My experience with Enbrel....

It is that time again, another installment. If you have missed my previous posts, I have gone into detail about my experience with topical ointments, tonsilectomy, methotrexate and phototheraphy. Today I talk about my most negative experience to date, which happened at the start of 2015...

In my other post regarding Methotrexate, I ended up feeling very ill while taking a higher dosage in December 2014, while also developing psoriatic arthritis in my elbow earlier that year also. At this time, I also found my skin to be bumpy around the back of my thighs leading me to think maybe my Psoriasis was becoming active again but it wasn't happening at a rapid rate, thankfully. I was always given the options of changing to biologics, but was put off at the thought of having to inject myself. To reference Psoriasis.org, Biologics :- "target specific parts of the immune system. The biologics used to treat psoriatic disease block the action of a specific type of immune cell called a T cell, or block proteins in the immune system, such as tumor necrosis factor-alpha (TNF-alpha), interleukin 17-A, or interleukins 12 and 23. These cells and proteins all play a major role in developing psoriasis and psoriatic arthritis."

Enbrel (etanercept) was prescribed to me in January 2015. With Enbrel, you have a nurse assigned to you who comes to your house and helps to teach you how to inject it yourself. Thursday January 8th was going to be the start date and I was to try 50mg, which comes in pen form (myclic pen pictured above). The injection areas to choose from are either the thighs or stomach, I found the thighs to be the area of choice, alternating between left and right each week. To use the pen, the cap is taken off, and the pen is place on the top of the thigh, pushing down so the guard is pushed back and once you're ready the button is pushed releasing the needle. The first time I did it, I did it wrong as the nurse had confused me saying to count to 10, but I was supposed to wait for the second click (which they say is 10 seconds, sounding that it is been dispensed). Due to my mistake, I didn't get a full dose, but I'd know better for next time, being a weeks time. 

Thursday January 15th, My nurse was unable to attend my home. I remember it the weather had been quite bad around that time, including snowfall in higher areas. I managed to inject myself, after about a half hour of building myself up, it was a case of "F**k it! *click*". I did find the pen to be painful. The nurse had asked if I would prefer to use a syringe which I felt sick at the thought of, but she made a good point that with the syringe you have more control. Once you click the button on the pen, its a case of grin and bare it. That same evening I found the back of my thighs and my scalp to be very itchy. As I've said above, it did have a few bumps on the back of my thighs, which felt more like pimples than anything else and didn't really bother me until then. 

Monday Jan. 19th, and I woke up feeling horrible, I had symptoms of a sore throat, runny nose, feeling cold and headaches at night. These symptoms persisted as the week went on and due to my next injection due on Thursday it was decided I would give it a miss. It should be noted that if you do feel sick while on a biologic and are due to take it around that time, it is best to not take it, as you could become more ill. My throat had worsened by Thursday and I felt congested in my nose.

I was sure to keep track of my symptoms and injections in my Enbrel diary. I also kept track of my psoriasis, which by Saturday 24th had worsened. It was now showing on my scalp, legs, back, stomach and my face. I was also still very congested at this stage. The following week I had noticed red patches on my thighs where I had injected. I contacted my nurse who had said to keep an eye on them. They were slightly red and a small bit raised but I was told nothing to worry about. It was now Thursday the 29th and as I was still sick, I was missing another injection, making it two weeks in a row without Enbrel. 

Monday Feb. 2nd which was a visit to my Rheumatologist who had prescribed Enbrel, for a month review. While in the last month, my joints had felt great, my skin was going the opposite way. He thought maybe the dosage was too much to start on so halved my dose to 25mg every week and to take a low dose of Methotrexate to help make it more effective.

I started my new routine of 25mg of Enbrel the following Monday, the 9th. The nurse had made the visit to help show me how to inject with a pre-filled syringe which is how 25mg comes. She got to see how back my skin had become and had supported my decision to go back to my dermatologist about my worsening skin and the possibility of starting phototherapy again. I took 10mg of MTX the same day, which was followed by 10mg of folic acid two days later.

I did find it strange injected with a syringe, but I managed to do so the second week with no supervision. I managed to get an appointment with my Dermatologist Feb. 17th and he looked over my skin and agreed with my thoughts on light treatment and I signed the appropriate forms and was book in for Feb. 23rd. I had 3 doses of 25mg of Enbrel in total before I was back to my rheumatologist for another review, and it was decided Enbrel was not beneficial to me and so it was stopped.

I was very unfortunate that Enbrel did more harm than good for me as I have heard and seen stories of how it has helped others with psoriasis and/or psoriatic arthritis. My Psoriasis had gotten so bad over my entire body, especially on my face which at times I felt I had to cover with makeup to avoid stares which were quite hurtful. I went on to continue phototherapy until May 8th 2015. I found it to be an expensive year as phototherapy 3 times a week at €30 a time which may not have been necessary had I not been prescribed Enbrel. Add in he cost of doctors visits on top of that and the fact I wasn't working. It probably seems like i'm cursing Enbrel and in a way, it was a negative experience but it did prepare me in other ways, such as injecting as I believe the nurse service is not available with some biologics.

As I always say, what happens to one might not happen to another and I know people whose lives have been made better by Enbrel. Its just a case of finding what works individually.

Did you have a similar experience? or what do you find works for you? let me know below.

Until next time....

Sarah x

Haul: Bioderma....

I decided to do something different today, a haul of recent skincare products. I always want to try and do whats best for my skin, even if I don't succeed in doing so. Recently the French skincare company Bioderma have launched in Ireland and I have been intrigued with all the hype about it lately so I decided to purchase a few products to try it out for myself.

 I was immediately drawn to some products that were developed for sensitive skin as I've said before, its hard to find a good skincare routine for myself especially for my face as I find a lot of things seem to break me out. I hope to do a future post reviewing these items properly but for now, here's what I picked up;

 (Bioderma BB Cream in Light)

I've heard alot about the Bioderma BB Cream, both good and bad. It only comes in one shade - Light, which tend to be too dark for fairer complexions. The product contains SPF 30 and claims to "Even out the complexion. Moisturises and soothes". It is aimed towards sensitive skin which is prone to rosacea. While I don't have rosacea, I do tend to get a lot of redness around my nose and cheeks which can sometimes show through in some BB creams/ foundations. I did give this a quick try when I bought it, i prepped and primed my skin and applied it using a foundation brush. I don't know if my skin was prepped enough or if I should use the method of a makeup sponge but it tend to cake on my cheeks. I'm not writing it off just yet as the colour is quite good with my natural tan right now so I will update when I give it a second try. This retails at €17.50, while it isn't the most expensive, I did splurge a bit on this so I hope it will be worth it.

 (Bioderma Miceller Water)

This is one of the first Bioderma products I had heard people raving about, the Bioderma Miceller solution. This can be used as a make up remover or a cleanser. I had used the Garnier and Nivea sensitive miceller waters and had found them to leave my face feeling hot as though it was causing a reaction so I stopped using them. I'm looking forward to trying this out, but I will be trying a patch test first to be safe. Its says "Cleanses, removes make-up and soothes sensitive skin. Excellent tolerance. Non-rinse. Paraben free. Hypoallergenic." As I have said before, I don't use make-up daily, only for nights out/ special occasions so I look forward to seeing how well this will remove my make-up. The 100ml bottle pictured retails at €5.50. I decided to the smaller option and if I like it, I'll look into purchase the bigger bottle.

 

(Bioderma Moisturising Stick)

I picked up this lip balm as something extra to try out as I always seem to pick up new lip products to try out. It is for Damaged and dehydrated lips, which I have had a problem with lately and I wanted to see if this might be as good as my trusty Blistex relief cream, and to be honest it is! I have been using it for about a week now and find it so hydrating on the lips and leaves them feeling lovely and soft with no stickiness from the product. Only downside is there is no SPF, but its not a major flaw. It cost €3.50 which seems to be the typical price for lip products these days. Well worth trying.

I will be sure to do more in depth reviews when I have tried these products further. Have you tried their products? Let me know which are your favourite!

Until next time....

Sarah x 

My experience with Phototherapy (light treatment).....

Welcome back again to another installment. Today I'm going to discuss Phototherapy, also known as light treatment or UVB. I have gone into further detail about this in past blog posts, on weekly to daily basis so this is going to be a summery of my experience and just explaining what phototherapy is.

Phototherapy involves exposing the skin to ultraviolet light on a regular basis and under medical supervision, in my case, in a hospital. This is very different to tanning beds which are advised against using for skin conditions as it is not beneficial and does more harm than good. UVB (ultraviolet B) is present in natural sunlight and slows the growth of affected skin cells, therefore helping psoriasis.

I have been through this treatment three times, in 2011, 2013 and 2015. If you'd like to go back to my first post on the intial assessment where I go into detail about what happens for the first session, check it out by clicking here. 

My first and second time doing the treatment were very beneficial, to the point that my skin cleared, or was close to clearing. I do wonder if the more you go for the treatment, the less effective it become. My third time doing the treatment, was when I had flared due to Enbrel (which will be in more detail in the next installment). It seemed like my skin was more stubborn, and a mixture of trying new biologics had maybe played a part in it also. 

As I came to the end of my third time, which was only the start of May this year, I still wasn't happy with my skin. It had progressed, but not to the extent it had done in the past. I would really recommend this treatment for anyone with very bad psoriasis, but not to be doing so too often. My doctor said after a few hundred session that it would be considered a higher risk to skin cancer. Each time I had only done 20 - 28 sessions at most so I don't have to worry just yet.

Another thing about this treatment is that once the days session is done, it is very important to try and avoid the sun for the remainder of the day and use sun cream when outside. Reason being, at each session you are getting your days dosage of sunlight recommended.

Any questions, or anything you feel I should go into more detail about, leave it in the comments below.

Until next time....

The "Me Time" Tag....

Back with another tag! This time the "Me Time" tag. Lets face it, we all need some 'Me Time', especially since Psoriasis is linked to stress, we all need to do little things to unwind, so here are mine....

What do you watch/read during me time?Reading usually consists of interesting or sad stories online. As for watching, I do love when Game of Thrones is in season and would catch up on a weekly basis. Lately its been all about Orange is the new black since it is back again. Usually watch it curled up in bed with himself.

What do you wear during me time?
PJs! with a comfy bathrobe, more times than not. Otherwise it would be a tshirt and tracksuit bottoms. Can't forget the slippers either :)

What are your me time beauty products?
I'm not one for using too many beauty products, but I am going to try and get into a proper facial skincare routine soon. I just like my hot shower, pampering my hair with a nice hair mask and hydrating my skin with E45. My skin tends to be very sensitive so it is hard to find a face mask that wouldn't break me out unfortunately, the search continues!

Current favourite nail polish?
Really liking NYC's Park Ave (246) its a nice mink/light brownish kind of colour. Not too dark for the summer.

What do you eat/drink during me time?
Probably be a takeaway, or a bit of junk food. Maltesers especially...yum!


Current favourite candle?
Anything Vanilla scented!

Do you ever have outdoor me time?Sometimes its nice to walk the dog on my own. I live in the countryside so it is quite calm and peaceful compared to the town or city which is nice to explore especially through the seasons and see the changes around. Also a trip to a local beach can be rather relaxing, just sitting watching the waves.

Would you ever go see a movie alone?Its something I haven't done and I'm not sure I would unless I couldn't convince someone to see a movie I really wanted to see. I think the company makes the trip a better experience too. My friend and I used to always go most weeks and it was more like a catch up and a laugh.

Favourite online shop?
Clothing and accessory-wise, I love New Look and Forever 21. I think Ebay is great for finding somethings that may be hard to find elsewhere or random gadgets.




Anything else to add?
Sometimes listening to music, a song that reminds me of good times, going for a drive or watching a movie on the couch are all other ways I get to relax. I find myself not having much time these days with work but I do look forward to the simple things on days off :)

Lastly, any bloggers that want to do this tag, I tag everyone. I found this tag randomly, so someone else might do also. If not a blogger, why not pick a few questions from above and give your answers in the comments below.

Until next time....

Sarah x

My experience with Methotrexate

Welcome back again to the second installment of this series, this time about my experience with Methotrexate...

In 2006, the same year I had gone through the tonsillectomy, I had noticed my right knee was very swollen to the point that it was double the size of my left knee. When I had a check up with my dermatologist I had asked about my knee, he then informed me that Psoriatic arthritis is a possibility due to having Psoriasis and he refered me to a rheumatologist to look into it further.

I believe it was around September of the same year that I first saw another new doctor. He checked out my knee and said it was fluid after building up which is why is was that size. He then drained the fluid and showed me it in a cup. It was yellowish in colour 'like Heineken' my doctor proclaimed. I was also given any anti-inflammatory injection in my knee in the hope it would keep it calm.

I saw my doctor every few months and had fluid drained a few times, thankfully not to the extent of my first visit. He gave me a leaflet about Methotrexate (MTX) a tablet (also available in injection form nowadays) which was known to be good for types of Arthritis. I came to the decision I would try it in the hope it would help. I was then sent for a chest X-ray which has to be done upon starting MTX, as well as regular blood tests to keep a check on liver functions, as it can have an effect on the liver. I started on a low dose of 5mg, followed by folic acid two days later. The dosage was increased as the weeks went on, to 15mg, if I remember correctly. MTX can be disruptive to the stomach and I did experience a few stomach aches but it was worth it to help my knees.

I was still on MTX up until Decemeber 2014. Over the years I have had the dosage switched up and down, depending on how bad/ or well behaved my knees were. The highest I was on was 25mg, which did not agree with me back in December and ultimately was the final straw in changing to a biologic which my rheumatologist had always offered as an alternative.

Another reason for going off MTX was due to developing psoriatic arthritis in my left knee and also last year, in my right elbow. I visited my doctor every two to three months and was usually given a steroid injection to help with any inflammation which may have been happening at the time.

I found that MTX was effective for a while, as I was on it long enough but I just found as the years went on I needed to try something different. I think it is a good option to start off on if you are new to psoriatic arthritis and are unsure of the biologics which are usually injections. I have heard other peoples experience with this drug that they could not that it as it would make them feel so ill. Also it is not recommended to drink alcohol while on it due to the possibility of it having an affect on liver function, which is another thing that turns people off. As stated above, it is now available in injection form, something that wasn't an option when I started and I have heard some people say they prefer this method. 

Its all down to personal preference and we need to remember that even if one thing doesn't work for you but works for someone else, there are plenty of options out there. That is something that will ring through when I talk about Enbrel.

Again, any questions you might have about MTX, don't hesitate to ask.

Until next time....

Sarah x