DMARDs and Biologics - A love/hate relationship

It's that day again (well, it was a few days ago, but I was slacking and didn't publish this post)--"shot day" as I have come to refer to it. I both love and hate this day, the day that I take my once weekly doses of Enbrel (the shot) and methotrexate (8 little pills).

Love
I love the day because, well, until about 4 months ago when I started taking Enbrel, I was in ridiculous amounts of pain nine days out of ten. About two months after I began taking Enbrel, I started to have fewer days of pain--now about four out of ten. My previous drug cocktails (Plaquenil, Azulfidine, Methotrexate) helped some, but not nearly as well as the new mix of Enbrel and methotrexate. Up until a few months ago, I was pretty much dependent on prednisone to be able to function at home and at work. Up until this week, I've been off of prednisone for about three months, and hopefully, in a few days, I will be able to completely taper off of the prednisone (6 day quick taper course, though that usually doesn't work and I end up hovering at 10-20 mg of prednisone for quite a while).

HateI hate this day though because it is a reminder of my illness. I am reminded that I will never get better, that each time I take the meds I will be weakening my defenses against illnesses, that the possible side effects could hit me at any time. Of course, there is the pain of the shot itself. Enbrel (the pre-mixed syringe) burns like fire as it goes in. A few seconds of pain is worth it for the relief it provides, but it still sucks. The day after I take Enbrel and methotrexate is rough (nausea, fatigue, weakness), but again, worth it in the long run.

It is difficult, once you find a drug regime that seems to work, to realize that your body can (and will) still revolt. Previously, I didn't worry about that because the drug cocktails I was taking didn't really work all that well, so I expected more pain. Now, after a few months of feeling the best I have in years, I feel let down that the Enbrel/methotrexate combo isn't working as well. The pain is breaking though, and worse, it is coming at me stronger in joints that never bothered me that much before.

I am at war with my body, and I think it is winning this week.

LED beer cooling device

This is pretty cool--beverage cooling, lighting, and style all in one.

The Coolight (via), is a product that may hit the market soon.

COOLIGHT combines a handle and a steel cylinder filled with cryogen. When you need an ice beer, just put the COOLIGHT into the beer bottle. It would help you to cool down the beer as soon as possible. On the top of the handle , there is a cork made by rubber would fix the hole device and the bottle close together, and you can drink the beer through the hole on the top of it. COOLIGHT has another convenient device on its body, LED. LED would display the information of time and temperature in order that you could know what time it is or what the temperature of the beer.

China to change adoption rules

As has been reported all over the place, China has changed its rules for foreigners to adopt children. According to the articles, the changes are in response to the overwhelming number of foreign applicants seeking to adopt orphans in China--currently applicants outnumber orphans.

I understand China's desire to tighten their current rules (which are apparently pretty lax), but one restriction strikes me: the physically disabled are not allowed to adopt.

I can understand some of the rules as they are geared to ensure the child has a parent around for quite some time, but most of the physically disabled are going to be around for quite some time too. At least this concern was brought up by the NYT article:

The quality of the Chinese system and the health of the children is what prompted Mindy and Michael Henderson of Austin to apply for a Chinese child this year, a girl, Grace, who they adopted last month. Under the new rules, Ms. Henderson, 33, would have been disqualified because she uses a wheelchair for a neuromuscular condition. As it was, she said, her adoption agency had to lobby hard to gain approval, and was successful only because Grace is 5, not an infant.

“It’s really a shame,“ Ms. Henderson said of the health-related restrictions. “I’m really, really active. I use a motorized wheelchair so I can get around by myself. I drive my own car, I’ve got a master’s degree and I work a full-time job in management. My husband doesn’t have any sort of a disability.”

Note: The new rules have not been officially announced by the Chinese government, so these reports may be off base.

Rituxan receives FDA warning

The FDA issued a warning for those taking Rituxan. Rituxan is a biologic response modifier that is approved for people with non-Hodgkins lymphoma and Rheumatoid arthritis. The warning comes after 2 deaths and 23 cases of progressive multifocal leukoencephalopathy (PML), a viral brain infection.

First Celebrex et al.. now this. I don't take this drug, but I know that this must be disheartening to those who are. Adding new "side effects" to your drug cocktail is never pleasant.

Illegal Workers Building Border Fence

It's almost too funny: Golden State Fence will pay "nearly $5 million in fines for hiring illegal immigrants".

As many as a third of the company's 750 workers may have been in the country illegally.

This doesn't really surprise me.

Sidenote: Carlos Mencia was right!

IT security hype, lots of it

Bruce Schneier beat me to it, but there has been a bit of a surge of IT security related articles in the mainstream media this week.

First we have:
Criminals target tech students - children as young as 14 being targeted by organized crime!

Then:
Hackers to step up 'cyberwar' in 2007

Usually, I'm all in favor of bringing security awareness to the masses, but sensationalism and hype are not going to help.

Chronic illness and relationships

What no one tells you when you're facing a lifelong illness is that it is going to wiggle its way into every one of your relationships. At first, when the symptoms aren't so bad and the drugs aren't so numerous, you think that it's no big deal. Yeah, you're not normal, not fully healthy, but you're not that bad off either. At some point though, the reality sinks in: this thing is going to be around for awhile

It's not a sudden epiphany, but rather a slowly developing awareness that the disease ravaging your body is starting to make your relationships more difficult.
It's hard to get up in the morning.
You can hardly sleep at night.
You don't want to go out for date night.
You're too tired/hurt/sore/depressed to make love.

At some point, it seems, anger and resentment will come from those you love. They can never truly understand what it's like to suffer the pain everyday. They don't understand that some days you're fine and others you're not. Or that the morning can be dreadful but the evening quite pleasant. The cloud of the depression, resentment and hostility is hard to escape in our closest relationships. A wall comes between you and them--one that, in my marriage, I fear will never be completely torn down.

Road trips and arthritis flares

I was on vacation all last week (though, I don't know if driving 2400 miles over the course of a week counts as a vacation). Of course, we drove because we had to take care of a few things, and driving made that much simpler. Unfortunately, I always forget how painful sitting in a car for 12 hours can be.

Typically I don't have terrible pain in my hips, but something about sitting in car seats for hours on end aggravates them. We did stop fairly frequently to let the dogs get out and do their business and for me to move around, but 5 minutes isn't nearly enough time to get rid of stiffness that sets in after 1, 2 or 3 hours in the car. By the time we arrived at our destination on the first day, I could hardly move and every joint in my body was swollen.

It seems that every time I go on a trip, I end up back on the prednisone for my PA. I don't know if it was the sitting all day, the stress or the changes in climate. On top of that, I got a sinus infection and had to skip the methotrexate and Enbrel when I came back. Thankfully, I'm getting over the infection, but I think I'm feeling the effects of skipping the immunosuppressants this week.

Someone really needs to invent a teleportation device! Or somethingto ward off vacation flares.

Good news for women's health

Breast cancer rates in the U.S. dropped in 2003.

The 7.2 percent decline came a year after a big federal study linked menopause hormones to a higher risk of breast cancer, heart disease and other problems. Within months, millions of women stopped taking estrogen and progestin pills.
...
About 200,000 cases of breast cancer had been expected in 2003; the drop means that about 14,000 fewer women actually were diagnosed with the disease.

New scan could be better (and certainly less painful) than mammograms.

The new scan produces three-dimensional pictures, which are better at showing whether a spot on the X-ray is a benign lesion or a tumor, the researchers at the University of Rochester in New York said.

It can also provide pictures of tissue around the ribs and outer breast toward the armpit, where 50 percent of cancers are found, the researchers told a Radiological Society of North America meeting in Chicago.

Better tools to detect breast cancer early, thus raising the odds of survival.

New oral contraceptives may allow women to forgo their periods!

After a year on the pill, roughly 60% of the women in the study experienced no periods and 20% had some spotting.
...
"There just is no good medical reason for a woman to have menstrual periods if she doesn't want them," gynecologist and study researcher David F. Archer, MD, tells WebMD. "It really does come down to an issue of preference."

Woohoo! I already do the 4 periods a year thing. No periods just sounds so much better than 4 (though 4 is way better than 12 a year). No more cramps, no more crazy hormonal changes, no more migraines during the week of placebo. I'm sure plenty of women out there will be thrilled with this development.

In case you thought the Dems would actually implement intelligence oversight...

"Democrats are balking, just as Republicans did before them" in regard to strengthening congressional oversight of intelligence.

This doesn't really surprise me. I don't really care for either party; I vote based on the issues that matter most to me. But, considering the Democratic Party ran on platforms against the war and against President Bush's intelligence activities, this is a slap in the face to voters who were seeking change--real change.

So once more, the 9/11 commission's recommendations are pushed off. Instead, Democratic leaders have decided to create a panel to look at the issue. So, more time analyzing, no time doing.

The Libertarian Party keeps looking better and better.

Bush says AIDS "can be defeated"

A Washington Post article discusses Bush's initiatives to combat AIDS. Bush's AIDS initiative has helped AIDS efforts in 15 countries. This includes a treatment program that gets drugs to 800,000+ people. On the downside, however, the initiative requires that a third of the money be dedicated to the promotion of abstinence.

I don't see how the President can say the AIDS can be defeated when abstinence is one-third of the education efforts. These efforts are targeted at adults. Adults will do what they want to do--abstinence isn't all that appealing to most. The initiative would be more successful if it took a holistic and realistic approach to its education efforts. Then, maybe AIDS really can be defeated. Until then, consenting adults will continue to do what they want to do.