Rove McManus discovers Adalimumab (Humira) is not something to be taken lightly

Abbot, the pharmaceutical company that manufactures the Adalimumab into little syringes called Humira have come up with some new Ads which are now screening on American telly. If you've ever been to the US and watched a little television, you will know how numerous, and outright scary those ads from pull pushers can be. Most companies have regulations around how pharmaceutical companies can market to consumers. For Australia, there's no room at all to advertise prescription meds, with Aussie law makers leaving the decision between you and your doctors alone without marketing interference.  But on the USA, arguably the largest pip-popping over-medicated country, these rules do not apply.

"Got *blah*, *blah* and *blah* symptoms?. Chances are it might be *blah* and you should be worried. Ask your doctor to prescribe *blah* drugs to you. Go see your doctor today."

Last time I was in the US, I even saw one that went along the lines of "Feeling okay? Well, that's wonderful, but you can feel even BETTER if you take THIS"

Let's not beat around the bush. These ads are designed to frighten people. Frighten people into see their doctor and requesting medication. Between the pressure from the patient and from the drug companies, doctors are in a helluva bind. It's a terrible state of affairs really, but that's a whole other blog article.

Recently, comedian and Australian ex-pat Rove McManus has picked up on these ads. But notably he picked up on the ads promoting Humira.  Now, Humira is no small potatoes. You have very seriousl problems if you are using it and doctors do not put you on it lightly. This is highlighted quite firmly in the ad. Rove's analysis is  quite funny and not unfamiliar or unwarranted. To those of us taking Humira such as myself, we all had these thoughts. But a comedian sums them up quite well. Better than us mere mortals,

Yes, my readers, the content in these ads are true. However, when one is suffering from a chronic condition that results in crippling pain, you'll pretty much do what you need to do to manage it.

Start the video at 1:34 seconds and enjoy.

Week 52 from baseline

A major milestone visit to K today.  That means the full gamut of tests: bloods for toxicity levels, renal function, liver function and inflammation ratings.  Then there's the blood pressure check, weight check, a full physical, joint assessments, the super-sized version of surveys, and peeing in a cup to ensure I'm not pregnant.

The way that they rate a inflammation is rather fascinating. C-reactive protein (CRP) is a protein produced by the liver and found in the blood, the levels of CPD rise when there is inflammation throughout the body.  When there is no inflammation in the body, there is no detectable reading. When I first started the trial, my original baseline visit showed my CRP score was 95.  Last time I was tested, 8 weeks ago, my CRP score was 32.

And for the first time since the early days of the trial, I had the pleasure of seeing The General walk in. And I delighted myself with talking with him for a good long while of my experiences so far in the trial and how we thought I was doing.

I am running regularly now with no pain. Furthermore, last week I completed a smooth and steady 9km run that took me around an hour.  So in essence, that's an hour of high intensity/high impact exercise where all my joints, especially the troublesome joints in the lower half of my body are put through some rough challenges.  Okay, so the times are no where they used to be.  Before I crushed my ligaments, before I broke my leg and before I had any idea I would be diagnosed with arthritis in the years that followed, I could crush 10km in 50 minutes. But it was still enough to make the General beam like the moon.

'It's good stuff isn't it?' he asked me referring to the Adalimumab.

'Oooh yeah' came my reply.

The General examined me and he found abnormalities in my ankle related to the trauma. He asked if I use Orthotics and stressed the importance of some correction specific to that area. Those who have read The Pathway to Diagnosis know I do, but it has been many years since I had the need to see my old feet-loving friends.

We also talked about the additional benefits I see during times I don't forget to take Sulphasalazine as well as Adalimumab.  I admit, there are times I'm forgetful and I don't take Sulphasalazine as often as I should.  Remembering to take daily pills was never my strong point. And the usual trigger for me to realise I have had a forgetful spell and get back on the bandwagon,  is that I have a noticeable presence of pain I know is SpA pain and not any other type of pain.

The General confirmed that all of their research concludes that patients who supplement Adalimumab with another drug generally see better results than when using Adalimumab on its own.

Next review is in 8 weeks. With any luck, I’ll have entered myself into my first fun run since 2003.

Week 46 from Baseline

Week 46 brings me to the half way point in the trial. So what has changed since the beginning of this adventure? It appears plenty.  I've done a little mind mapping to represent the 'then' and the 'now'.

Pretty awesome if you ask me.

Week 42 from Baseline

For the non-medically minded, I introduce you all to the notion of 'Plantarflexion'. This motion, is a motion of the foot. It describes the movement where the toes or ball of the foot is pushed down towards the ground. For example, you Plantarflex when you're pressing down the accellerator pedal of a vehicle.

Are you with me?  Okay then.

Plantarflexion isn't interesting to you until your ability to do it has been removed. And I would fall into that category. But today, I am excited about it becuase I have done something I haven't been able to do in a long time. I stood up on tip-toes using only my left leg to support my entire body weight.

Did I say a long time? I should qualify that. The last time I stood on my left leg and successfully raised myself up high onto tip-toes like any other normal person can do would have been September 2004. Of course we all know that I've only known about my arthritis for a little over a year and a half now, but that goes to show that I have been conscious about it and living with its symptoms for a lot longer.

Plantarflexion exercises using my left side only was the first physiotherapy exercise that Stretch assigned me after I rolled that ankle on a lunchtime run and shattered it like a piñata. It was the first of many weird and whacky exercises to come over the months and while the other exercises came and went, this was the one Stretch demanded I continue. It was painful for me and he knew it, but it was necessary to do as many of these lifts as I could. And after a while, once it was clear that the ankle troubles were plainly not limited to simple soft tissue damage, I stopped. But I never really stopped that exercise, not completely. Instead, I adopted it as a measuring tool and it became a very useful one. During the undiagnosed era, if it hurt like there's no tomorrow, I was in for a limp'n-filled day. On good days, It didn't hurt so much and I could get 3/4 of the way up into the lift. I have never been able to get anywhere near the same degree of extension I enjoy with my undamaged right foot, but it was still a fantastic way to benchmarking how my foot was going to be on any given day.

Since the commencement of my treatment, the need to use the exercise to gauge how I felt has steadily declined as my body has responded and my symptoms have dissipated. I used it early on to measure the improvement I was starting to feel. I used it again to determine when my ankle had improved enough to chance a pair of heels. And yesterday, I did it by complete accident while reaching for something on a high shelf only to instantly realise that I had achieved a full extension with no pain or any other negative sensations at all. No pain. NO PAIN!

It's often the little things that make you grin for days.

Week 36 from Baseline

It's been quite a number of weeks between updates, hasn't it? While I haven't enjoyed neglecting the blog, there really hasn't been too much to tell. My symptoms have been consistency negligible. And there is no point filling this blog with posts that tend to waffle on and on for no good reason.

But I thought it be prudent that I at least drop in.

Last time I posted, was around the last time I had a clinic visit. My visits are now every two months. So it was first time I would visit the clinic since my CO left to move interstate. Actually, my visits are always scheduled for Tuesdays and this week was no different. But since I hadn't set a push notification for the calendar item on the 'ol iPhone, I forgot the appointment. Naturally this did not go on unnoticed.So my appointment was rescheduled for today instead.

As it happens, I missed out on seeing my old CO, who happens to be in Melbourne vising family.; And while she was here, she dropped into the clinic to help out. But she wasn't in when I was there. I am a little disappointing she wasn't there. A part of me misses her familiarity and her friendliness. That's not to say my new CO, CO2, isn't friendly or likable. But my former CO did have a way of making the visits, the poking and prodding almost fun....... Almost.

But there was some familiarity. Flames was around to do my joint assessment.

Today's visit started with CO2 leaving me to the full monty of survey questions while she prepared all my drugs.

Then came the "How are you feeling" question.

I told her about that the SpA is all good. Little bother since my last visit. It's never really been made clear to me what I am supposed to say at these times. I know I'm supposed to talk about my SpA symptoms but I never know if I'm supposed to tell her if I'm noticing other changes as well. I think I'm supposed to. After all, there's a billion and one side effects one can get from taking Adalimumab as can be seen here. So I also told her I think I'm feeling my heart beat in an abnormal way. This is true. I have only noticed this in the past two weeks. When I am idle I notice it. My heartbeat changes to an abnormal beat for around a minute or so. Since I am a First Aid volunteer, I am pretty quick to check my pulse. It feels irregular and thready. And then, just as quickly as it started, it will go back to it's usual normal beat. On two occasions, I recall I felt a little odd at the time. It's hard to describe 'odd'. I guess it could be described in one way like a little bit like a rush. Not the head-spinning kind. But like..... I dunno. A rush.

I'm 34, not overweight, have a decent diet and when the Melbourne winter isn't at its finest, I like a little exercise. I don't really fit the profile for someone who has a high-risk of cardiac issues that require immediate action. I've told my CO2 so I assume its on the record and the doctors, possibly The General, will see it. And I have little doubt that if its a problem I'll get a call soon. And if its not, it'll go into the filing cabinet of irrelevance. Still, I have made a mental note to raise the matter with Dr Flowers next time I see him should the symptom not go away.

My CO2 did have two interesting things to say regarding the post-injection itches which, as have mentioned in previous updates, wasn't an issue until many injections into my treatment. I had pondered whether the preservative that they use to keep the drug good in the syringe was changed. But she said that once I start in the medical trial, they aren't allowed to change anything. The second thing was that it is important to shake off any leeching of the Adalimumab from the end of the needle that occurs after you take the cap off. This is also true. When you take the cap off the syringe just before you jab yourself, a tiny drop or two always comes through the tip of the needle. It will either hang there or it gets too heavy and drops. Well according to CO2, that can bounce onto your skin as the needle penetrates. And this can contribute to the allergy symptoms.

So I made sure to shake any leakage off before self-administering my invasive lovely.

There is no itching now. But the lack of drippage isn't the reason. There is no itching now because there is something else. A dirty rotten bruise. The only time I have ever bruised up after a needle since I started the trial was when my CO stuck me badly. I've never caused that in myself before. Another first.

It might be a choice between bruises or itches. Grand.

AAARRRGGGHHHHHHHH *scritch scritch scritch*

I had to take my Adalimumab dose on Tuesday.

Stupid itching... It's driving me insane.

So I have decided to give the Zertec a try. And I found some old out-of-used-by-date creme that had 'steriod' as part of another word on the side of the tube. DermAid it is called. Mum and Dad tend to give me a lot of stuff they think I'll find useful. I'm sure they gave it to me. It's for minor skin irritation of a varying nature.

It doesn't work.

AAAARRRRRGGGGGGHHHHHHHH!

Week 30 from Baseline

Has it been 30 weeks already? My golly gosh! How time flies when people poke you in many places and you subject yourself to regular session of self-voodoo.

In the days since my week 28 update, my arthritis sympoms have been practically non-existent. In the last few months, a few occasions have seen relatively minor symptoms interrupt what has been substantial periods of relaxed normality. This has seen me gradually increasing the times I wear my heeled shoes. And aside from the usual misery your put your feet through when wearing these shoes, I have had no problems whatsoever.

I felt so confident that I have finally ghained back some choice over the matter, that two weeks ago I bought a new pair of black boots and a pair of red shoes, both with heels. Not overly high. But heels nonetheless. And since I refuse to wait for rainly days to wear all my new purchases, I have pretty much lived in these two pairs of shoes ever since.

But I know I need to give my feet a break, so I jump into my runners and flats in between heels in the office. I suppose it would be inevitable I would also suffer foot cramps, a sure fire symptom that one's feet has been over-smooshed from the wearing of high-heeled shoes. Smooshing cramps aside, I am so pleased my ankle is performing well under such conditions.

All I ever wanted, was the choice. Becuase for many years, there has been no choice. It's nice to have choice back.

Farewell to my CO (Week 28 from Baseline)

This morning, I attended clinic visit number something. My CO greeted me with news.

"I'm moving back to Queensland. This is my last week"

WHAT? *sniff*

Truth be told, I am a wee jealous. Yes, it was the state who gave us Pauline Hanson, Bob Katter and the place is full of rat-tailed bogans. But Queensland also has the best weather and, despite being one stubby short of a six pack, Queenslanders are the most genuine, positively spirited Aussies who give visitors the friendliest welcome and greatest hospitality. And despite my Melbournian heritage and my tendency to get a gleeful when stoking the fires of our interstate rivalries, I can definitely see Sharon of the future living and being very happy up there.

Now, back to the visit.

My CO told me several patients report a 'recently' a severe itch at the site of the injection. And my whining about it is consistent with other reports. I got the feeling by the use of the word 'recently' that this may be a fairly new-ish phenomenon. If that's the case, then one can logically deduce that something in the syringe has changed. My CO hasn't been informed about any changes. So, I would like to take a moment and say to Abbott Technologies, the producers of Adalimumab PLEASE FIX IT! MAKE IT STOP!

I'm going to try out Stingose. But my CO recommended some over-the-counter allergy stuff like Zirtec the day before and the day after I jab. I would rather not really. I'm already feeling like enough of a pill popper as it is.

Week 27 from Baseline *scritch*

Forget earthquakes, tsunamis, global warming and corruption. The real tragedy of importance right now can be revealed by my posing to you, my dear readers, a question.

Are there any other Humira/Adalimumab users get itchy at the injection site after administering their dose?

No seriously. I'm going totally batty.

The last several injections, probably 4-5, have resulted in the type of insatiable itch surrounding the injection site that could drive one into a murderous rampage. On the basis of my moaning misery I am convinced no jury could convict, particularly not after anywhere between five to seven days of tingling, tickling terrorism.

I am the only one? Is this is normal?

As you all were. Nothing to see here. *scritch* *scritch* *scritch* *scritch* *scritch*

Week 25 from Baseline

The arthritis has been quiet.

Very quiet.

Very very quiet.

Good! Wonderful! Excellent!

Unfortunately, the news isn’t all roses. The headaches are still hanging around. They range from mild to raging and last for 2-4 days at a time. It’s been a several weeks now since I have gone a whole week without one. So I’ve been hitting the Panadene Forte and the Nurofin Plus a lot. More than even I am prepared to accept and regular readers know my free-flowing history with the stuff.
So in short, I’m probably going to end up sitting down with Dr Flowers for a little chit-chat. I’nm headache free for now, but if I get another one this week, I’m scheduling an appointment without any further delays.

Here’s hoping for a headache-free existence.

Week 24 from Baseline

Back to K today for another monthly mashup. Today's visit was obviously another major milestone given the number and breadth of tests that was performed on my person. There was the full gammot of surveys, blood tests, pee-in-a-cup tests, joint counts and a physical by a doctor.

All previous tests were normal and it kinda nice to see that hardly any swelling was picked up in any of my joints, including the ever-depressing left ankle.

The last week has been better than the previous week in terms of my SPA. I have remembered all week to take all my prescribed doses of Salazopyrin, and this has made quite the difference with the lower-grade general soreness I get in my ankle. So over all, where my SPA has been concerned, I'm pretty pleased.

But where I am less pleased, is the number of headaches I've bene getting lately. I had a particularly filthy 3-day category hell nightmare bestowed on me a couple of weeks ago, and the headaches have been intermittant ever since. For example right now, as I type this, I have a headache that I'd issue a pain score of around 3. This one popped up on Sunday morning. It was worse then. But I had a day on which I had a ticket to a WordPress event called WordCamp, so I masked it with the usual overdose of Nurofin Plus and carried on. the headache was only gone completely yesterday afternoon. But it has come back today, so more Nurofin Plus has already been had.

And yes, I very much hate this shit and I know I take too much of it. But when Paracetamol doesn't work at all, that doesn't really leave you with a bucketload of other options.

I've started keeping a diary to document the occurances of these latest batch of headaches. I'm recording what I eat, drink, location and the severity/type of pain I am experiencing and if they don't sort themselves out, I will be booking an appointment with Dr Flowers. Do I know where they are coming from? I suppose there are things going on that aren't helping keep them away. But I don't really have any hard evidence that I can point to and give an emphatic "YOU!"

Week 23 from Baseline

Well, since I last provided an update, I have remembered to take my morning AND my evening doses of Salazopyrin and it seems to have made all the difference. I’ve been barely symptomatic at all since the last time I provided an update. The times that I have been a little symptomatic, it’s limited to the ankle and its because I’ve gone on a run, or had a long St John shift. Perfectly reasonable and expected if you ask me.

All in all, I’m very pleased with my progress provided I take both the Adalimumab and the Salazopyrin. I guess that makes me a little concerned in the sense that I wonder what will happen when he General lets me step down off Salazopyrin altogether and how I will react to that. Right now, I wonder if longer term, I will need to continue to take both. I do hope not. After all, it is toxic medication. And the less one has to endure in the long run, the better off one will probably be.

But I also think that I shouldn’t worry about all that right now and enjoy the fact that I have been quite stable and pain-free. So I’ll do that instead!

Week 21 from Baseline

This last week has seen my left ankle quite grumpy. It's not grumpy enough to bring back my limp, but there has definitely been some general umpleasantness about it. From a pain score point of view, it's around two and a half.

Of course it would help if I remembered to take Salazopyrin at night. Over the entire week, for some reason, I have remembered to take the two tablets in the morning, but I haven't remembered my evening dose.

BAD Sharon. BAD BAD BAD Sharon.

Must make more efforts and perhaps set up some reminders.

Aside from that, I am pretty well and I'm looking forward to a relatively relaxing weekend. And with any luck, I'll be heading out for a run should the weather become a bit kinder and the pathways less wet.

And on that note, it's just after 4pm on Friday. Beer O' Clock! Happy weekend all.

Week 20 from Baseline

Yes, another weekly update that is four days late. I really must make an effort to get back on schedule.

It was last Friday in the afternoon that I last posted on here (complete with the pictures) details regarding my post-run swelling. So naturally, you might think a smart person would have learned to take it easy. A smart person would slow down. A smart person would not back up their run two days later with another run after such arthritic results.

Hey, I never professed to be smart.

The run on Saturday actually went better than the first run the previous Thursday. For starters, I ran further and longer. Not much longer and further mind you but a little bit makes the difference. The pain and swelling I experienced from the run on Thursday had gone so in all honestly there no real barrier to having another go. After the run on Saturday, the ankle swelled up and there was a little bit of pain. It behaved in exactly same manner as after the Thursday run, except that the symptoms didn’t take 20-something hours to appear. My ankle was ‘tired’, if I can call it that, immediately after I pulled up Saturday morning.

To make matters more interesting, the Big Day Out was held in Melbourne the following day (Sunday) and since I love these big events, I had put my name down to volunteer. It hit 39 degrees C at some stage in the afternoon. ‘Carnage’ is a word I’d happy use to describe how the BDO went. There were no moments to rest. Given what I had put the ankle though the past 4 days, I was extremely pleased with how it held up. Again it was quite tired-feeling by the time I got home but this was no surprise given that all us volunteers were completely knackered and stank worse than a council tip.

I haven’t been able to run since as the weather has not been all that wonderful. I might try and go tonight or tomorrow. We will see.

This week (Week 20) was also noted by a trip to K. My blood tests from last visit were all fine. There was some swelling in my left ankle (duh) and also in my right ankle (????). But other than that, it was a fairly unremarkable visit with only the small batch of surveys to complete and no physical assessment due.

You’d think by now, I should know to keep my mouth shut

This morning, I posted a blog about my run yesterday and how my ankle held up. Pretty pleased with myself I was. All was fine and dandy.

At 4:00pm today I got home from grocery shopping. After putting all the groceries away, I sat on the couch and put my feet up. That’s when I noticed ‘that’ type of achey pain in the ankle. 

Let’s fast forward to now.

And a close up for good measure.

The photos were taken at 5:15pm. And yup, that’s some nice swelling I’ve got going on there on the left. I guess that run yesterday had more of a negative effect on my arthritis than I thought. I know it’s arthritis and not the trauma. I can feel it.

Bugger!

Week 19 - 'Ang on! That was days ago

It was only late last night I realised my week 19 date had come and gone and I had not blogged an update. What can I say? Time flies when you're taking a few days off the job.

I think it's probably fair to suggest that my Arthritis has stablised. <------ (update: 5:30pm - This was a stupid thing to say...... ) At least for me and what I can detect in myself, this feels a fair thing to say. Occasionally, my right ankle becomes a bit of a grump for a day, but this is honestly nothing when I compare it to how it was behaving before I commenced in the trial when there was only the occasional good day. Now, in terms of my overall symptomatic experiences, 95% of all days are good days.

Now, for an admission.

I failed to note in this diary in between now and my very first run attempt back in November, I had only once attempted another run just prior to Christmas. The reason I didn't mention it was because I failed to make a full kilometer before I decided to turn around and walk home quite pissed with things. I don't know really what happened to make it such a fail. I do k now it was cooler than I prefer, probably 18 degrees. And it was also very windy. The wind got in my ear, even with my music headphones in. Within a few minutes of getting started my ear was aching and the ache started to make it's way into my throat and my neck. It wasn't pleasant at all. The rest of me was wasn't performing either. I recall having to make an effort to will myself into giving it a go. In the past when I was running regularly, this generally worked in my favour and I'd normally end up pretty pleased with myself for pushing myself to go. On the odd occasion, the mind is stubborn and the body follows suit. So the combination of an impending throbbing headache and a petulant flesh caused me to admit defeat and try another day. But I was disappointed and to be honest, a little angry.

Since then there have been a variety of other factors made it difficult to summon the motivation I needed to try again. This include a couple of disappointments but also Christmas came along as did my Noosa/Sydney break. But yesterday that changed. The conditions were perfect. 21 degrees and not a whiff of wind on the horizon. I was in the mood to go. And in the afternoon, I did.

40 minutes and roughly 5.5km later I got home buzzing. Did my ankle hurt? A little while I was running. But the run was great. My body was willing and the spirits were high. I went further than I thought I would. I would have been content with less than 5km, because distance wasn't the priority. Getting my heart rate up and keeping it there for 45-50 minutes was the priority. I was only stopped by the horn of a car that was sailing past. It was my husband coming home from playing a round of golf Since we were only around a kilometer from home, I jumped in the car very satisfied with what I had done. At this point, there is no need to push things. The fact remains that yesterday I did close to 6km and accomplished 40 minutes of sustained exercise. And today, aside from a little muscle soreness in the legs, I feel perfectly fine. <------ (update: 5:30pm - Hindsight is a beautiful thing. Spoke too soon ...... )

That in itself is something to smile about. A reminder to forget about the last attempt. A reminder that I really do enjoy running.

Week 18 from Baseline

In the last week, my back has been extremely grumpy which I assume is due to lack of attention by my Chiropractor. But since my visit on Monday, I have had no further troubles.
I’ve also been prone to a few more headaches of which I am putting down to an overabundance of stress. It’s true that there are parts of my life that are a little stressful right now. And sometimes, in the weak and sooky moments, it does gets the better of you.

But in terms of my arthritis, I’m fairly pleased with how the last week has gone. I did experience a bit of pain in the ankle briefly last week. It felt painful, but really, it felt more tired than in pain. I wasn’t wearing any heels when it started and it was a day in which my physical activity was limited. It might very well be the makings of a flare up, but if that’s true, it was definitely subdued by either the Adalimumab or the Salazopyrin.

I have to confess, the pain in my back, my head and to a lesser extent, my ankle has once again combined to make Nurofin Plus my best friend in the world. And that’s never a good thing. I did attempt to dull my aches with some Paracetamol, but as usual, it works as effectively as hitting the sore bits with a hammer. It doesn't only fail in its job to relieve the pain, it fails to stop it from getting worse.

Week 17 - Time out for Queensland

I simply wish to say:

- To all the people currently cleaning up from the QLD flood disaster. I wish you well. Stay strong.
- To those who are still waiting for the floods to come, good luck and stay safe.
- To those who have lost loved ones, I am so sorry.


Donate to the Premier’s Disaster relief appeal online or by phone on 1800 219 028.

You can also donate via Internet Banking

Account Name: Premiers Disaster Relief Appeal
BSB: 064 013
Account number: 1000 6800
SWIFT code (for international donations): CTBAAU2S

And don't forget the a little bit for the animals. Donate to RSPCA QLD Flood Appeal here

PS. I have had no arthritic problems and no pain this week. So there you go. This matters not today.

Week 16 from Baseline

I have always set up my visit to K at 8:00am in order to get to work at a somewhat respectable time. Given today is the last day of my annual leave, and I am most certainly not at work, you’d think I’d have been smart enough to change this weeks’ appointment time and allow myself a final day sleep in. Since I didn’t, I might have possibly been seen driving to K cursing my stupidity and lack of forward thinking on the issue.

Its obvious most of Melbourne is still on holiday. I zoomed over the Westgate Bridge and arrived at my appointment at 7:30am. At other times when I leave at 7am, I usually get there right on 8am. And being early had another benefit. I got out of the clinic earlier than usual and zoomed home again.

What also worked about getting seen early lies in the law of unintended consequences. My CO obviously needs her morning coffee before stabbing any arms with needles. I expect a mighty bruise later on my right arm later and the stab was definitely not ‘just a little sting’. I left the clinic with Cotton balls taped to both arms. If I turn up that early again, I will take in a coffee for her.

My blood tests from last visit were all normal. In terms of my joints, I have swelling in my right ankle which is a first as far as I can recall. Without a joint assessment, I would never have known. It’s certainly not noticeable in any way.

Took my dose, packed a traveller and I was off again to start my day.

Zoom Zoom!

We're all going on a summer holiday.....

Oh, would you look at that. I missed the Week 15 update while I was holidaying up north and north-ish.

I have a visit to K booked for Wednesday. Since I expect to leave with some progress data, I will leave the week 16 update until then.

In the meantime, please enjoy this short video from my summer holiday.