SIXTY? NINETY? HARD TO TELL

Weeknight four mile run with Sunstone

Ahoy! Mid-August update coming fast and hot. Make sure you are strapped in, because this is going to be some Earth shattering shit. Okay, not really.

Training for the New York Marathon is going fairly well. I made a "training plan" around the beginning of July because at that point it was four months until race day and I needed some kind of structure or something to keep me accountable. By that point I had worked up to a half marathon distance (as evidenced by the last post), so it was really just a matter of getting my way back up to 20 miles in a way I think my body could handle. And then hopefully get the normal three 20 miles runs in.

So far, so good! I have been able to hit each long run. So that's encouraging. My 16 last weekend went pretty darn well, all things told. Not quite as "easy peasy" as previous years, but it wasn't painful or anything. I'm starting to feel confident on my ability to work up to that 20 mile mark. That wasn't something I would have been confident about just a couple of months ago. If I can keep hitting these long runs as scheduled, I'll essentially do my normal long runs for a marathon training cycle.

The weekday runs are another story. Basically, I'm running twice a week and they are usually four miles a pop. Not exactly what I need to be doing for marathon training. However, in my mind, the weekend long runs are the most important to being able to shuffle painfully across the finish line, so I'm trying to make sure I can hit those without issue. Normally, I'd be running three times during the weekdays and total about 20 miles. I'm running twice totaling 8. That will be felt on race day.

I haven't let totally loose because I'm still not quite there with Simponi. If I were writing this post two weeks ago, I would have said it was working just barely enough to not immediately want to change to another medication. But the last ten days or so, I've felt fantastic! Not 100%, but the best I have felt on Simponi. I need to keep tabs on when I am feeling good and bad to see if there is any rhyme or reason to it. Maybe toward the end of the monthly "cycle" before my next shot it does wear out? That would square with my most recent "blah" period. And my most recent "wohoo" period started about a week after the shot when it had a chance to ramp up. Maybe. Or maybe not. I hadn't been paying attention closely enough in the previous months to know if that was a trend.

When I'm feeling crummy, it sucks. I have maybe 60% relief. Which, even that, I am grateful for. Because I know what 0% feels like and its miserable. So even when it's not working great, when it's enough to get me about my day and not be in a fetal pain ball, eh, I'll take it. But in terms of running or doing any sort of activity? It sucks. Right now? I feel like... 90% relief maybe? I mean, I feel pretty good. The arthritis is still there in a very mild fashion, but I feel like I can do active things and not get up from chairs like an old man. The problem right now is consistency. If it was consistently like when it's bad, I would have to try a new medication. If it was consistency like I have been feeling very recently, Simponi for life.

So yeah, that's the update. I will just ride these flares of good and bad all the way to the marathon. I plan to just run New York at my long run speed, 11:00/mi, and call it good. Running a marathon will be victory enough. Under five hours is like 11:20/mile or less, so I'll probably make that my informal goal.

In the meantime, hopefully the Simponi can continue to ramp. The 25th of August will be six months, when it is supposed to reach it's full efficacy. So technically I do owe it another two weeks. It's just frustrating when lefluonomide had it in 100% remission and I basically forgot I even had it.

2021 INDEPENDENCE DAY HALF MARATHON RACE RECAP

During the much more populated first loop of the race.

July 4th, 2021 marked my first in person race in nearly 17 months. Crazy to think about for someone that has been racing every few months since 2012. Since the pandemic hit, I've really been struggling with my psoriatic arthritis, so I guess the timing worked out in terms on not really missing out on anything. Races in Oregon have been doing in person events for a couple of months, but with the official "opening" of Oregon on June 30th, this one was particularly back to  normal. No wave starts, masks at the start/finish, nothing like that. Just a regular old race.

One thing that has happened with the pandemic is my sleep schedule getting really fucked up. It is painful to be awake by 9am. So with the race starting at 8am, a 6:45am wakeup call was in order. Couple that with not being able to sleep well the night before in anticipation of the early wakeup/race and it was particularly painful. I got, at best, three hours of sleep. I think it was more like two and a half. I tried to avoid looking at the clock. However, I've done Miami and other races plenty of times on that amount of sleep, so I knew I could do it.

Upon arriving at Champoeg State Park, I could almost immediately feel the energy of the race. It's crazy how much I missed that vibe. Any tiredness was immediately gone and I was starting to actually get pretty excited. It felt like there was electricity in the air. Damn, it was good to be back! I went and picked up my bib, put it on, and then went to the start line. In usual Thomas fashion, I didn't leave too much time to dally. By the time I had my bib on and my race shirt in the car, there was only 15 minutes until the gun went off.

THE FIRST LOOP (9:50, 10:19, 10:08, 10:16, 10:11, 10:00)

My plan going into this race was not to actually race it. While I am building mileage and feeling alright, if I were to actually race a half marathon at this point... it would probably take me out for a couple of weeks. Overall, it would just not be smart. My longest long run had been twelve miles and that was really tough, so I knew I had to take it easy. I figured I would just do my normal long run pace and make sure I didn't roped into anything faster. I needed to be smart and just enjoy an expensive, atmospheric long run.

Turns out my pace settled into about 10:10ish a mile, which was a little faster than I was expecting. I knew the race would motivate me a little bit, but I was expecting more of a 10:30. I didn't want to micromanage my pace though, and my heart race was right where it normally is for a long run, so I left it alone. I was very conscious to just stay within myself and do my thing. It felt great to be out there again! Even if I was seeing people I knew way ahead of me on the out and back, people I would normally beat, it was all gravy. I missed this so much, and the fact I wasn't suffering, like during a raced half marathon, was an extra bonus!

This first lap of 10k flew by pretty quick. I did have to go pee and skipped the first bathroom thinking I would hit it up later. The race director made a big deal of saying there were bathrooms all along the course at mile 2 and mile 4 or whatever. What he didn't mention was that was the same single port-a-potty at the one point the loop turns into an out-and-back So there was one bathroom at a highly trafficked portion of the course. Anyways, at mile 4 I was going to duck in but a dude just beat me to it, so I figured I'd hit it up again around mile eight. Aside from that, my race was going great. 

THE SECOND LOOP (10:08, 10:47, 10:06, 10:26, 10:02, 9:49, 8:40)

The second loop of the course is basically a repeat of the first, there is just an extra (hilly) out and back for the final kilometer or so you need to hit the half marathon distance. I was feeling really good! That 10:47 was not me tiring out, that was me peeing. I missed the bathroom again as someone ducked in right before me a second time. I couldn't wait any longer. I really had to pee. And holding it seemed to be starting some activation in the number two department. Well, the race is largely in a forest setting, so I found a good spot and darted off the course. Ah, sweet relief. I felt SO much better. And any tummy rumblings were also gone. Onward.

Frankly, there is not much to say about the second loop. I was still feeling great! A lot less people this time around as the 10Kers were all done, obviously, and the half marathon was the smaller of the two events. So a lot of time just running on my own. Which was fine... I was enjoying myself! I had been delaying drinking anything because of the pee situation, so the next aid station after fixing that I tanked a couple of cups of fluid. The uphill "extra" section kind of sucked, but I was able to get it done without issue. That's that 10:26 mile.

Otherwise, as you can see, I was rolling. I was feeling good! By the time I hit mile eleven I still felt relatively fresh. The magic of a race, even if you aren't racing! I decided if I still felt good at mile twelve I would allow myself to kick it in. It looks like I started a little early, but not too bad. I was feeling good at 12, so I started to gear up in that final mile. Felt good all the way through the finish. For how much of a struggle 12 miles the previous week was, I was honestly surprised at how good I felt. That final mile kick also allowed me to squeak my overall pace just below 10:00/mile. So that was a mini accomplishment, even if I wasn't trying for speed on this run.

THE AFTER PARTY

I knew a few folks at the race so I said "hi" and ate my free food and beer. Most of the 5k and 10k racers were already gone by that point and I imagine the biggest party was about an hour after the race started. Eventually I meandered back to my car and checked to make sure I didn't make the podium (hey, you never know with a small race). I didn't, so I headed back towards home.

Honestly, I felt great the rest of the day. There was no delayed pain or anything. In the days afterward I felt normal too. A little sore but no DOMS or anything. So, I call this race a great success! I feels good to be back at a half marathon distance. Getting my long runs up to twenty this summer in preparation for New York is going to be a bitch, so I'll take my victories as they come. Plus, the photographer at the race offered photos for $1.99 each, so those are gracing this post. TAKE NOTES OTHER RACE PHOTOGRAPHERS. I will actually purchase your photos if they are reasonably priced.

Official Results: 2:10:52, 9:58/mi. 67/123 overall, 40/61 male, 5/7 M30-34.

FIFTH SHOT AND RACING AGAIN!

I took my fifth shot of Simponi a few nights ago. I accidentally forgot to take it on my normal day, so it was the 26th instead of the 25th. Guess that could be considered a sign of progress that I wasn't jonesin' to take my next shot like I was on the first few.

The relief level seems to be petering out... I would say I am like... 85% relieved. I am not sure if I am "better" than last month... maybe. Maybe I was more like 80% then. I don't know. I'm not getting the "full" relief like I did with lefluonomide. However, I am getting enough relief where I don't want to upset the apple cart. I'm hoping it'll slowly continue to get better, despite the marathon training. Hah.

When I'm running or doing activities, I usually feel more than fine. It really is only noticeable when I am laying around doing nothing. You know that phrase "sitting is the new smoking?" Well, yeah, I can totally see that. Because when I have a "rest" day and I slob around the house, I often feel like shit. I went on a vacation to Lake Tahoe over a long weekend and was doing active stuff the whole time and felt pretty good. Whenever I'm feeling like crap, it's usually because I've done nothing all day. So, I need to get better about doing stuff on my off days. Even a quick walk can make me feel a lot better.

Hopefully Simponi will continue to work and I won't have a Humira-like relapse. We'll see where I am after the New York training cycle and marathon in early November. For my training, I'm just continuing to slowly ramp up miles. I haven't tried to increase my running from three to four days a week yet... I think my body could probably handle it; but, I'm afraid if it couldn't, it would set me back multiple weeks. I do need to ramp my mileage though, so maybe I'll start that third weekday run at like two miles and see how it goes.

My long runs are up to twelve miles and on the Fourth of July I'll be doing a half marathon... an ACTUAL half marathon, with people and aid stations and whatnot. Oregon is "open" again, so it should just be like a normal, old school race. No need for a mask in the corral or a wave start of socially distant runners or whatever... back to a normal race. So I'm excited! I figured it would be a good way to celebrate (and motivate me along) the return to that distance. It will be one of my slowest half marathons ever as I plan to run it in the 10's. I cannot afford the gamble of "racing" it with the shape I am in and the uncertainty with how my body will react. It will be hard enough just as a normal long run.

Other than that, I ran in 112 degrees last weekend. That was fun. It was 108 when I started and 112 when I finished. I did not do a long run obviously. I just did laps around the shaded park and called it good at five miles. No need to be any more stupid than I was already being (no direct sun and 10 degrees color in the shade though). With the heat and whatnot, it was probably the equivalent of an eight mile run. I just stopped at my car every lap or two to refill my water and rewet my neck towel. It was actually surprisingly bearable with these adjustments.

I'll give a report back on the half marathon. It is the Independence Day Half at Champoeg Park I did in 2018 and 2019 as well. Last year it didn't take place (they may have had a virtual option) so we'll call this the third year in a row. Toodles.

Mmm, toasty.

MEMORIAL DAY MUSINGS

Well, I guess I have kind of settled into a once a month post rhythm. So welcome to your end of May Thomas update!

The monthly Simponi shot was effective even longer this time around. In fact, I got to the 25th of the month without feeling the need for it. My knees still felt A-OK on the 25th. So that was encouraging! I do think the relief is building in my system, so hopefully another two shots, six total, and I'll be at full effectiveness. If I am already getting month-long relief four shots in, that's probably a good sign.

I am not going to celebrate too early though. I thought Humira was working for a long time too. I was even able to get back up to 10 mile long runs (I think I even threw in a half marathon distance at one point). All of a sudden though everything went to shit. So right now I am still very much proceeding with a "wait and see" approach.

Last weekend I was finally able to get back up to 10 miles on my long run. I've been increasing it by one mile each week being very conservative and deliberate. It was really hard... I'm not going to lie, it was a huge effort to go ten miles and my body felt like I usually do after a twenty mile run. However, my knees felt 100% fine. I think I am just very out of shape. Ten miles is a LONG way for me right now. So I'm not too concerned over the fact I was pretty sore for two days after that. My knees were seemingly fine. Hopefully it is just the matter of getting my distance legs back underneath me.

The pressure is on though, because I got accepted into the New York Marathon for 2021. I was supposed to run it last year but it was cancelled due to the pandemic. So I deferred to this year (with 2022 as a second choice) and I got in for this year. Which... I'm not thrilled about. I was kind of rooting for 2022. I have to decide for sure in a couple weeks, so I'm going to continue to monitor my body. I have plenty of time to train, I just need to make sure my body is going to be up for it. And then I'll just need to run like a 4:45 or something. This will not be a fast marathon. I am so out of shape. If I can maintain a 10:30ish pace for 26.2 miles it will be a minor miracle.

So yeah, that's about it. Ready for summer to start!

APRIL SIMPONI UPDATE - SHOT THREE!

Well, the pattern seemed to continue this past month. The second Simponi shot had a bit more staying power than the first one, and I only really began to feel the need for the next shot about a week before I was able to take it. Down from two weeks the previous time. So maybe the "building efficacy" theory I proposed in my last post was on the right track!

I took my third shot on the 25th and again felt almost immediate relief. It takes about 24 hours or so to "kick" and then after a few days I feel like I have the full effect of the shot. I will say that it is similar to Humira in that I haven't felt "cured" at any point. So while I do feel much better and I'm able to do stuff, I do feel like a little creaky and old. I wouldn't expect full relief right away though, that is something that gradually built up through time with methotrexate/lefluonomide so if Simponi keeps working, maybe the back half of my first year on it I can get there.  It just needs to keep working and not faceplant like Humira.

As for running, I'm slowly getting back into shape. It is such a huge pain the ass to be back starting where I am again. It was kind of fun the first time around after getting treated to get back in shape ... now this is the third time I've had to crawl back from the clutches of "out of shape-ness" ... I'm over it. Running 11:00/mile is no longer cute. It is just annoying. Because I worked so hard to claw back to what I considered adequate... to have that taken away, AGAIN... ugh.

Anyways, I'm trying not to let that get me down. My mental game has to be on point! So I'm running by feel and just trying to ignore the numbers. My long runs should be at an easy pace, so if that means I'm running 11:30/mile, then that's the pace. If a 9:55 pace is tempo, then that's my tempo. If I am able to keep going then these numbers will come down. Patience is the key. As long as I ease back into it, listen to my body, and wait for the medication to kick in... hopefully by this summer I can be somewhat back to my normal self.

So yeah, that's about it. Nothing exciting to report other than Simponi continues to appear to be working, although I'll have to be patient and see if I can get the results I ultimately want. Oh, I did get both of my Pfizer COVID-19 shots this past month, so that was a very positive development!

SOMEWHAT SUCCINCT SECOND SIMPONI SHOT SUMMARY

I've never looked forward to getting shots so much in my life. Between the COVID-19 vaccine and my second Simponi shot, I've started to get hearts in my eyes whenever I see a needle.

Flashback to the weeks after my first shot... I felt almost immediate relief. I was very suspicious of some sort of placebo effect because relief that quickly off the first shot seemed suspect. The proof was in the pudding though, and I was able to go for some short runs and stuff without any sort of ill effects. I did feel much better across my whole body. While the worst of the flare had subsided before the shot, I still didn't feel great. After the shot, I almost felt normal. I still wasn't normal, but I was much closer.

Over the weeks it seemed like the effect slowly faded. I guess that makes sense when the shot is only once a month. I looked up the half-life of Simponi and it is two weeks. So if I'm doing my math right, that means at the month mark you are rocking about 25% of the original shot. There is the potential that I could start feeling arthritic a week or so before each shot, which would suck.

Before the second shot I did feel much better than before the first shot though. So I was still getting some effect. What I'm hoping for is eventually, after a few doses, it will have tamped things down to the point where I don't start feeling stuff again before my next shot. Let's say a terrible flare is 100 on the "PsA scale." Before my first shot, I was at like a 50. And let's say each shot you can subtract 50 points. So I was at 0! I felt great! But slowly it crept back. But let's say every month I only gain 35 "inflammation points" back. So after my shot yesterday, I went from 35 to -15! And before my next shot I'll only be at a 20. So a few shots in, I'm suddenly not in the positive "I feel arthritic" territory.

That's my hope at least. That's what I going to tell myself will happen. I mean, I did feel immediate relief again after my second shot. So much better. Hopefully by the time my third shot rolls around, I'll feel better than before my second shot, even if I am feeling a little arthritic again. And then four or five shots in, maybe I'll have it back in remission status. That would be great. Because I'm having no bad side effects (that I know of) to Simponi and the fact that it is only once a month makes things really easy.

Anyways, that's the update. I'm getting out for runs twice a week. My long run right now is four miles. I'm completely out of shape again. Oh well!

I made a thing in MS Paint. Please clap.