So Far, So…Good……zzzzzzzzz

After 13 -1/2 years, close to 5,000 injections and nearly $700,000 I have finally moved off of my trusty “bruise juice” Copaxone and moved on to a new pill for treatment of MS. Hooray! This is big news by anyone’s standards (especially for the diabetics in my life) but I have been suffering big time from what is called “needle fatigue”. This is a condition according to MSers whereby the daily injection of….oh for Pete’s sake, it’s when you are bloody sick and tired of shooting up, plain and simple. The initial plan is to rotate and keep track on this nifty little body part chart the drug company gives you: Monday left arm, Tuesday right arm, Wednesday left leg, and so on. This results in a series of nasty little dents in your biceps, thighs, hips and belly. In my case, I don’t carry enough meat on my arm or leg parts, so I resorted to injecting in my rather ample belly and hips only for the last 5 years or so. The Copaxone made sure to increase the dented, blobby mass of those areas for me as well. Yay!

But – pshaw! That’s all behind me now. This new drug, called Tecfidera, is made out of dry cleaning fluid or some such disagreeable thing and like all MS drugs they have zero idea how it works. I swear I was a Guinea pig in a former life because I get these RX’s and go, OK! let’s pop some formaldehyde! Does it contain resin, plastic and particle board bits? Bring it on!

Not surprisingly, there is a long list of not so pretty side effects that goes along with the prescription. The main ones are flushing, itching, projectile body fluids of all types, weight gain, hair loss and so on. Not one to go marching into this new pill popping venture unprepared (I was a girl scout leader after all), I loaded up on baby aspirin (for flushing), Benedryl (for itching), Gas-X and probiotics (for the intestinal distress). Good to go.

I took my first pill and waited at home. Nothing…nothing…nothing….uh oh! My skin is starting to get prickly. No worries ~ I’ve eaten, taken an aspirin and now take a Benedryl to nip this in the bud. And it works! After about an hour, I head over to the store to exalt over my success with my first pill to Anna. I am happy, she is happy ~ we’ve read some horror stories and this is turning out to be a cake walk.

About an hour or so later, I start to feel really droopy.  I can’t keep my head up or my eye lids open and so excuse myself to go home and take a 3 hour nap. Anna suggests that if I can avoid the other nasty effects and the pill only makes me tired, that’s not such a bad thing. I agree, but am thinking I can’t go through the day feeling this fucking tired all the time ~ I’ll become bed ridden! Forget the needle fatigue, this is just plain old fatigue.

After a little bit of research and some advice from  a few seasoned veterans, I realize much to my chagrin, that the Tec doesn’t cause fatigue, but boy Benydryl sure does. Doh! of course.

So now I’m on my second week, taking the full strength dose and thinking I’m feeling pretty good. This is a cinch! It seems I have a cast iron constitution and no little systemic methanol is going to slow me down. I woke up this morning perky, raring to go, and planned my day. First some yoga, then some errands, then a nice dinner, then my drum class.

It started in yoga. We were working on balance, always a particular challenge for me. This time though, I found that in addition to falling over I had big tears running down my face. Huge crocodile tears. Non-stop emotional release tears. Not being much of the crying sort, I brushed them aside and soldiered through class (kind of weeping the whole time) and then came home and just sat down. For about four hours. The errands went out the window and I canceled my drum class. I had to hit the store though for some groceries so I ran into Trader Joe’s. The nice clerk asked me how I was doing in a standard chit chatty sort of way as I was paying and I started to cry. Wow, really!? Choked up over bananas and quinoa?

Despite the fact that I’m bloated, sobbing and half asleep most of the time, I’m hopeful that this truly is my panacea for MS. Considering I can’t face another needle, it damn well better be!

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Lucy in the Sky

I was born in 1957, which put me pretty much smack dab into the middle of high school when it was cool to be a hippie. I didn’t let the grass grow under the platitude of “peace, love, sell some incense”. I ate it up. Long hair parted down the middle, abalone shell necklace on a leather thong, natural wool dyed hats, Joni Mitchell, hairy legs…bring it on.

I had just missed the drug induced 60s (“if you remember the 60s, you weren’t there”), but there was still plenty of pot and things around in my world. A “lid” of pot was about $10 and smelled mainly and suspiciously of lawn clippings. Never was my deal and still isn’t. (MS bonus = medical marijuana, but despite the slight, yet coveted, “bad girl” image it invokes, I just can’t go there.)

So along comes MS. Early symptoms around 26, final diagnosis at 43. My hippie persona was well behind me (six figure salary, BMW, Prada perfume, $100 haircuts, W Hotel).  I had luckily survived the music industry during the crazy 80s and 90s and my drug of choice was now a solid  $30 bottle of Pinot Noir.

Welcome Copaxone. Ew. Are you fucking kidding me? A DAILY injection? As I’ve chronicled here before, it’s an uncomfortable, lumpy, burny, creepy, bummer. And it’s like, wow, a MONDO drug. Not only that, but to be 100% honest here, I still really don’t have a clue what the heck it does or how it works after 12 years (that’s well over 4,000 shots). It also now costs over $4,000 per month (thank you health insurance and co-pay assistance!). Huh. I haven’t done the math before….holy cow!!! I had gone from sanctimoniously turning away from lawn clippings, to daily injections of drugs I imagine are more expensive than the finest grade of heroin.

But back to my hippie roots. I’ve discovered that since I’ve had to quit my high powered, super fun, big dollar, high pressure job and been forced to slow down and nap, hirple and read all day that I’m starting to pull out the Joni MItchell, quit dying my hair, and only occasionally dabbing on some left over Prada. I’m now reduced to $10  boxed wine – mainly because of financial issues, but also because it is much more eco friendly……

The proverbial drug cat got out of the bag though. My doctor has given me valium to take when the spasticity is bad or I’m feeling a little too anxious. I take a statin for high cholesterol as I can’t exercise enough to get it down naturally. I take a nightly dose of antibiotic to counteract UTIs caused by catheterizing. You get the idea.

I’ll continue to recycle. I’ll continue to conserve energy. I’ll continue to eat organic. But, I think a little chemical help is warranted and welcome thanks to this interloper – MS.

Illustration by Hizza Siller

 

Lumps and Grinds

I am generally a pretty sunny person, and don’t like to spend a bunch of time lamenting my lot in life. Overall my lot includes beautiful children, an amazing and loving family, fantastic friends and the gift of a sense of humor (thanks, Mom). But every now and again, something just pisses me off, so allow me this rant.

Eleven years ago, when I was first diagnosed with MS, there were 3 therapies available commonly referred to as the ABC drugs: Avonex, Betaseron and Copaxone. The choices between them were wonderful: weekly injections or every other day injections or daily injections. Golly – how to choose? The first two apparently can cause such bad flu-like symptoms that after injecting, you can be down for the count for days. You’re kidding me, right? I didn’t think that was my best choice. But a daily injection? Ugh.

Fortunately, (I use the term rather tongue in cheek here…) Liza was giving herself up to 6 million insulin injections per day for her diabetes, so I was chagrined at what a pussy I was being; and we were also rich in sharpies disposal containers.

During this time we also had a cat named Lila (sister of the demon Cleo) who got sick and the vet informed me the she would require daily injections. I didn’t think so. She got exactly ONE if you take my meaning….

Anyways….so I chose the daily injectable of Copaxone, as the side effects seemed minimal. My doctor at that time was a Dr. K who worked at USC. He had been one of the early champions of Copaxone (I believe he was one of the developers of it (certainly he spearheaded up clinical trials of it) so he of course agreed with my choice. (Dr. K was great ~ he once told me after seeing my MRI that yes, in fact, I had brain rot. We shared a similar sense of humor…).

When you begin a new therapy that costs over $4,000 per month, it comes with a nurse who makes a house call. She showed me how to wash my hands, open an alcohol swab and how to mix the alchemy that was my shot. When I started this therapy, I used to have to mix up my own potion. I had little vials of stuff that I’d measure out and swirl around until the concoction was ready, and then I’d draw up my own syringe. Egad. It was like high school chemistry all over again. Oddly enough, I flew overseas one time with this make shift lab in my carry on, and nary a word was spoken through security. Must have been pre-Sept 11.

The nurse showed up with support materials: a little stick figure picture detailing the 7 points of entry: left arm, right arm, left thigh, right thigh, left hip, right hip, belly; a little calendar to put on the refrigerator to remind me of which location on which day; and an 800 number for support.

All good, let’s go. I took the first shot in my right arm. H-O-L-Y F-U-C-K. Big giant alligator tears streamed down my face ~ it HURT. In trying to describe it later to my sister I called it Bruise Juice. There was no other way to describe it. You know how when you’ve bruised yourself and you inadvertently lean on the bruise you get a very distinct and unique wave of pain that spreads up to your ears? Imagine, if possible, that feeling being injected into your body. It was the worst.

The capacity of the human body to adapt is nothing short of amazing. In a relatively short period of time the bruise juice feeling subsided, I scrapped the support items and I was jabbing away like an old pro. My daily grind, day in and day out. And then, about 3,500 shots into it, a new phenomenon set in. Scar tissue. I guess it’s inevitable that you just can’t keep stabbing ourself over and over and expect the tissue to remain soft and supple, but it got so hard the needle could no longer penetrate. And I got dents. Dents in my arms, thighs, hips and belly.

Since no piece of cake is complete without a cherry on top, I added menopause into this olio of battered flesh. This change in hormones almost always includes a healthy helping of unanticipated and rapid weight gain, particularly in the middle. I am no exception. So here I am: a pair of skinny legs with dented thighs; a set of skinny arms (I don’t even have flapping underarms) also deeply dented; some good cratered curves on top and a nice comfy and lumpy belly. Pretty.

Now that you have that fabulous imagine seared into your mind, let me explain the reason for the rant. I stopped injecting in the legs and arms as they don’t have the…let’s call it the traction, that the hips and belly do. Now I’m down to 3 locations and they have taken the brunt of the over 4,000 shots I’ve given myself over the last 11 years. This hardly seems fair, so the other day I decided to give the leg a shot. It got all swollen and creepy and I had to run over to a friend who’s a doctor to look at it and then ice it for an hour. So, next up, I tried the arm. Son of a gun if that old Bruise Juice feeling didn’t come burning back through, AND I couldn’t lift my arm for 3 hours.

That is what pissed me off and prompted this rant. We all have to take our lumps in life and I know it as well as anyone, but sometimes it feels really good to just get mad and vent. I feel better now, so I’m going to go back to Googling the new oral meds that are coming out ~ I hope to heaven they are not Bruise Juice pills.