Wednesday, September 29, 2010

Baseline (Week 0) - Let the trial begin

Sometime in the last week, I officially became medical research subject #1303.

The clinical study of which I am now wedded is studying the effects of adalimumab on people with undifferentiated or peripheral seronegative spondyloarthritis (SpA).

The article How Did I Get Here is the story of, well obviously, how I came to be in this position. Over here, are the Players. All the people who have been and, in some cases, continue to be part of this story are given a mini-bio right here. Finally, over here, is my explanation regarding why this blog exists.

We begin this blog, at Baseline. Another name for Baseline is Week Zero. In practical terms, it involves filling out 20 pages of surveys, blood tests and clinical assessments. In my trial, the medical alumni at K are studying arthritis sufferers, so in addition to weight, height, and other physical facts one would expect to part with, it also includes joint assessments.

My joint assessments involve poking and prodding into joints looking for signs of limited mobility the range of motion, pain and swelling. If you have read How Did I Get Here it would be no surprise to find swelling and pain in my left ankle. There was also swelling in my right elbow, something I didn't expect and have assumed it to be to do with the fact that two days prior I was pushing my 11 lbs bowling ball down a set of polished floorboards which is an activity I have not been in a position to do much of in the last couple of years.

The last thing to be done during my baseline visit, would be to take my first dose of Adalimumab. Easy enough one might think until you learn that Adalimumab is administered by way of a needle and it is up to you to learn the art of performing subcutaneous injections. We've all seen it being done to someone else but how many of us think we can learn to do it without being told a very important secret. The golden gift of the perfect words which must certainly exist and when these words fall upon our uninformed ears, their power and wisdom make us an instant craftsman.

Seriously, these words don't exist.

The instructions are crap. They are crap because you just have suck it up and have a go. In fact, if the instructions said 'Suck it up and have a go' I think I would have actually helped. So I sucked it up and had a go.

I failed the first attempt. I flinched right at the last second and by the time my hand pulled away, the needle was almost touching the skin. If it did I didn't feel it. On the second attempt I didn't flinch. The needle penetrated like it was supposed to and I plunged the contents into the tissue.

Adalimumab fact #1: Adalimumab has a filthy sting.

My CO would tell me that the sting is not caused by the needle, because the needle is very fine. It stings due to the preservative that is used to keep the drug protected from early expiration. Now I'm no genius, but surely they can use another preservative. Last time I checked, there were millions of preservatives the human race has managed to either find or synthesise. Furthermore, my exposure to them whilst in the process of eating a meal has yet to result in my tongue and my gums going through such trauma. I'm just sayin.


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