tuesday

Every Tuesday, I am almost guaranteed to think the following two things to myself when it’s time for my Enbrel injection:

“It’s Tuesday already?”
“This definitely hurts more than last time.”

I don’t need to remember which leg I’m on because I just pick the one that’s not yet bruised/has just healed.

My first Volunteer Day today. I’m not interested in doing this again. I think the entire shebang is a plot for UCLA to maintain it’s #1 in community service ranking. The incoming freshmen weren’t excited or interested in doing service, just in getting it over with (which is understandable because it’s a mandatory event for them). It wasn’t well organized. I didn’t have fun.

On the plus side, I met a fellow mechanical engineering Master’s student (in MEMS) who told me that taking three classes + a bit of research isn’t crazy. Especially with one of my classes being 281 with CJ. No problem! I’m totally ready for fall quarter :)

1. What does it mean to be homesick? How does one differentiate wanting to go home with not wanting to be at work?
I imagine myself being back at my apartment, and compare that with how I would feel being somewhere else, like the beach. No change. What about being at the beach by myself compared to being at the beach with friends? It’s still hard to tell. This exercise is making me tired.

2. What is fatigue? Am I fatigued, or am I merely tired?
Fatigue as a symptom of my disease and/or medication, seems to be defined as when tiredness effects your lifestyle. I.e. too tired to get up in the morning, naps or else ktfo, inability or lack of interest in maintaining one’s social life. According to my feelings on these aspects, I’m not fatigued. There are other factors that also play a part. Like not eating well or consistently, or other emotional changes that have a mental (followed by physical) sense of lassitude. I am losing interest in things. Do I write it off as a temporary effect of the RA, or do I treat it as a problem that I need to/can fix?

3. What is a relationship?
I want there to be a fair recognition of efforts. Or more than fair. I want a pro-con list that is overwhelmingly pro. I want apologies when I need them and not just when they’re mandatory. I want a constant strive for better and happier, not contentedness with being content. There are a lot of things in my head that I can’t express because I will be judged as “moody” and “girly.” Unfortunately, this is just how I am.

wrist twisting

A couple weeks into starting Enbrel (may or may not be correlated) I noticed my wrists getting sore daily. The discomfort was not as bad as sore fingers, but still pretty annoying. Right now I’ve taken 6 dosages of Enbrel (= six weeks) and things are not better. For the past two days I’ve been taking the max dosage of ibuprofen (800mg q 6 h (that means per 6 hours!)) and it’s not helping either. I find it kind of strange, because on my flight back from Seattle, I hurt my left bicep putting my luggage in the overhead compartment. But even eating four Advil didn’t make my muscle soreness go away. This makes me doubt the effectiveness of Advil in general for anything, not just joint pain. But I’m still giving it a fair trial. Two more days and then I’ll be moving on to Naproxen.

Anyway the reason why I decided to make a point about my wrists, is because I started a new painting today. I was having trouble opening my tubes of oil paint (twist off caps about 1.5 inches in diameter). Not that weird, since I haven’t opened them since early August, but when I had to put extra torque to the caps, my wrists hurt a lot. A lot a lot. More than they should, definitely.

Basically, if my symptoms don’t go away, I need to make friends with my male neighbors for jar/lid/cap opening. Or buy some ridiculously engineered tool that probably exists to open twist off caps for me.

nsaids

Popping ibuprofen like candy! I’m afraid of getting heartburn or ulcers or acid reflux, but since the effectiveness of Enbrel hasn’t kicked in yet (it’s been 6 weeks) I decided to rechallenge all the different NSAIDs that failed in the beginning of my diagnosis. Namely, max dosages of ibuprofen, naproxen, and meloxicam. I’m going to try each one for three to four days and hope for the best. The most inconvenient thing is that all these NSAIDs have to be taken with food. On the bright side, maybe I’ll be eating more consistently?

School is starting next week! I’m excited to get back into the busy and consistent lifestyle of a student. This summer has been up and down and frustrating when it comes to work and vacation. It really felt like I didn’t have a good grasp on my motivation. But school, yay school! I’m signed up for MAE 281 – Microsciences and MAE 250C – Compressible Flows, and going to go to MAE 182C – Numerical Methods for Engineering Applications before I decide which one to drop. The MS program is 9 classes, and typically students take 2-3 classes each quarter, which could include 1 “class” of research. So I’m planning on being done in four or five quarters. :) I have a feeling time is just going to fly by this quarter. Cannot wait.

enbrel

I started Enbrel two weeks ago. Now, my weekly RA medication count has gone up to 3. Like many other RA patients, I’m taking methotrexate (20 mg) alongside etanercept (Enbrel) for a more effective treatment. The third drug I’m taking is folic acid, which is supposed to counter the side effects of MTX.

Enbrel is administered subcutaneously, for me, in the thigh. I chose to get the SureClick Autoinjector instead of a regular syringe because I don’t know if I’d have the mental strength to self-administer a syringe. I read that some people prefer using a syringe because then they can control the flow rate, but I don’t feel uncomfortable with using the SureClick. It’s super easy to use; just press against your skin and click the big button. It hurts like any other shot would, nothing unexpected.

I chose to get on Enbrel because being on just MTX wasn’t cutting it. My fingers were starting to get sore (while doing things like driving), and it was bothering me a lot. My two choices were to either get on a biologic (ie Enbrel or Humira) or add on two more pills for something called “triple therapy.” In studies, it seemed that biologics, which act as TNF inhibitors, were more effective and faster to boot. Between the different biologics, I chose Enbrel because 1) it’s the oldest, 2) it’s not developed from pigs, and 3) it can be flushed out of one’s system relatively quickly.

I opted out of a currently ongoing study which randomly assigns RA patients to either Enbrel or Humira in order to compare the two, because I wanted to make my own decision. (The main perk of being part of the study was free medication.) Also, I signed up to take part in a service that fills my Enbrel prescription and delivers it to my door, as well as picks up the used sharps for disposal. Complete Infusion also eliminates my copay (which was $20) each month because it’s collected from the insurance company.

So far I haven’t felt much of a difference. But I’ll continue to update to keep track of my symptoms, for my own reference and others’.

/pescetarian

After it was very apparent that being pescetarian wasn’t helping my joints at all, I kept at it for the sake of… nothing. I liked the feeling of calling myself pescetarian, and it was nice to have a simple diet to stick to. But I realized that there was really no point or concrete reason for me to continue. So I’m done! I think that it was a good habit to start, because it has made eating at home a lot simpler and faster without having to defrost, marinate, cook etc. meat for each meal. I heard somewhere that it takes two weeks to make a habit, and I’m a believer. I can’t imagine myself buying giant packs of chicken breasts and drums just to put in the freezer anymore. It seems like for the most part, I’ll still be eating pescetarian dishes at home, but without the added stress of having to pick vegetarian-friendly restaurants. I’m going to be re-introducing meat back into my diet, starting with something like once or twice a week. Somehow, eating pescetarian has made me feel more health-conscious, and I know that eating meat daily is not necessary.

In other news, I’ve still been doing P90X yoga almost every day. It’s much easier to do it in the evenings after I’ve already been relatively active during the day, but it’s much more motivating to do it in the morning as my body is still a bit stiff. Is there a philosophy to morning vs. night yoga?

Every time I take a shower I lose around 40-50 strands of hair. This has been happening for about a month, a little while after I upped my MTX dosage, so it wasn’t unexpected. No visible difference (yet), but if I start balding I will be unhappy. (There are worse things in life.)

(readme.)

fruit cleanse part two

I started on Tuesday afternoon, and then:

5pm – one kiwi, handful of grapes
6pm – one banana
8pm – 11 strawberries, one apple

Wednesday:

8:30am – two strawberries, one banana
10am – three clementines, 1 c mighty mango naked juice
12pm – one white peach, one fuji (?) apple
4:30pm – 1/4 personal watermelon
7pm – handful of grapes
9pm – 2 clementines

Thursday:

I think I ate a banana in the morning but I didn’t write it down…
10am – one kiwi, one black plum
11am – two clementines
1pm – 1/4 personal watermelon
4pm – one gala (?) apple
7pm – 10 strawberries, four clementines
8:30pm – one red plum
10pm – 1/4 pineapple, two clementines

Friday:

9:40am – one white nectarine
12pm – one black plum, one pluot
2pm – two clementines

Total cost: I bought about $38 worth of fruit and juice, and probably consumed about $25 worth. I still have a few kiwis, half of the grapes, most of my mango juice, and some clementines left.

I pretty much just felt hungry for the entire three days, but felt unable to consume more fruit. I think this has something to do with the high water content of the things I was eating, filling my stomach but not really being satisfying. Possibly relatedly, I noticed my ankle was no longer swollen and the inflammation in my knees seemed to be a bit better on Thursday. So on Friday morning, I woke up early to try my joints at running… which was no good, and my knees hurt more than ever. I stopped and power-walked for about five minutes (back home) instead. Oh yeah and also during the entire 72 hours, my mouth would water at the sight of “real” food in pictures; Oh how I missed savory flavors! I didn’t notice any change in energy levels or skin quality (lol), but I’m a pretty energetic person to begin with, and my skin is pretty reasonable as well. It was hardest the last day, when I knew I was close to being able to eat bread again. I was kind of hesitant to leave my apartment during the cleanse because of all the temptations I know I had to resist Outside so I pretty much stayed home and didn’t do much. Had I tried to continue going out and being an active person, maybe I would have noticed more changes re: my energy, etc.

First thing I ate when I was done was: Matzo with Taiwanese tuna. Delicious. Is it just me, or does matzo now have more flavor and depth than ever??

Since I figure keeping track of my food intake might be a helpful thing to keep track of alongside my RA symptoms, I’m continuing a pescetarian diet (since I already ate that tuna without thinking). More updates about vegetarian recipes and food I’ll try my hand at making coming soon

Lastly, on Friday night my knees hurt as bad as they used to before I increased my mtx dosage. I couldn’t keep them bent or straight for more than a minute without the soreness/pain from creeping back. I don’t think this is a function of the fruit cleanse ending, but rather a sign of my RA coming out of remission. It didn’t last too long though, and today has been much better so far.

fruit cleanse


I decided to go on a 72 hour fruit cleanse. This means that for three full days, I will eat nothing but fruit, drink nothing but fruit juices and water. My reason is vague; it was a bit of “challenge accepted!” and a bit of actual curiosity for how things might change. I went to the store yesterday and bought a lot of fruit (as seen above, yes I took my bananas out of the fridge), but I’m not sure how much of it I’ll actually eat. Last night, my dinner consisted of an apple and 11 strawberries and I was really really full afterwards.

Probably a bad thing that I was surfing online and came across a bunch of pictures of delicious pizzas and pastas. Now I have a starch craving :( but I will power through!

healthy or happy

If I had to make a decision whether to be completely healthy (sans all diseases and infections and even colds, and dying a natural death) or to seek happiness, I would choose to search for what makes me happy. It’s more important to me to try and figure myself out than to wish for something that is out of my control. I think that one’s happiness is completely up to oneself, it’s just a matter of how you get there. And I think it’s totally possible if you open your heart enough and embrace the world enough.

Healthiness, on the other hand, is completely out of your control. Someone might sneeze on you and the sneeze particles somehow make their way into you, and bam, you’re sick. On the less mundane level, genetic diseases just happen as well, and creep up on the unexpected. As much as you try to stay out of the sun, away from cell phones, not eat salmon, and not breathe polluted air, cancer is likely to still find its way to where you are as well. Humans are a fragile species.

Yes, there’s a bit of coupling to the equation of healthiness and happiness. I experienced a strange sense of dissatisfaction when I was first going through the painful symptoms of RA. The constant pain put a real damper of my outlook on life. It was hard to remember what it was like to be pain-free, and imagining a future just like the present time took the optimism out of my life. I remember outwardly wishing that all I wanted was to stop hurting and to be healthy again someday. But really, if I had been able to look past the disease and accept it, I could have continued to search for happiness, finding little gems of such along the way. The hurt would just be background noise and I would grow to accept it for sure. So it’s time for a new (refreshed) view on my future. Time to open my eyes and look for what is waiting for me.

Sounds like Buddha.