Wed, March 27
I thought I would add an update on Zach’s journey with arthritis. About two months ago the doctor recommended increasing the dosage of the methotrexate (once a week scary drug) to 8 tablets rather than 6. The swelling in his wrist and thumb had definitely gotten better, but it wasn’t “perfect” yet so she wanted to try this. Meanwhile Zach has been doing well. He continues to be great about taking his medications with no side effects and no complaining! Also, he does not seem to be limited with activity at all which I’m so thankful for.
So cut to this most recent check-up appointment this past Wednesday. As I suspected the doctor is still not totally happy with how his wrist is progressing. Since we have maxed out on the amount of methotrexate that Zach can take she recommended that we try Humira. Ugh. This drug is a tad scarier than the methotrexate and has multiple serious side effects including lymphoma. The doctor assured us that since 1995 she has prescribed the drug to many kids and she has only had one child who has developed lymphoma. My first reaction is – BUT THAT IS ONE CHILD TOO MANY!!!! We don’t really have a choice here, however. If we continue to just use the methotrexate there is a chance for bone damage in Z’s wrist and thumb. We just can’t do that. So, we start on this new adventure with Humira. Oh, and did I mention it has to be injected??!! At home?? By us?? (And by us, I mean Mike!). I mean, I COULD probably do it, but it freaks me out putting a needle in my child! Mike is probably the better bet for not only staying calm, but getting it right!
The nurse had us practice with an empty syringe on a pillow like thing. (My favorite part of the practice session was when the nurse asked us if we were familiar with using syringes. My smart-ass mind immediately wanted to say, “yeah back in my heroin days I got really good at it!” but I refrained and just said, “no”). The injection has to go into either his thigh or his stomach. Guess which one he prefers?! The other administration option is a pen. The advantage of the pen is that you don’t see the needle (that would be my choice!!), but you don’t have control of how fast or slow the the medicine goes in – you just have to watch the little window. On the other hand with the syringe you see the needle, but you can control how fast or slow the medicine goes in. The weird complication with the syringe is that you have to put it in at a 45 degree angle and pull the plunger back first. If blood gets in the syringe you can’t use it and you have to start over. Now, do you see why Mike should be the nurse?! Yeah, I’m not good with tools of any sort and that is too much pressure! Apparently the medicine stings going in (gulp). After practicing both options, Zach chose the syringe method. He actually got a kick out of the whole thing. Yeah, it is fun to play with when it is not actually going in your skin!! This medicine is stored in the refrigerator and we were instructed to leave it on the counter for 20 minutes to warm up before using. The one good thing about this whole thing is that he only has to take it every other week so that is good! He keeps taking all of his other medicines too. We will probably start the Humira this weekend just as long as all the insurance stuff goes through and Zach’s TB test is negative!
I was remarkably calm and unemotional during this appointment and hearing this news. I’m not sure why. Well, Zach and I could not stop laughing at the funny habit the student doctor kept doing in the room (we are so bad!), so that might have been why. I think at this point we just trust in our doctor that we are doing the right thing and have faith that it will eventually heal my little duder.