Pushing My Autoimmune Limits and Preventing the Flu

As discussed in my previous post on the results (benefits & side effects) of taking Humira, I went on a cruise to test my autoimmune system now that my inflammation is back to normal.

caribbean cruise - half moon cay

Caribbean Cruise – Paradise on the Private Island Half Moon Cay

Pushing My Autoimmune Limits and Getting the Flu

I went on a 4-day cruise and I could tell the night before I was leaving that I got the flu. Last year I went on a similar 4-day cruise, was not taking Humira (was taking Prednisone) and did not get the flu.  Here are the main reasons why I believe I got the flu this time:

  • Previous cruise I was very strict with my diet and ate only a few fringe foods.  This time I ate almost anything I wanted + lots of new foods I haven’t tried in years except for bread / grains / flours.  I wasn’t loading up on dairy, yeast-based products, etc., but lots of the food I ate (both at the buffet and even the upscale Chinese restaurant on the last day) contained many hidden ingredients.
  • The 2013-2014 flu is affecting more young adults than the 2012-2013 did.
  • The ship was sold out with 2,104 passengers; some from all over the world.  Even with all the sanitizer I used on board, a boat can be like a giant petri dish.
  • My immune system may have been lowered since I needed to take Humira on the 2nd day of my trip. [Flu requirements when taking Humira]
  • I was much more active this trip than last year.  4-5 hours of walking in Key West, 4-5 hours (all outside) on Half Moon Cay (played volleyball 1st time in years and walked around most of the island).  By the end of the third evening (Half Moon Cay) I saw that I was much more dehydrated that I thought.  The only downtime I had was the day of the Bahamas, but danced most of the evening until 1-2am in the morning.
  • Interacted much more with people and danced with many new people.  While this makes for a fun time, just one of those people could of had the flu or touched someone who had the flu & was passing it on.
  • I did not use my air mattress like last trip as I was able to sleep on the standard bed.  However, I did not get full nights of sleep and rarely took any daytime naps.

Preventing the Flu Before and After with an Autoimmune Disease

In the future, here are the steps I suggest people take preventing the flu before their trip with an autoimmune disease while on Humira (or any other biologic):

  • Although there is a lot of temptation out there, limit the types of foods to “simple foods”.  These foods are typically made of a few ingredients and don’t contain any fillers.  For example a meal like steak, rice, and broccoli would be fine.  But eggs benedict might not due to the extra dairy and possible flour used as a filler for the sauce(s).
  • If possible, don’t go on vacations with a lot of people confined in a space.  This one is really hard because that would restrict you from airplanes, cruises, or anything that travels with more than 20 people.  To help prevent this I suggest the next step…
  • Take lots of immune boosters.  Vitamin D3, magnesium, zinc, and echinacea are a few supplements to bring along and take at least a few days before you start your trip.
  • Get in the habit of washing your hands for at least 20-30 seconds per the requirements of the CDC.  Hum the “Happy Birthday” song while washing your hands to cover the 20-30 second time.
  • Take your biologic medicine at least 3-4 days prior to the trip.  If you need to take dosage twice a week, consider the larger dose sizes available (this mainly applies to those taking Enbrel).
  • Make sure you are getting plenty of rest prior to the trip.  This may be very difficult since most of us are finishing projects prior to the vacation.  But really try to get a solid 8 hours of sleep per night.  Naps in the afternoon a plus.

What if you got the flu after the trip or want to prevent the flu from sneaking in?  Here are steps I suggest people with an autoimmune disease take after their trip and especially those who got the flu.

  • Continue to take lots of immune boosters like vitamin D3, magnesium, zinc, and echinacea.
  • Drink lots of juice (even better to juice your own orange juice and other juices) to boost your Vitamin C.
  • Eat homemade chicken soup.  I have this excellent recipe for mom’s homemade chicken soup that uses mostly organic ingredients.  The broth from the chicken bones help boost your immune system and other key nutrients.
  • Stay away from people.  No one wants your flu and being active around people is not going to improve your health.
  • Drink hot teas to help soothe your throat.  Just make sure there is no caffeine in it.  I was the unfortunate recipient of drinking 3 hot teas on one day and the literature stated “naturally decaffeinated”.  Needless to say, I could not sleep till 3am.  Not fun.
  • The cold weather can not only get you the cold, but stay there.  More information from this ASAP science video below about how cold and humidity play a role in developing / continuation of a cold.
  • Try not to take your biologic medicine 3-4 days after your trip.  If you need to take dosage twice a week, consider the larger dose sizes available (this mainly applies to those taking Enbrel).
  • Consider using a diffuser with essential oils to purify the air around you.  Open up doors / windows from time to time to flush out the stagnant air.
  • Wash your hands for at least 20-30 seconds per the requirements of the CDC.  Hum the “Happy Birthday” song while washing your hands to cover the 20-30 second time.

My Flu Diary

My flu lasted from the evening of 12/22 – 12/28, 12/23 being the worst day (slept for 18 hours with 2-hour naps & getting up for 5-15 minutes in between) and Christmas Day being my psychological low point (home alone and sick sucks).  I then had a lingering cough which bruised my rib from 12/22 – 1/6.  My ribs are finally healing on 1/10 but may take another week to fully recover.

Have a suggestion on combating the flu before and after with an autoimmune disease?  Feel free to comment below & I’ll add it into this blog post.

Humira – My Autoimmune Benefits, Side Effects, and Results

As discussed in my previous post about Iritis, I’ve had enough of playing the chronic inflammation game and wanted my life back.  I discussed this over with my Rheumatologist and we both agreed that Humira would be my choice of biologic medication. Not only would Humira block my chronic inflammation, but it is FDA approved to treat Crohn’s disease – one of my root causes.  To recap, let’s look over my rates / percentages of health since I got off Enbrel for good on February 7th 2012:

Rate of My SED and CRP Rates of Inflammation

My SED and CRP Rates of Inflammation from Dec. 2011 – Dec. 2013 (2 Years).  Note the normal rates for both are under 15.

  • 10-20% Health – Mid-March 2012:  Enbrel out of system, could barely tie my own shoes.  Life unbearable at times, but parents lovingly got me through as my body was slowly healing.  Many symptoms developed at this time.  Rates of Inflammation:  CRP spiked from 9 in Dec. 2011 to 142.8.  SED rate at 101.
  • 20-40% Health – July 2012:  Eating and learning to cook a healthier lifestyle improved my condition, but times still unbearable and started a regimen of ibuprofen to function in my daily life.  Started many tests to determine root causes of my issues.
  • 40-50% Health with Bursts:  December 2012 – Found major root causes from the tests I took.  Symptoms / issues pointed to Crohn’s Disease / IBS / Ulcerative Colitis (Which might have developed due to the ibuprofen I was taking – Mayo Clinic states:  “Don’t use ibuprofen (Advil, Motrin, others), naproxen (Aleve) or aspirin. These are likely to make your symptoms worse.”).  My bursts were coming from taking Prednisone (hard to sleep taking this) and going off ibuprofen.
  • 40-60% Health: April 2013Detoxification off of meds and supplements.
  • 30 – 50% Health:  June – Early September 2013:  Recommendations from an autoimmune specialist put me on a new set of supplements and tests.  Although I reverted back to my lowest points in 2013 (I needed other people to help drive me to places and did not leave the house sometimes for a weeks), I did find root issues:  Mold / fungus in my house, oxidative stress, and leaky gut syndrome (nutrition dysfunction).  Taking medications helped the root cause, but made my system weak.  Supplementation either had little help or was harmful.
  • 50 – 70% Health – Mid-Late September 2013: Introduction of Low Dose Naltrexone (LDN).  With low cost and minimal side effects, LDN boosted my health around 20% + getting off all the “fixing the root cause” medication & supplements.
  • 70 – 85% Health – November / December 2013:  Along with the Low Dose Naltrexone (LDN), I started taking Humira due to my Iritis attack.  Within the 1st 3 days after Humira I saw significant consistent improvement.  Increasing weight along with exercise / Yoga has continued to increase my health.  In December, back to a “normal” weight, Iron levels back to normal (no anemia), and have more energy than I ever had in my 30s.  Rates of Inflammation:  CRP rate at 3.3 (better than when I was on Enbrel and had a CRP of 9.5) and SED rate of 4 (review latest test).

What is Humira?

With autoimmune diseases, your body produces too much of a protein called TNF.  This TNF then triggers an inflammation response that goes throughout the body.  Humira is designed to block the receptors that hold TNF as explained in this video.

humira-pen-figure-a-pen-image

Humira is used by injecting the grey cap (Cap #1) into your skin (I inject into my thigh) once every 2 weeks.  Since Crohn’s disease deals with the digestive system, the Humira injection does not interfere like a pill would.

My Humira Results

If you examine my comprehensive autoimmune blood tests, look for the results of my SED rate and CRP (C-Reactive Protein) – they are both markers of inflammation.  Normal ranges for SED rate are 0-15 and CRP are 0 – 4.9.  In April 2012, my SED rate was 101 and CRP was 142.8; abnormal and dangerously high.  After taking Humira, Low Dose Naltrexone (LDN) and all that I’ve learned throughout my journey, my comprehensive autoimmune blood test in mid-November shows a SED rate of 4 and a CRP rate of 3.3; a vast improvement.

Here is an update on autoimmune symptoms listed in my last post about Iritis:

  • My weight on 12-13-13

    My current weight of 134.5 lbs. on 12-13-13 (Wii Fit Plus).

  • Continued to lose weight and at my lowest was 116 pounds (originally 158 lbs.)
    My weight starting Humira was 116 lbs. and has increased to 134.5 lbs (roughly 1 1/2 months time).
  • Continued nutrient malabsorption Current increase in weight and ability to eat foods I could not before prove I am absorbing food.
  • Fatigue / Anemia (usually sleeping twice a day & needing 10+ hours of sleep / day) I no longer need to take naps and 8 hours a night of sleep is typical (most of the time without the need to get up in the middle of the night).  Review my Iron Level tests prior to taking Humira and after taking Humira.
  • Sitting in chair too long makes my body very stiff.  I can sit in the chair for hours although my back gets 2-3 out of 10 in stiffness…I can live with that!
  • Stools loose.  No problem now, I can poop like a champ!
  • Very hard to squat down or bend over (can’t really do this unless I assist with holding onto something) to pick something up.  I can now do a Sun Salutation in Yoga, and I can bend over and pick things up off the floor.
  • Flare-ups from foods, sometime even safe foods.  No flare-ups because the Humira blocks the receptors that cause the inflammation (but the process still happens).  I still avoid the foods that caused me to flare up the most – breads, grains & flour mainly.
  • Get cold quickly along with poor circulation & purple fingers (Raynaud’s Syndrome) – I still get this, but less noticeable.
  • Weak body: Need a rope to get out of bed, can only go to the pool for 10 minutes, no gym workouts, etc.  On 12/4 was my 1st major (45 minute) workout on my chest, biceps & triceps.  I can now go dancing for hours and walk around the block with no issues.  Driving is also so much easier.  Did I mention that I removed the rope from my bed (it was the only way I could get out of bed for more than a year) a few weeks ago?  That was a great moment.
  • But the last and final straw was developing Iritis on 10/9/13.  6 Ophthalmologist visits over 1 1/2 month span (1 month of which my right eye was dilated the entire time), it’s all cleared up.  The medicine made my condition much better after the 1st day.

Humira Side Effects

Humira, like all biologic medications, can have serious (even deadly) side effects caused by fungus, bacteria, and virus infections.  Liver infections and psoriasis has also showed up in patients taking Humira.  My symptoms include increase sneezing and my ability to fight infections.  The LDN & eating a healthy lifestyle help my immune system and could have a better chance at fighting infections.  Finally, and I know this might sound strange, is that I have to adjust to my new level of energy.  It’s hard to go to sleep because I don’t feel like I need to (but when I lie down for 10 minutes I do sleep – kind of feel like a kid again).  When I wake up, I’m up and need to do activities if I wake up too early.

Future Plans – Finding the Autoimmune Root Cause

Conclusion

Two words:  “I’m back!”

Thank you to those who have continued to pray for me.  Please focus your prayers on having me find my root cause(s) and for the other millions of people to find their root cause(s) of inflammation.


Diary – Getting Back on Humira

Since most of the major gains were made in the first week, I will only supply a daily diary for the first seven (7) days and then a weekly diary afterwards.

10/25 – Bed at 10:30pm, up at 4:30am and then 7:15am.  Slept from 9-10am and rested from 1-2pm.  Woke up stiff & sore due to all the work I’m doing, doctors, insurance, etc.  Same old routine with the right foot, left elbow, back & shoulders along with the right eye cloudy from the meds.  I began taking Humira in the morning with the pen instead of taking with the syringe like I used to with Enbrel and it’s much easier to administer plus I only have to take one time every two weeks.  I was finally able to start my mini-vacation at 6pm (which is just the weekend + a little on Monday) by traveling up to Venice (1st time since March).  One great steak dinner & some Chardonnay later & I was beyond exhausted by 7pm…but very happy to be with my parents and George.
10/26 – Bed at 10:30pm, up at 4:45am, then 7:30am.  Napped from 3-4:30pm.  Noticeable areas of pain / stiffness are right foot, neck, low back & cloudiness in right eye due to meds. 1st day after taking Humira and I can already start to see the effects of the medication.  I feel less stiff when I woke up and my Yoga was easier to do in the morning.  I had a full sleep from 10:30pm – 4:45am & then it was on & off as usual.   Where it started to really shine was I could walk at the Ringling Museum for 2-3 hours.  And for lunch I had fries along with a Colada & grilled fish.  Normally this would flare me up, but it didn’t.  But I could notice my stomach not feeling so good for a few hours after that lunch.  By the afternoon I was exhausted but felt better after getting up.  Fajitas and margaritas in the evening with fringe foods with no flare-up and my stomach felt fine afterwards.  Lower back still stiff & hurting if I stay in a chair too long.  Shoulders / neck / mid-back OK throughout day but my sides (front rib areas) hurt a bit.
10/27 – Bed at 11:15pm, up at 5:15am and then 8am.  Napped from 11:30 – 1pm.  For 1 1/2 years, I dreamed of what arrived today. Woke up much easier and my pain & stiffness is much less.  Neck still limited left & right, but better up & down motion.  Right eye cloudy due to meds.  Went to the cold pool and hot tub (Russian bath style but not as bad as this) at 9:30am for 20 minutes.  Drove back to Naples, cooked dinner for me & three friends & no flare-ups.  Prior to taking LDN, I could not do it.  While on LDN alone, I could do it, but would need help from my friends to cook / clean while I rested.  Today, no problem.
10/28 – Bed at 11:15pm, up at 1pm, then 6:30am, then 8:30am.  Tried to nap in the afternoon but too much to do & phone calls.  Neck range same as yesterday + shoulders & low-back a bit stiff.  Right eye cloudy with meds, right foot inflamed & hips hurt.  I can now get out of my own bed without using the rope!  In the morning was able to do a Plank for 30 seconds and got up much easier than I did trying this on 9/29.  Bending down to put dishes away is better but still cannot pick stuff off the floor.  Dressing myself takes much less time and is easier to do (feels kind of like a joke now to do).  10:30am walked around the entire neighborhood block for the first time in over a year.  6:15pm walked down the end of the street and took 15 minutes, not 20 minutes like before.
10/29 – Bed at 11pm, up at 6:30am.  Napped from 2:30pm – 3:30pm.  1st time I didn’t get up in the middle of the night.  Looks like my adrenals are getting back to normal now.  Noticeable areas are right eye (meds), right foot but better than yesterday.  8:30pm walked down the street for 15 minutes.  Lower back sore in the evening (probably due to plank yesterday).
10/30 – Bed at 11:15pm, up at 6:15am & napped from 3-4pm.  Waking up with low back stiffness at 3 out of 10.  Neck is still 4 out of 10 left to right & 3 out of 10 up & down.  My stools have pretty much normalized at this point and my weight is now 119 1/2 lbs.  I seem to gain a little over 1/2 lb. each day since taking the meds.  8am and & 6pm walked down the end of the road.
10/31 – Bed at 11:45pm, up at 2am, then 8:15am.  Napped from 1:30pm – 3:15pm.  Shoulder blades, neck movement from side to side, and right eye cloudiness / light sensitive (due to medication) are the main issues;  minor stiffness throughout & low-back pain.  Today I helped out some kids for Halloween and was able to hold onto bags of candy for a long time along with a 2 hour walk.  Stayed out past midnight without issue.
Week 2 (11/1 – 11/7) – Sleep continues to be getting up 1-2 times per night along with mid-day naps for most days.  Noticeable issues throughout the week include pain / stiffness in shoulder blades, neck movement from side to side, and right eye cloudiness / light sensitive (due to medication).  I took a few walks in the evening and was able to travel to multiple stores without issue until the end of the week when I started to develop pain in my right hip.  Sleep was also becoming an issue (developed nightmares on 11/2) as I started working 12+ hour days for my company CGschool (setting up events in Boston & San Francisco).  Back was also stiffer as it progressed to the evening due to all the sitting & work I had to do.  Without the Humira, none of this would have been possible.
Week 3 (11/8 – 11/14) – Sleep continues to be getting up 1-2 times per night  along with mid-day naps for most days.  Beginning of the week, the right hip was worse (went from 2 out of 10 to 6-7 out of 10 on pain scale) and was due to the workload / sitting too long / walking too far at night / new exercises I would try on the Wii Fit (especially ones balancing on one leg).  Other noticeable issues throughout the week include neck stiffness from side to side, some shoulder blade pain (probably due to exercises and sitting too long in the chair) and right eye cloudiness / light sensitive (due to medication).  Stomach issues arose in the early week due to gas & trying fringe foods (dairy, crackers).  When I started Humira, I was at 116 lbs.  Now I am up to 124.5 lbs. (+8 lbs.).  11/8 was a long day & had to fix a major issue for CGschool (was up until 2am).  Weekend ate at Roy’s with no issue as they were very accommodating to my food sensitivities.  Mid-back continued to hurt along with hip & knew I had to go to the pool.  Did a hard workout on 11/10 in the pool (as I need to build strength) which helped my hip heal itself throughout the week.  As a side note, if I did not take Humira, my pain would be a 9 out of 10 at this point.  End of week was getting better as my responsibilities were getting less – still  needed to do 12 hour days for San Francisco class.
Week 4 (11/15 – 11/21) – Sleep continues to be getting up once per night  along with mid-day naps for most days.  Hips bad in beginning of week healed up mid-end of week (as long as I didn’t do anything to stand on one leg like Yoga exercises or getting my pants on one leg at a time).  Right eye continued to get better and 11/19 Opthamologist gave me the OK to stop the meds altogether on 11/24.  Range of neck motion getting better but still noticeable and some stiffness in the back through mid-week.  Travelling around town again was easy to do.  Workouts once at the pool (11/16), Wii Fit 1-minute planks worked and started push-ups / side planks on 11/19 (failed at 5th & 6th rep), started downward dog Yoga pose on 11/22, and walked most evenings.
Week 5 (11/22 – 11/28) – Sleep continues to be getting up once per night  along with mid-day naps for most days.  As I continue to get stronger, I still feel noticeable pains (probably due to workouts) in the shoulder blades, neck, and back (2-3 out of 10); right hip continues to be fine.  My right eye cleared up by 11/25 and my weight is now 128 lbs (+4 lbs. from 2 weeks ago).  Starting to get harder to go to sleep due to increased levels of energy (my body was so used to being with so little energy before).  Went ballroom dancing 11/24 and felt in right hip again, but cleared up same day / next day.  Was able to travel to Venice (it’s been over 6 months since I have been able to leave the Naples area without assistance) for Thanksgiving.  Had small amounts of stuffing & lots of mashed potatoes & gravy and I could tell my body wanted more veggies by end of weekend – still no flare-ups.
Week 6 (11/29 – 12/5) – Beginning of week, I needed to get up once per night during sleep but by end of week I slept straight through.  My issue is getting to sleep due to adjusting to new energy.  Shoulder blades / back / neck (side to side) are 2-3 out of 10 due to all the sitting, travelling and eating (eating is also making my facial complexion worse) Thanksgiving leftovers (not to mention the pumpkin pie).  11/30 had my first major workout at my parent’s gym in Venice (1/2 hour).  12/4 did another major workout (both times were upper body – biceps, triceps, chest, abs) and also able to walk around the block with no issue at all (finished in less than 25 minutes; used to take me 40 minutes).  I’m also starting to be able to do short bursts of jogging / running since I lost the ability to run.  12/3 – travelled to Fort Myers and back in the evening time and traveled a few places – no issues.  Some days during the later part of the week show no significant pain / stiffness issues.
Week 7 (12/6 – 12/12) – Tested my body’s endurance at the beginning of the week – 12/6 took 3 hours of ballroom dancing lessons, 12/7 2 hours of social ballroom dancing, 12/8 one of my hardest workouts + laps + 2 minutes treading water at the pool for 1/2 hour straight; did it all without issue.  Upper workout mid-week without issue but felt it on 12/12. All together I worked out every day and felt some pains, but those are the pains of getting stronger – big difference than a flare-up due to inflammation. Neck range got better throughout the week (was at 3 out of 10, now 1.5 out of 10).  As for food, I won’t go back to Pei Wei as they do something that does not agree with my system (had the Thai Chicken coconut curry) & am learning to avoid Chinese stir-fry style meals now.  I also learned that I should not do more than a 1/2 a cup of black beans as anymore doesn’t work well with my system.

 

Iritis – The Last Straw

I have spent almost two years researching and trying to find the root causes to my Ankylosing Spondylitis / Autoimmune condition without taking a biologic medicine like Enbrel.  Although I’ve taken many steps to improve my condition like my Crohn’s disease diagnosis or my usage of Low Dose Naltrexone (LDN), I was being forced back into taking a biologic:

  • Continued to lose weight and at my lowest was 116 pounds (originally 158 lbs.)
  • Continued nutrient malabsorption
  • Fatigue / Anemia (usually sleeping twice a day & needing 10+ hours of sleep / day)
  • Sitting in chair too long makes my body very stiff.
  • Stools loose.
  • Very hard to squat down or bend over (can’t really do this unless I assist with holding onto something) to pick something up.
  • Flare-ups from foods, sometime even safe foods.
  • Get cold quickly along with poor circulation & purple fingers (Raynaud’s Syndrome)
  • Weak body: Need a rope to get out of bed, can only go to the pool for 10 minutes, no gym workouts, etc.
  • But the last and final straw was developing Iritis on 10/9/13.

What is Iritis?

Iritis which is basically inflammation of the eye.  Symptoms include (and I felt) pressure, sensitivity to light, redness and soreness – not to mention I was almost blind in my right eye.  If you are reading this somehow and develop Iritis GO TO THE OPHTHALMOLOGIST RIGHT AWAY.

Here is what it looks like:

Iritis before & after

How Did it Affect Me?

On 10/9/13 I had my mother come down to help me out and went to an Opthamologist in the afternoon to get the generic for Pred Forte & Cyclopentol.   Delaying the eye drops will only make things worse.  My Iritis was so bad I had to go to the doctor’s office blind and have her guide me to sit and move from one room to another.  Even in low light it was very painful and the eye exam was not easy.  Before I left, I requested & received blackout glasses and they have been very effective.    Rest of the day was low-light in the house, sleeping and keeping my eyes closed as much as possible – no TV, no electronics of any kind.  For the next week I had to stay inside and close all the blinds to my house and keeping the lighting very low.  I could only work on the computer for short periods of time and had to take naps to recover and keep my eyes from the light.  After a week or so, I was able to travel, but the Pred Forte continued to keep my right eye in a foggy haze along with seeing halos & stars around artificial lighting.  On 10/31 I saw the doctor and need to take an additional medication called Phenylephrine to stop my Iris from sticking to my Pupil.  I take that 3X/day along with Cyclopentol (1X per day) for a week.  The Pred Forte I take 3X for 1 week, then 2X for 1 week, and then 1X/day for a week.  Total time taking care of the Iritis:  1 1/2 months + 4 doctor visits.  For more info, visit my daily diary on Iritis starting from 10/9/13.

If Iritis was the Last Straw, What Did I Do About It?

As I mentioned below, I was being forced back into taking a biologic because my symptoms were becoming my root problems.  Instead of taking Enbrel again, I talked with my Rheumatologist and he prescribed Humira.  It works the same as Enbrel only it’s FDA approved for Crohn’s disease and Ankylosing Spondylitis.  I’ve been on it for a few days now and I have seen vast improvements to all my symptoms.  I will be posting my results along with my daily diary while on Humira in the next few days.  If you prefer to see my daily diary on Humira right now, review my diary on my LDN page starting on 10/25.