 25 minutes off my half time! Wohoo! Unfortunately, I am now at a pace were gains will be much harder to come by. But the journey of rapid improvement from 12s to 9s certainly was fun!

Official Chip Results: 1:56:34, 8:53/mile. 585/1846 overall, 324/674 male, 53/92 M30-34.

2017 HOLIDAY HALF RACE PREVIEW

Starts under the arch near Adidas USA headquarters.

This Sunday I'll be doing a race I've been eyeing for years... the Holiday Half! This race is notorious for shitty weather, which has been the main culprit scaring me away from it. I signed up a while back ready to embrace whatever Mother Nature had in store and luckily she has decided to be very gentle with me. So I'm excited! It's a race I've been meaning to do since I started running and now I'm finally doing it!

Before I get into the nitty gritty of the race preview, let's do a quick update with how things are with my body. Everything is still clear sailing on the psoriatic arthritis front. It's now been a full month since I stopped taking methotrexate and I still feel GREAT. Very encouraging. There are virtually no side effects I've noticed so far with leflunomide. A little rumbly tummy for a few minutes right when I take it (before bed) but that's it.

The verdict is still out on some of the other side effects that I had with methotrexate that I could have with leflunomide. Sunburning more easily will have to wait a while to be determined, along with my lips chapping ridiculously easily due to sun. One thing I can test out is how easily methotrexate made me bruise. Like a peach! Like I peach I tells ya! That seems to be gone with leflunomide. The other day at work I really whacked my arm and it for sure would have been an ugly bruise before. Now, not so much. I'm also not finding random bruises on my body which came from who knows where.

Rolling downhill toward the finish line on Greeley.

My legs did feel a little worn this week but it makes sense. Last week I ran four times for a grand total of 25.6 miles. Definitely the most since the onset of psoriatic arthritis. I only ran twice, 5.5 on Monday with PRC, and then 4 on Thursday with Sunstone. My legs felt a little worn but it was the normal worn, not "flare impending" worn. They should feel fresh enough and ready to go on Sunday for the half marathon. So I'm excited to get out there and give it my best shot!

As for the race! Expect temperatures around freezing with partly cloudy skies when the gun goes off at 8am. I remembered similar conditions for the Hot Buttered Half Marathon two years ago, so I double checked my outfit for that race. I plan on wearing a long sleeved shirt with gloves and a beanie. I can always roll up my sleeves and take my beanie off if I get too hot. I'll have a red/green color scheme going on to be festive. I am truly a hobby jogger now!

In regards to the course, it's pretty flat. Sure, nothing in Portland is truly flat except maybe Sauvie's Island, but in the grand scheme of things this one isn't very hilly. I have seen a couple of elevation charts that differ with each other, so I'm not sure quite what to expect. I think the area right near the start/finish will be hilly and then again near the turnaround point in St. John's. I know for a fact that Willamette Blvd, the bulk of the race, is very flat from many training runs and the Portland Marathon.

Luckily the race has an indoor area to hang out before and after the race. Thank goodness! I will know a number of people at the race so I'm hoping to bump into them. There is beer and chili and general festiveness after the race so it should be a good time. Will be nice to run a half marathon in half marathon shape again. It will be hard but the question of whether or not I can run 13 miles is not really a question at all!

GOALS:

"C" Goal: Beat my "post PsA" half marathon PR of 2:22. If all else fails, I need to at least beat that mark! This is 10:53/mile.

"B" Goal: Sub 2:10. This is the next step. Miami in January was around 12:00/mile. Boring was just under 11:00/mile. This would put me just under 10:00/mile and get my half marathon pace back into the 9s. Heck yeah!

"A" Goal: Sub 2:00. The old "sub two hour" marathon goal. I am now a proud member of this club. I think if I'm feeling good and run a good race my time could realistically be anywhere from 1:57-2:03. I could run my best and not get this. But there's a chance! I'm going to start the race by pacing myself to this time and we'll see if I can hold on!