I suppose it was only a matter of time, but that doesn't make it suck any less.
An MRI a few days ago has revealed that my faithful MS med of the last eight years[1] has pooped out on me; according to the radiology report of the scans, I've got a "significant" increase in lesion activity in my thoracic and cervical spine and a couple of new lesions in my brain. Thankfully I still feel mostly fine; the most obvious thing I can point to as a symptom is numbness in the fingers of my right hand for the past month or so. Good thing I'm a lefty!
That being said, it seems it's time for a change in medication strategy. "Jennifer, we have to do something about this," says my very earnest neurologist, peering over his glasses in a very earnest way.
The problems with changing meds become clear when the options are examined a little more closely. The med I've been taking, Avonex, is 30 micrograms of interferon beta-1a given once a week via intramuscular injection. Interferons are a class of naturally-occurring cytokines that are partly responsible for the chills, aches, and general sense of having been hit by a bus that one feels when infected by the influenza virus. So, as you might suspect, putting interferons into your body stimulates all the same feelings as having the flu. When I first started taking Avonex, it put me out of commission for an entire weekend. It's gotten better now, and generally it only kicks my ass every couple of weeks, and only for half a day or so. Not ideal, but not horrible either.
The other two interferons available are Betaseron and Rebif, which are dosed every other day and three times weekly, respectively. Betaseron is 30 micrograms, and Rebif is 44 micrograms. Either way, it's a huge increase in dosage with, I would expect, a concomitant increase in resulting fluziness.
There is a non-interferon option called Copaxone, which is dosed daily and gives a not-small percentage of people a weird panic attack type thing that lasts for about 15 minutes before it spontaneously goes away. It's not associated with any other side effects.
So my choice is either a daily injection and a possible attack of shortness of breath, flushing, heart palpitations, and anxiety every day; or feeling like I have the flu, possibly more often than not. This makes me very grumpy. Avonex has been ideal; I can plan it around the rest of the stuff going on in my life so that if I feel like crap afterwards, I'm not missing anything important. But apparently 30 micrograms a week isn't enough to keep my messed-up immune system behaving itself, and it's time for bigger guns. I knew, intellectually, that MS is a progressive disease and that sooner or later I'd have to deal with un-fun stuff, and I should be grateful that I've had eight years of surprisingly good health. I am grateful, really, to have done so unexpectedly well. But I'm also cranky that my cunning plan of never getting any sicker seems to be unraveling.
In other, much happier news, the move to the evening shift has been fantastic--many thanks to all of you for encouraging me to go that way. I adore my coworkers and the hours are really ideal. Changing jobs continues to be the best thing I've done since moving here, and I hope to stay at St. Luke's for a long time. They let me catch babies! On purpose!
unsound and I have been hiking up a storm lately, thanks to a great book called 60 Hikes Within 60 Miles: San Francisco. We've seen beautiful redwood forests, staggering ocean views, and more critters than I can count. Deer! Pelicans! Crawfish! Snakes! Herons! Egrets! I've been in animal-geek heaven, and this new med change had better not make it more difficult for us to go hiking or I might have to cut a bitch.
[1] Sweet zombie Jesus, it's been eight years.
That being said, it seems it's time for a change in medication strategy. "Jennifer, we have to do something about this," says my very earnest neurologist, peering over his glasses in a very earnest way.
The problems with changing meds become clear when the options are examined a little more closely. The med I've been taking, Avonex, is 30 micrograms of interferon beta-1a given once a week via intramuscular injection. Interferons are a class of naturally-occurring cytokines that are partly responsible for the chills, aches, and general sense of having been hit by a bus that one feels when infected by the influenza virus. So, as you might suspect, putting interferons into your body stimulates all the same feelings as having the flu. When I first started taking Avonex, it put me out of commission for an entire weekend. It's gotten better now, and generally it only kicks my ass every couple of weeks, and only for half a day or so. Not ideal, but not horrible either.
The other two interferons available are Betaseron and Rebif, which are dosed every other day and three times weekly, respectively. Betaseron is 30 micrograms, and Rebif is 44 micrograms. Either way, it's a huge increase in dosage with, I would expect, a concomitant increase in resulting fluziness.
There is a non-interferon option called Copaxone, which is dosed daily and gives a not-small percentage of people a weird panic attack type thing that lasts for about 15 minutes before it spontaneously goes away. It's not associated with any other side effects.
So my choice is either a daily injection and a possible attack of shortness of breath, flushing, heart palpitations, and anxiety every day; or feeling like I have the flu, possibly more often than not. This makes me very grumpy. Avonex has been ideal; I can plan it around the rest of the stuff going on in my life so that if I feel like crap afterwards, I'm not missing anything important. But apparently 30 micrograms a week isn't enough to keep my messed-up immune system behaving itself, and it's time for bigger guns. I knew, intellectually, that MS is a progressive disease and that sooner or later I'd have to deal with un-fun stuff, and I should be grateful that I've had eight years of surprisingly good health. I am grateful, really, to have done so unexpectedly well. But I'm also cranky that my cunning plan of never getting any sicker seems to be unraveling.
In other, much happier news, the move to the evening shift has been fantastic--many thanks to all of you for encouraging me to go that way. I adore my coworkers and the hours are really ideal. Changing jobs continues to be the best thing I've done since moving here, and I hope to stay at St. Luke's for a long time. They let me catch babies! On purpose!
unsound and I have been hiking up a storm lately, thanks to a great book called 60 Hikes Within 60 Miles: San Francisco. We've seen beautiful redwood forests, staggering ocean views, and more critters than I can count. Deer! Pelicans! Crawfish! Snakes! Herons! Egrets! I've been in animal-geek heaven, and this new med change had better not make it more difficult for us to go hiking or I might have to cut a bitch.
[1] Sweet zombie Jesus, it's been eight years.