My Ocrevus Odyssey

I am frequently asked about my current MS medication regiment, so this is a good time to catch up my readers. On September 20, 2017, I wrote about my first dose of Ocrevus:

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My MS has changed over the years – originally diagnosed as “relapsing-remitting,” Dr. Stevens now classifies it as “relapsing-progressive.” Progressive forms of MS have fewer treatments available, but this spring, a new one entered the field: Ocrevus – ocrelizumab. News stories showed promising results, and though our goal is for this medication to help prevent further progression, I can’t help hoping for a smidgen of improvement. Yesterday, I had my first half dose, and the second half will come in two weeks. Then, I will receive this infusion once every six months.

What will it do? I don’t know. I can tell you that my only reaction was a bit of an itchiness and redness that was zapped with Benadryl. So it is that September 20, 2017, marked the first page in this chapter of my medical saga – time will tell what the other pages hold.
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The immediate part that came next had absolutely nothing to do with the new medication, though I first thought it did. That itchiness and redness, then hives that followed? My thick, dark, curly hair (with natural silver streaks) had been hiding something I had never experienced: head lice. We traced back the source, and it has since been dealt with (not in our house, church, or school), and my dear husband assisted me in winning the fight against the nasty buggers. Once my locks were louse-free, I had them chopped two inches shorter, helping me avoid tangles and other issues. So…the second half of my first Ocrevus dose came about four weeks after the first, and those four weeks were no picnic.

Because of the unrelated craziness, it was difficult to tell if the medication was making a difference in my health. With this medication formulated for one infusion every six months, I do appreciate that I don’t have to go in as often or treatments. Is it effective? I can tell you that that the debilitating tongue and jaw problems (hypoglossal and mandibular neuralgia) that hit me two years ago have not returned. This is indeed HUGE.

Three months have now passed since my third Ocrevus treatment. I do take other daily medications in relation to symptoms, but I feel like I’m at as level of a spot as I’ve been for a while. I must admit that when I first started this medication, I had truly hoped to see a few glimmers of improvement. What I think I have found is a more solid line that may be slowing down progression. MRI scans have shown no additional scars in my brain, and we did find scarring in my spinal column… it was encouraging, in some ways, to find that there was a clear reason for some difficulty walking. Did those scars come before or after Ocrevus? I do not know, but I do feel that, paging through the current therapies that fight this MonSter, Ocrevus is the one that serves me best.

Several years ago, I was an example patient for a medical school course Dr. Stevens was teaching. After I shared my symptoms and they guessed my diagnosis, he shared that my disease was trying to progress. He said he’d give this an 8 on a scale of 1-10, with how fast it was trying to move. And this would explain why he had tried so many options. In November, my husband and I had a consultation with the director of the IU MS Center in Indianapolis, and I was encouraged that he agrees completely with Dr. Stevens. The trail thus far has been appropriate, and of two medications that could help me, Ocrevus is the best choice for me.

So for those who ask how this is going for me, the answer continues to be a process. It has involved a fine-tooth comb, patience, education, faith, and partnership. As I continue travelling this odyssey, I will certainly share snippets of life. The next blog post proves to be a fun one, “Knight Rider.” Is it an 80’s series about a talking car? Likely not, but stay tuned…

A new start -Angie’s blog returns!

Happy 2019, friends! It’s been entirely too long since I have posted to this blog. Am I still battling “invisible issues,” you ask? Hmmm… will there be snow in January?

Yes, life with disability leads to paths I never would have foreseen. MS may not be a walk (or stroll) in the park, but blessings still come our way. Though I’m not one for “New Year’s Resolutions,” I do wish to give my blog a jumpstart of sorts. I intend to post at least twice a month, sometimes more. Topics ahead include our “Knight Rider,” driving decisions, my Ocrevus experience, caregiver challenges, chair that offers a lift… and definitely National MS Awareness month and National Poetry Month

So why “Queen Anneangela knight blog header’s Lace” on my cover page? For one thing, it’s one of my favorite wildflowers. I also love how it pokes up where it wasn’t planted, sometimes considered a weed. I’m convinced that people would pay good money to grow this bloom if it weren’t so common. I find blessings in this flower that was not purposely sown. In a similar way, I wish to bring attention to blessings that may be found despite very real struggles.

So let the blog begin!

MS Awareness Week, March 11-17

     Spring has been a favorite season of mine for as long as I can remember, but it has taken on new meanings in recent years. March doesn’t just mark the start of spring, but the MS Association of America declares it “MS Education and Awareness Month.” Since a June 1997 diagnosis, every month has fallen into this category for me. Along the same lines, The National MS Society declares “MS Awareness week” to be March 10-17.

     So what is MS anyhow, and why do we need to be aware? Valid questions. Multiple Sclerosis is an autoimmune disease, meaning that the immune system, which usually attacks things that make us sick, is misbehaving. With MS, the immune system attacks the coating of the nerves, a fatty substance called myelin. Imagine that your nerves are electric wires, and the myelin is the protective rubber coating around the said wires. Then the renegade white blood cells snip away at parts of that myelin “rubber coating.” When a power cord has this type of damage, it can cause a short circuit. Lights may flicker or sparks may fly, depending where the power was headed. Your biggest bundle of nerves is one that you use whether or not you’re thinking about it; you need it in order to think, in fact. The brain is, essentially, a huge, organized bundle of nerves. For an MS-laden immune system, the brain acts as the main target.

This leads to the reason for the name, “Multiple Sclerosis.” Multiple means many, and Sclerosis refers to scars. What happens when the myelin is stripped away? Scars, or lesions, are left behind. Where? The brain, of course. And this leads to that need for “awareness.” You see, the brain is responsible for quite a bit. Imagine if your home had shorts in the wiring at various spots. More than just flickering lights, your doorbell may not work, the furnace may fluctuate, your computer may flash new error messages, and the electrician would have quite a job in store. Scars in the brain can act this way also, affecting mobility, energy, balance, heat sensitivity, vision, speech, memory, and so much more. A few shorts may only affect the lights in the attic, and a person with MS may not experience very many symptoms. But one trait these both share is the same: unpredictability. What symptoms will strike when?

Do you know people who face MS? Whether or not you realize it, you likely do. Eighteen years ago, just a few weeks before we moved to a new home, I discovered that our next-door neighbor had MS. We had lived there for two years, and I had not realized this, as it was “invisible” in many ways. In the United States, it is estimated that 250-350,000 individuals in the USA currently face MS, about two thirds of these female. A person with MS may experience all or only a few of the symptoms mentioned earlier, and this may change. MS symptoms can come and go, and they aren’t very predictable, though they often become worse during stressful times or in hot weather.

So what to do? The good news is that although we had zero medications to fight MS twenty years ago, there are currently sixteen available. A cure remains elusive, but we keep coming closer. Medicine can help slow progression, and more answers are found each day. There isn’t a single, clear cause for the onset of MS, and there likely won’t be a single, clear cure, but continued research and awareness of this disease and its effects is key.

Summer used to be a much-loved season also, but MS has caused me to shift, as my body just can’t tolerate heat. I do adore new life that begins showing itself in spring, and my hope and prayer is that this “MS Awareness Month,” we can gain understanding of these hidden scars that affect our friends and neighbors with MS. As spring progresses, we can know that each day brings us closer to a cure.


You may also read this article in the “SEG-WAY News” of Grant County, Indiana, published March 9, 2018

My MS Medication Trail…

ocrevus

To understand how yesterday, September 20, was a key step in my MS treatment journey, allow me to take you back in time with me, where we’ll glance through the therapies I’ve experienced. When I was first diagnosed on July 30, 1997, T.R. and I shared with the doctor that we did want to start a family, so I’d like to wait a bit before starting a medication (the first two injectable therapies were just becoming available). I remember, then, an appointment at his Fort Wayne office in October 1998, and before he could share with me the suggestion of beginning a medication, we handed him a positive pregnancy test report. (We’d stopped at a doctor’s office to make certain.) Dr. Stevens shared the encouraging information that MS symptoms usually decrease during pregnancy, sometimes extra bursts of energy will even come! What I found, I’m afraid, is that the extra energy isn’t quite so likely when two little ones are growing… but I digress. Em and Rach were born June 8, 1999, and while I was nursing, MS symptoms  stayed in remission. When my body wasn’t able to keep up with the growing needs of these two little ones, I started using formula also, and this was the norm by Christmas.

So it was that in early January 2000, I started Avonex – interferon beta 1-a. The nice thing is that this medication only needed taken once a week – wonderful! Two negative things: one, it made me feel like I had the flu weekly; and two, I had to give it to myself via intramuscular injection (via a long needle). This is its own story, as my loving husband, who also hates needles, learned to administer this medication. And we gave it on Sunday night – while Monday became a day that my mother often came to help with two little ones while her daughter snapped back from side effects. (They say the side effects stop after a few months –  mine didn’t.)

After about three years, when MRI scans showed disease activity – and I was tired of feeling like I had the flu weekly – we decided to try a different injectable therapy, Copaxone – glatiramer acetate. This one was given with a much shorter needle, and it had a special autoinjector pen I could use, so I didn’t have to watch the needle as it did its job. It was a daily injection, but it had very few side effects. (Copaxone is now available as an injection only given three times a week – nice improvement there!)

After less than a year, though, symptoms and MRI scans were not encouraging, so we moved to injectable medication #3, Rebif – interferon beta 1-a again. Unlike Avonex, this interferon medication wasn’t injected with a 1” needle and didn’t have flu-like side effects. It was also not as effective as we wished.

So late 2004, I was asking Dr. Stevens what he thought we should do… there was something coming that he had read about and was watching. Until it was released, he thought Betaseron – interferon beta 1-b – would give us the best results. (At this time, I was not yet using a cane daily.) The medication he had been waiting for was available January 2005, and I was the first patient in Fort Wayne to take this new medication, natalizumab – only given once a month! But then we hit a snag. On February 28, I called to schedule my March infusion, and I was told there were complications… after a while on hold, they told me the FDA had just announced that this medication was pulled from the market. So back to Betaseron for another year and a half.

During that year and a half, the cane became a necessity. But that was okay. Monthly natalizumab did return to the market, now labeled as Tysabri. There were strict limitations on how it was given, blood tests to watch for really nasty things (that had caused it to be off the market for a year and a half), but I was a proud recipient of Tysabri for almost ten years!

I say “almost” because of a 3-month break. Summer 2013, Dr. Stevens and I wished to try a new treatment option, Tecfidera – dimethyl fumarate. Finally, just two pills a day, not a needle! And he legitimately thought it would be just as effective as Tysabri. But during those three months, I went from using a cane each day to being essentially required to use a walker. And that was the end of my “no more needles” time. So Tysabri re-entered my life, and my final Tysabri infusion was July 2017.

My MS has changed over the years – originally diagnosed as “relapsing-remitting,” Dr. Stevens now classifies it as “relapsing-progressive.” Progressive forms of MS have fewer treatments available, but this spring, a new one entered the field: Ocrevus – ocrelizumab.  News stories showed promising results, and though our goal is for this medication to help prevent further progression, I can’t help hoping for a smidgen of improvement. Yesterday, I had my first half dose, and the second half will come in two weeks. Then, I will receive this infusion once every six months.

What will it do? I don’t know. I can tell you that my only reaction was a bit of an itchiness and redness that was zapped with Benedryl. So it is that September 20, 2017, marked the first page in this chapter of my medical saga – time will tell what the other pages hold.

20 Years…

Rich ticket stub

Twenty years is a long time – but sometimes, it seems like no time at all. Time is funny that way.

1997 was particularly significant for me in a number of ways. In late May, I cleaned out my middle school classroom for the last time, saying goodbye to a career that would take unexpected turns. We moved to a new town, and my husband was now much closer to his new job at Taylor University (as he had been commuting until I completed my school year… I had signed a contract, you know). In May, I also visited my eye doctor… who led me to another doctor and a diagnosis in June for probable multiple sclerosis. (Because we weren’t busy enough the first week in June, as we packed boxes to move four days later… but that’s another story.) The official diagnosis came on July 30 – yep, it was MS.

This part of the my own 1997 story took a step in August when I attended a concert of my favorite musician, Rich Mullins – the link here will lead you to a review of the concert I posted the next day. What I did not realize was that this, the final concert of his tour, would be the last of Rich’s performances I’d have the pleasure of seeing. Of the fifteen concerts of his I had attended, this was also the first one that led to tears. During “Bound to Come Some Trouble,” the floodgates let loose. Two weeks earlier, that diagnosis had come, and I really wasn’t certain what it would mean. (Attached is a clip of this song that somebody recorded at his Wisconsin concert on August 10, four days before I had my little tissue-soaking time.)

September 19 was a day like any other – I was a graduate student, commuting to Ball State for class and work during the day, and the phone call came from my younger brother that evening. I had been listening to Rich’s “Canticle of the Plains” as I could throughout the day, but now I stepped into our back yard, where I could lean against the towering oak and gaze at the stars. The lyrics of “Elijah” scurried through my head, as I teared up and wondered about that candlelight in Central Park, and what it would mean to say “Goodbye.”

So here we are twenty years later, and I still feel that my life as it is today has been enriched by the music and ministry of Richard Wayne Mullins. His songs still traipse through my head, and I’ll still be reading scripture and thinking, “So THAT’s the spot where that lyric originated!” But a huge smile came to my face last Sunday morning when our associate pastor was describing what his two-year-old son had been doing at breakfast. Music was playing, and the little fellow left his cereal at the table and felt he needed to dance before our Lord… we were told this was a Rich Mullins album that was playing. I have a feeling this would have made Rich smile. And I have no doubt that Rich’s music will continue touching countless more lives in years to come.

This year, my own story will instead mark September 20 as a significant point. As I begin new medical path for my MS treatment, a new chapter may begin in my own story. I’ll plan to listen to Rich’s music as I venture on – and I’ll post more about that tomorrow or Thursday. In the meantime, I’m thankful for the legacy of Rich Mullins on this day in particular.