Cassandra Kicks AS is moving

Cassandra Kicks AS is still an active website but has moved to the following address:


http://web.me.com/cmkoits/Cassandra_Kicks_AS/Home_Page/Home_Page.html

Starting Simponi in September

I saw my Rheumatologist last week, and we agreed that I would try the new biologic therapy, Simponi. Although Humira has proven effective at reducing my inflammation, stiffness, and fatigue, the pain of injecting the medication is too much to bear--the medication stings like battery acid as I inject it under my skin. Getting lemon juice in the eye could be comparable. I just injected my second-to-last dose of Humira. One more painful dose to go.

New Race Goals

I've been feeling antsy. Despite taking up two new sports--golf and tennis--I feel as if something is missing from my life. It took me a while to come to terms with the fact that I was missing running. I had literally stopped running since the Goofy Challenge in January, touting the need to start running for fun rather than to be race-ready, to regain my core passion for the sport. The sad thing was that I was not running for fun as I thought I would; I would not consider running 5K once or twice within four months a commitment to running for pleasure.

I am now seeing a sports nutritionist to get my eating on track for racing in the Scotiabank Half Marathon in September of this year. My goal is to surpass my last personal best by 11 minutes. Today is day three on my nutritional plan; so far, so good.

My experience taking Humira

Humira works incredibly well at controlling my stiffness, fatigue, inflammation, and night sweats. I inject myself every two weeks. Occasionally, I forget to take the medication or I postpone the injection because the solution stings. Consistently, within a few hours of my scheduled administration time, I start feeling the pangs of stiffness developing, my SI joints start to crack, and my mobility is markedly reduced. If I don't receive Humira within 48 hours of my scheduled time, I begin to experience night sweats, worsening mobility, and increasing fatigue. If Humira did not sting, I would likely not "forget" to take it as often.

Health Canada approves Simponi for AS

Health Canada approves new medication for treatment of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

(Posted April 29, 2009)

Centocor Ortho Biotech Inc. and Schering-Plough Corporation recently announced that Health Canada has granted approval of Simponi (TM) (golimumab) as a once-monthly, subcutaneous therapy for the treatment of moderately to severely active rheumatoid arthritis (RA), active psoriatic arthritis (PsA) and active ankylosing spondylitis (AS).   With this approval in Canada, Simponi, in combination with methotrexate (MTX), is indicated for reducing the signs and symptoms in adult patients with moderately to severely active RA; reducing signs and symptoms in adult patients with moderately to severely active PsA, alone or in combination with MTX; and reducing signs and symptoms in adult patients with active AS who have had an inadequate response to conventional therapies. According to a company release, this medication is the first biologic therapy to be approved concurrently in three distinct rheumatologic diseases. Schering-Plough anticipates that the medication will become available in Canada in the second half of 2009.   "This first approval marks a major milestone in the clinical development program for Simponi," said Jerome A. Boscia, M.D., senior vice president, Clinical R&D, Centocor Research & Development, Inc. "More importantly, the approval of Simponi expands the therapeutic options for physicians and offers patients an effective new medication that can be self-administered once monthly."   "This is the first approval for Simponi, one of the five stars in our late-stage pipeline," said Thomas P. Koestler, Ph.D., executive vice president, Schering-Plough Corporation and president, Schering-Plough Research Institute. "Offering once-monthly subcutaneous dosing, Simponi will provide an important and convenient new treatment option to rheumatologists and their patients. Simponi expands our leading immunology franchise in meeting the needs of the rheumatology community."   Centocor Ortho Biotech Inc. developed and discovered Simponi and has exclusive marketing rights to the product in the United States. Following regulatory approvals, Schering-Plough will assume exclusive marketing rights in Canada and other countries (except for a few) outside the United States. The approval of this medication in Canada is based on data from five pivotal clinical trials: GO-BEFORE, GO-FORWARD, GO-AFTER, GO-REVEAL and GO-RAISE. Each trial found the medication to be effective in reducing the signs and symptoms of RA, PsA and AS.   Simponi is a human monoclonal antibody that targets and neutralizes excess TNF-alpha, a protein that when overproduced in the body due to chronic inflammatory diseases can cause inflammation and damage to bones, cartilage and tissue. The first once-monthly subcutaneous anti-TNF-alpha therapy, this medication is available either through the Simponi SmartJect auto injector or a prefilled syringe. It's also being studied as an intravenous infusion therapy for the treatment of rheumatoid arthritis. (Source: PR Newswire - Centocor and Schering-Plough)

Goofy Challenge--I did it!!!!!!!

I can't believe I accomplished my third dream running goal: to complete the Walt Disney World Goofy Challenge. I can't describe how proud I feel!!

HALF MARATHON
I went to bed early and awoke at 3am to start fuelling and hydrating. I was on the bus at 4am for the 6am start. Two hours of waiting around in the cold temperatures for the start of the race did not impress me--I could not see the logic in the wait. For extra cash paid ahead of time, a heated tent with additional luxuries, such as private toilets and a full post-race meal, was provided.

I decided weeks ago that I would pace myself for the half-marathon component of the Goofy Challenge. It was very difficult to not pick up the pace when I experienced sudden bursts of energy. The race took me through Epcot and the Magic Kingdom, where Disney characters lined the streets for photos with racers, and to provide moral support. As I ran through the castle in the Magic Kingdom, horns trumpeted as I emerged on the other side, and hundreds of spectators cheered us on.

FULL MARATHON

My body was slightly sore on Sunday, and my IT band was tender on both legs, however, the vision of the finish line and an accomplished dream goal caused me much excited anticipation. I went to sleep early on Saturday night, but I felt exhausted when I awoke at 3am to start the hydrating and fuelling process. I knew the challenge that lay ahead, but I tried not to think too deeply about it and redirected my thoughts to the present moment of preparing for the eve

nt. The morning routine mimicked yesterday's, including the early morning boarding of the bus to go and wait at Epcot until the 6am start. I continued to hydrate and fuel as I huddled in a tent with others trying to keep our muscles warm.

The race took us through all the theme parks. There were points in the race I was hurting terribly (sore muscles, particularly both IT bands that felt they would tear at any time) and needed to walk to stretch out my tight muscles. I gratefully accepted Advil and blue gooey muscle rub at the Aid Stations along the route. Occasionally, a few choice four letter words would slip past my lips as I would semi-run, semi-limp along...words the would mingle among sentences of self-encouragement and visionary motivation. The runners with the blue wrist bands stood out--we were the Goofy runners--and we supported each other along the way with pats on the back and pep talks; anything to distract from the pain was welcome.

The finish line, finally a distant memory, awarded me three large gold medals: Mickey, Donald, and Goofy. They were heavy weapons of achievement, and I wore them proudly that day.

Goofy

The Goofy Challenge is just around the corner. Just a few more days before I jet-set to sunny Florida to fulfill my dream goal of running in this particular group of races. I plan on running nice and easy for both the half and full marathons, primarily because I have succumbed to a terrible virus that has left me with severe laryngitis, mild fevers, night sweats, and frequent uncontrollable dry coughing fits. Not very sexy at all. As a result, I can focus on enjoying the scenery, the spectators' cheers of support, the live bands, and the experience of all that is Walt Disney World.

First day on Humira

My package of Humira arrived on December 22nd, perfectly timed with my return from hitting the sloped in Mont Tremblant, Quebec. A Registered Nurse from VON was expected to arrive on Christmas Eve to show me how to administer the medication properly, and to answer any questions I had. I prepared my list of questions in anticipation and waited with bated breath.

I was not impressed with the nurse's skills, I'm afraid. I never told her that we were members of the same registered body, and I almost wished I had: the basic skill of proper hand hygiene was sorely lacking. Despite the nurse telling me that I should wash my hands before injecting myself, she failed to do so and then proceeded to manipulate the area on my abdomen that I had carefully swabbed with alcohol. I swabbed a second time the now-contaminated site, and she once again manipulated the area and then quickly injected me the with medication. I was warned by the pharmacy that the formula was very acidic and burned, but I was not prepared for the intensity with which it stung. Reflexively, I tensed my muscles tightly; the pain was unwavering. The nurse told me, as I watched drops of medicated fluid spill down my stomach (I counted the hundreds of dollars being wasted with every dribble), that my abdominal muscles were creating resistance and pushing the needle out of my body. I was not sure if that was the true cause for the wastage of my precious medication, or if she was not as competent as her professional title implied. I am sorry to be so harsh, but if you been there listening to her...watching her...you would have been shaking your head and wondering if she had ever given a subcutaneous injection before. When I asked her about the side effects, she told me to read the pamphlet that came with the drug; which is all well and good given my nursing background, but she did not know of my clinical expertise and should have explained the side effects instead of directing me to small-printed clinical-trial jargon. She also directed me to do searches on the internet. Geez...why didn't I think of that (sarcasm dripping down the screen so thick you can barely read my blog anymore).

On a more positive note, Progress contacted me to find out if the nurse had shown up to provide the instruction and to learn of my experience. I was not brutally honest about my experience with respect to providing all of the details, but I did share my disappointment with the lack of hand washing. Progress committed to following up with VON to have another nurse come on January 6th to provide my second dose and answer any outstanding questions. At this point, I am extremely impressed with the comprehensive case management of Progress; it has certainly eased any anxieties I had starting a new biologic.