HUMIRA TREATMENT FOR PsA - THREE WEEKS IN

I'm pleased to report I'm already feeling relief of my psoriatic arthritis symptoms with Humira. I did my first injection about three weeks ago and the second injection about a week ago. They say it can take 6-8 weeks to really kick in, but I'm already feeling a lot of relief. Since my case is more moderate, it might made sense that I am feeling it kick in earlier than someone with a really bad case. My knees almost feel normal again. I do overdo it playing basketball over this last weekend because I was feeling pretty spunky and was barely able to get up the stairs when I came back home... so I'm not all the way back yet.

As for the injections themselves, they are super easy and painless. I already injected methotrexate, so injecting Humira versus popping the leflunomide pills is not a big deal for me. It's pretty funny though getting calls from the nurse aide and pharmacist, trying to reassure me how easy it is, offering to walk me through the process, etc. I'm fine guys. I've been poked more than a pincushion these last few months, I'm over it. I definitely had some hesitation the first few methotrexate injections, but this time around... whatever. Jam it in there, I honestly don't care.

And not to sound like an advertisement, but these auto-injector pens are super easy. A little wasteful, the tree hugger in me hates the waste... but they do make it super easy. Basically painless as well; I could barely feel each of my first two injections. I'm sure at some point I'll stab it right into a nerve or something and it'll hurt more, but so far I've felt very little and the drug doesn't burn or hurt going in either. Overall it is definitely easier than when I was injecting methotrexate manually every week.

In regards to any side effects with Humira, the only one I have noticed, and this is the most common one people get, is headaches. I haven't gotten actual headaches, they are sort of almost like the start of a headache... but then I never get a headache. It's hard to explain, but I'll notice the feeling and it feels like I'm going to get a headache but then it never comes. It's just lightly threatening for a certain period of time and then it goes away. Not ideal, but honestly not that bad. If I was getting actual headaches, it might be a different story, as this is something I am feeling just about every day. Although, honestly, I don't know of I got a "sorta-headache" yesterday or so far today.

Throwback Thursday.

I'm hoping as my body adjusts to the medication, the headache side effect will go away. With leflunomide, I don't remember if I put this in the blog or not, but the first few weeks I had horrible diarrhea. That was basically the most common side effect for that drug too. I actually lightly shat my pants at work (TMI?) like the second day I was on it. And I would get five alarm poop alerts almost out of nowhere. However, eventually my body figured it out, and after a couple of weeks I was back to normal. So I'm hoping for a similar adjustment period here. Since these aren't "real" headaches, I could probably live with it, but I am hoping they go away.

Other than that, things are ticking along. I have another, hopefully final, liver test at the end of the month. That should hopefully show my liver enzymes back to normal. I haven't had a drop of alcohol in two and a half months. Honestly, I don't miss it. However, it will likely come in handy on election night, one way or another.

RUNNING WITH PSORIATIC ARTHRITIS (PsA)

So the last month or so has been a trip down memory lane. I stopped taking leflunomide about seven weeks ago after my liver function test spiked. For the first couple of weeks, I still felt basically normal. That medication has a long half life so it remained at a decent level in my system for a few weeks. I probably started to feel the first twinges of PsA after about two weeks. Slowly them symptoms have come back on, although, as I mentioned in my last post, they are nowhere near where they were before.

Here is a sample run over the last few weeks....

Mile 0.0:    I feel stiff and old. Not sure if I can do this today. We'll see what happens when I warm up.

Mile 0.5:    Warmed up and ready to go! Don't feel a thing! Do I even have arthritis? Shit - I think I feel better than I ever did even when it was treated. Maybe it magically went away.

Mile 1.0:    Still feel good! Four miles should be no problem. Maybe I can do five. Maybe I don't feel better than when I was treated, but this is no problem!

Mile 2.0:    Yeah, four miles is enough. Starting to get a little tired. Legs are feeling a little slow. Still, shouldn't be a problem. Still feel pretty good.

Mile 3.0:    I have to do ANOTHER mile? I feel like I'm running in molasses. My heart rate has spiked. God my legs feel heavy. I just want to be done.

Mile 3.9:    This is taking every ounce of strength to finish this run. I feel like I ran a half marathon. My whole lower body is zapped and sore. I hope I can walk up the steps when I get home.

To recap... I feel good when it starts but I peter out pretty quick. I think because my knees are inflamed and weak, all the muscles, tendons, and ligaments around my knees are working overtime to do some of the work a normal knee would do. This results in the more rapid "breakdown" of my energy levels and muscle condition. My breathing is also labored because I'm working much harder than usual for the same level of forward momentum.

This is all very reminiscent of when PsA first crept in on me back in 2015/2016. The first signs were definitely in 2015. I did a run on Valentine's Day with Coach Jim that I view as the first time PsA symptoms smacked me in the face. I was able to train and run a marathon that year, but my knees never did feel quite right. At the time the PsA would kind of come and go in waves, so I was able to train during the good times and ride the bad times out. I still ran 3:39 despite all of that.

In 2016 the symptoms started becoming more problematic. They definitely started to escalate after the marathon and by Valentine's Day of the next year, I could no longer ignore something was going on. By May, I had to shut things down and seek professional help. Take a look at this quote from a blog post back then:

"Something is jacked up and it's primarily affecting my knees. The my knees themselves feel fine, they don't hurt when I run or anything. So I don't think it is anything with the knees themselves. But whatever is out of whack is putting a lot of strain on the muscles and ligaments around my knees so afterward they swell up and complain."

Okay, obviously I was quite wrong about it not being the knees themselves, but those symptoms back then match exactly what I am experiencing now. My knees feel fine during the run, but afterward they hurt and a bunch of surrounding muscles hurt too.

Maybe someone is reading this and wondering if they have PsA based on the way they feel when running. I'm not sure if this is what most people would feel, but my experience has been very consistent over the years. It is very confusing because you'd think if your knees were fucked up they'd hurt while you ran! Well, they don't. And in my case, it led down a rabbit hole in the medical system and it took me another nine months or so to actually get diagnosed correctly.

Anyways, I look forward to my new treatment working and getting the PsA back into remission! I will have a post about how that is going after my second injection (they are every two weeks, I did my first one a few days ago).