Simponi and Methotrexate

It's been a while. 

I made a post a while back about starting Humira. It did wonders for my skin and I couldn't have been happier in that respect. However, after some time I started to notice some odd swelling in digits and joints and it began to escalate into full blown level 10 pain. I suspected that it was the Psoriatic Arthritis that I hadn't been officially diagnosed with, but knew I had. At Kaiser, I had been told to take naproxen and sent on my way. Unfortunately, the naproxen did nothing to help - nor did any other OTC pain medicine. 

Eventually, it got so bad that I would get home at the end of the day and I would have to crawl and scoot from the door to my bedroom. The pain radiated from my joints into tendons and muscles. There wasn't a joint on my body that didn't suffer at some point. It was horrifying but I kept up hope that it was going to just go away - but it slowly started to become my life. I wasn't able to ride my horse, hike with my dog, and some days I couldn't even get out of bed.

With the help of a veteran, I was able to find a physician who would accept Tricare. I had to make an appointment with a primary care doctor at OHSU which was a month out. After seeing her and getting the referral to a rheumatologist, I had to wait another month for an appointment. I started to get worried that by the time I was seen there was going to be irreparable damage - or, more melodramatically (but not really, because if you could feel the pain, you'd understand), that I was going to wither up and die. 

After my experience at Kaiser, I was anxious that the OHSU rheumatologist was either going to be a resident or not know how to help me. Boy, was I ever wrong. When I went in for my appointment, I met the most compassionate, empathetic, attentive doctor. She listened closely to my issues and then looked at the areas of my body that were hurting. She ordered lab work, x rays, and prescribed a few things she thought might help. We decided on a course of treatment. 

She recommended Simponi (golimumab). Another biologic TNF-blocker, but more potent than the Humira and only once monthly. Still a self-injector pen, it is much more user friendly and the serum doesn't burn like acid. While on it, I need to be careful about my environment and go so far as to avoid people who have received live vaccines or have strep throat. In addition to the Simponi, we are trying a low dose of Methotrexate again. Not my favorite medication and it hadn't done anything positive while I was on it the first time, but I am willing to give it a try if it helps get the inflammation under control. 

It has now been about four days since starting the Simponi and the inflammation has gone down and there is a lot less pain in my feet and fingers. There is still some stiffness, but I'm hoping that will alleviate as well. If it stops working sometime during the month or anything gets worse, we have other options we'll try - but for now I'm enjoying just being able to move around at a relatively normal pace. 

From the Simponi website

On where I almost, finally got a house

Back in October (I know, that long ago?) I started looking for other options to my current living situation. Quarters were cramped with all the animals, people, and all my stuff. I was shopping for apartments in Beaverton when I decided it might just be better to look into buying again (We house shopped for a long time prior and came up empty). 

There were a couple houses that looked promising, but I was very interested in a cute little home in Gaston, not far from where I currently live. The home is a two bedroom, one bath with a partially finished daylight basement and a third of an acre of property. It is set back from the main gravel road and surrounded by trees and a big, open field that gives the home a lot of privacy. The inside was definitely a cosmetic redo but there didn't appear to be anything structurally wrong with the home. Since we plan to use VA financing to purchase, there are very strict stipulations on what condition the house can be in prior to lending. We knew there would probably be a couple things that they would want repaired: water entry into the basement, a broken toilet, some missing plumbing under the sink, moss on the roof, and the installation of a couple wall heaters. Otherwise, it looked fine to move forward.

Because the property was a foreclosure, we had to deal with a bank as a seller. This was a very frustrating process as we scurried around to gather everything we needed to start the lending process and submit an offer. Because Andrew is in Afghanistan, I had to do most of the footwork (along with my Mother in Law, Jennifer) myself. Even with him being deployed, we were still able to get everything done extremely quickly. The seller on the other hand dragged their feet and acted like they really had no interest in selling the home. After a couple set backs, we finally had a strong offer on the table and the seller was ready to move forward. After they accepted our offer, we were then told they could not turn on utilities due to open permits on the electrical work and issues with the plumbing. Unfortunately, our appraiser for the VA had already gone out since we were assured the utilities would be turned on that day for the inspection. Because we are charged for that service (quite a chunk), I was willing to hold out and see what could be done to fix the issues.

Over the next several months it turned into a convoluted mess. More and more repairs kept cropping up and the seller was being uncooperative and unwilling to negotiate. I had been ready to walk on the deal for months except that I was worried about our earnest money and the money we had spent on the appraisal. In hind sight, I should have never even bothered putting an offer in on the house, but hindsight is 20/20 right? After so much heartbreak and anticipation of having to drop the deal, the bank unexpectedly offered to pay for all the repairs on the required punch list. We took them up on the offer and got to work having everything fixed and brought up to code/VA requirements. I put my own elbow grease into it and so did Andrew's family; they selflessly helped me to check each thing off the list. 

After getting my hopes up again and starting to feel excited about having a home to move into and prepare for Andrew's homecoming, the bombshell hit. The seller had had the utilities turned on and the water was not flowing correctly from the main to the faucets. Anticipating a costly repair for that, I knew the seller was not going to pay for it. On top of that, a peg board in the basement was removed to unveil a bowing foundational wall. There is no way the VA would ever approve lending with those two major issues and I knew we were done. After a good cry, I let my MIL know that we had to let it go. After four months of investment we had to just drop everything and walk away.

I'm in a sort of daze, after the roller coaster of emotions. Every week it was "you're getting the house", "it's probably going to fall through", "we're moving forward", "we're at a standstill", "start packing up your things! You're moving into the house in two weeks!", "We're done."

I just hope this means there's something even better in store for us. I'm fortunate that we found the issues before we took over ownership of the home. I'm disappointed I don't get to wake up to the amazing view from the living room window, but now I can be excited about new, fantastic opportunities that have been presenting themselves.

Um, Forest Fire?

So, on September 19th at around 2:00 PM it was discovered that there was a brush fire happening by the Scoggins Creek at the backside of Hagg Lake. Unfortunately for us, we live on the backside of the lake. Fortunately for us, the location of the fire was about 4 miles from us (if you're driving it by road. A little shorter as the crow flies). We were surprised but not overly concerned at first. You could see the plume of smoke behind our house and it looked like it was RIGHT. THERE. There were also ashes and charred leaves falling everywhere.   But we could also hear helicopters and planes and they were obviously actively fighting it. By evening though, we knew it wasn't a good situation. They hadn't had enough daylight to keep using the air support and the small ground teams could only dig fire lines so fast.

Smoke a couple hours after it started

You can see the growing amount of haziness in the sky and a sort of illumination of the fire in the smoke

The next morning, sky is full of smoke

By the next morning we realized it was getting a little more serious; a lot of people on a far neighboring road had been evacuated, but the wind had been blowing away from us since the previous day. I left the house to go visit my horse for a while before I got a call from my MIL letting me know that our road had been issued a level 2 evacuation notice. It breaks down into 3 levels: level 1 means get packed and have your plan, level 2 means get set to go (and voluntarily leave), level 3 means GO NOW. The winds had changed and were blowing the fire our direction. I hurried back towards home and got stopped at a check point where a park ranger had NO additional information for me other than if I didn't live on the lake I couldn't pass. I live up there, thank you, now excuse me while I bundle up my life's belongings. 

Within a couple hours, MIL and I had everything important to us stacked in the middle of the living room and all 7 of the cats (yes, seven, don't judge us) and dog accounted for. I was even making plans on how to transport my two adolescent hens. 

Everything stacked in the living room

FIL had taken it upon himself to save the Chevelle first and when he returned to start packing his other important items, MIL and I broke out the alcohol I had been hoarding in my room. Red wine, honey wine, blue Kinky, Jose Cuervo and Kraken rum (FIL polished off the hard A). FIL and friend even made a beer and snack run and we hosted a very exclusive Fire Party at the Graham house while we waited to hear if we were being upgraded to level 3. 

Eventually our excitement fizzled out (no pun intended) and we gave our goods pile the hairy eyeball and meandered off to bed. By the next morning we were pretty much in the clear thanks to the amazing air and ground support fighting the fire. We were pleased to not have to evacuate but of course there was the whole problem of putting everything back. It made me realize how much useless shit I have and could do without.

It also made me realize just how precious everything is. A house is a house until a house is a home, and this is home. It's filled with memories and love and a feeling that's not really tangible but has something to do with homesickness. This may not be my permanent residence and there are for sure times where I wish I had my own little place, but it is so special to me and I feel so grateful to get to live here. I couldn't imagine it being ripped away from me by a man-made fire. 

Here's to the drenching, quenching rain we've had the last few days. No more fires for a long time, please.

Humira

So I've been dealing with Psoriasis since I was 11. It sucks. A lot. It is an incurable, non-contagious Autoimmune disorder and the symptoms are widespread inflammation of internal organs, skin, and sometimes joints (Psoriatic Arthritis). Someone without Psoriasis sheds their skin cells about every 28 days, an individual with the disease sheds every 3-4 days which is why you will see us with scaly patches on our arms or other areas of our body. For some people, they only experience small patches that flare up every once in a while. For some, like me, they are ultimately going through a constant flare up. I have been on several kinds of yucky medications, I have been without medication and been in a constant state of flare up, I've also been on nasty medications that made me sick and didn't work.

Two weeks ago I finally was able to start Humira. If you've seen commercials on TV for it, you know that it is being marketed for Psoriasis, Psoriatic Arthritis, Crohn's, and Rheumatoid Arthritis. I am fortunate to be able to try it. My Kaiser Permanente health plan only covers 50% of it which means it still costs $1600/month. Because Andrew is active duty I also am covered under Tricare military insurance which brings my grand total to $13 every two months.

Humira (adalimumab) is what's known as a TNF (Tumor Necrosis Factor) blocker. TNF is ONE cause of inflammation in Psoriasis patients and because our immune system is in overdrive we are producing more than we need. The Humira attaches itself to TNF and helps to reduce the inflammation and pain associated with it. However, this is detrimental to our immune system and can lead to an increased risk of infections and serious illness. Unfortunately, you have to decide whether or not the risks outweigh the benefits.

So, to start, they send you a Psoriasis Starter Pack. This includes 4 self injector pens. The schedule works like this: Day 1: Administer two 40mL pens, Day 8: Administer one pen, Day 22: One pen, and then one pen every two weeks after that.

Google image.

Injecting yourself with the pen is simple enough. You remove the caps on both ends of the pen, pinch the skin on your thigh or belly where you intend to inject, press the pen down on your skin and push the button. A spring loaded needle is released into your skin and the serum starts flowing. However, the serum burns terribly while going in and it takes 10 seconds for it to finish. Pressing that button is like ripping off a strip of wax from your own skin. Only, the pain lasts a little longer. Generally they say you'll see results in about 12 weeks.

For me, the results have started immediately. After the first day I started to immediately see a reduction in inflammation. Today, I am 85% clear of scales. There is some redness where the scales used to be but this is an amazing improvement. Hardly any itching, no cracking, no flaking. I'm starting to look like a human being instead of a Psoriasaurus. Will keep updating on the progress. Hopefully the positive results continue with very few negative side effects.

Anyhow, that was my informative post for the year! Carry on!

My Favorite Spot

All my life I've been drawn to water. I love to swim, I love to watch waves lap against the shore, I love the way light moves across the water. It was not too hard of a decision to move back up to Hagg Lake for the duration of Andrew's deployment. Sure, it's pretty out of the way and it takes so long to get anywhere. Sure, I don't get cell service at my house and the internet is sub-par at best. I wouldn't trade the convenience of living back in town to the feeling I get when I drive across the dam at dusk and the sun is setting and casting the most amazing colors across the water and perfectly reflecting them back to the sky like a flawless, otherworldly mirror. I wouldn't trade convenience for the hard emotional days when I just pull up to my favorite spot and sit on the edge of a cliff dangling my bare feet and letting the sound of those waves wash the stress away. This place is so special to me. I have lived here during a few phases of my life and it's just home. I actually wish I could just pitch a tent and live like a wildling, just to be closer to that sound. 

Medford: Deployment Ceremony

So this post is a bit overdue, but on Wednesday the 16th I got up early in the morning and myself and another military wife made the 5 hour drive down to Medford to attend the Oregon Army National Guard deployment ceremony that was happening for the 186th Infantry. For anyone who doesn't know, my husband is a Staff Sergeant and has been in the military the entire time that we have been a couple. This is his second combat deployment; his first was to Iraq in 2009-2010.
I got there a couple days before the ceremony so that we had time together. Conveniently enough, the hotel shared a parking lot with the armory and Andy was able to just walk back and forth between reporting and being released. 
Medford was unbelievably hot, breaching 100 degrees, and I think I had the AC in the hotel room at 68. Unfortunately, the ceremony was in a Gymasium in Ashland and there were no fans or AC and I'm fairly certain all of Oregon was crammed into those bleachers. I was smooshed shoulder to shoulder with a high profile politician and my M-I-L. 
The ceremony itself was ... disappointing to say the least. These types of things are never fun to be at but this event in particular was sort of botched. The speeches were very cookie cutter and those who got up behind the microphone could hardly peel their eyes from their scripts. To make things worse, our own state rep made the grave error of referring to the 186th as a cavalry division. There were a lot of perturbed faces under those camo caps. 
All the other speeches were redundant. "We'll take care of your family while you're gone." - "You are so brave." - "We WILL make sure your family is taken care of." Words like this are sort of a slap in the face to the soldiers and to those of us left behind. Once our men (and women) leave, we are pretty much on our own. Luckily, the ceremony only lasted about an hour and I watched as what could have become the worst Zombie Apocalypse situation formed around the only exit. It probably took us another 20 minutes to get out into the fresh air. We hung around for a little bit so I could take some pictures and then we all bounced to go get some Kaleidoscope Pizza (DELICIOUS). 
The following day we said goodbye between lots of tears and clutching. My friend and I climbed into the car in silence and drove away from our other halves. Fortunately, the scenery from Medford to Portland is unreal and I used it as an excuse to stare out the window in teary-eyed silence. One more leave before Afghanistan, this time in Texas. 
Have some photos:

Andy and Dad

Andy and Mom

Ishack and Jessica

Stosh, Johnny, Andy, Ishack

Stosh, Johnny, Andy, Ishack

Johnny and Allie

Photographed by Johnny. Thanks, Johnny! <3

Rest in peace, pork chop.

Tonight I discovered that one of the pork chops died. For those of you who don't know, Andy and I started a beginner 10 gallon fresh water tank last year. We stocked it with a beautiful betta fish, two catty-wompas (cory-catfish), 5 or so pork chops (raspboras) and a couple flighty sucker fish. All was going well for quite some time and then things went downhill real fast.
 First, my betta started to show signs of illness. Being very new to fish, we tried everything that we could find on google and fish forums. It came down to putting him at rest (it's a fish, I know) and I was extremely torn up about it. I was so proud of my betta and how well he was getting along with his tank mates and how he seemed to recognize us and he would come to the surface begging for treats. Not long afterward, one of our catfish died. And then the other. And then a couple raspboras here and there. And then a sucker fish. It was obvious the tank had been compromised by some fish-borne illness. We treated the tank with fish antibiotics and anti-fungals. In the end, three raspboras were left and one elusive sucker. The survivors even endured the 50 minute truck ride to move from the apartment to the house. 
And then Andy left. Tonight I discovered that one of the pork chops died. I think it's my fault. This was his fish project after all. I had wanted a ferret and when we got to the pet store, he decided we were getting the fish instead. There are three fish left. As I watch them dart around the tank I am really burdened by a sense of sadness and inevitability. Tomorrow will I discover that one more of the pork chops died?