Eugene Fischer

Month: April 2009

Finally!

I’ve been waiting for a fourth of a year to be able to take this picture:

My Humira Package

At long last, I have some medication that has a chance of being effective.  As I alluded to in my silliness yesterday, Humira is an injectable antibody for a cytokine called tumor necrosis factor alpha.  TNF-alpha is used by the immune system to mediate inflammation.  As I have inflammatory bowel disease, I am producing far too much of it.  Humira will, hopefully, inhibit this.

As it happens though, I will have to wait a little longer to find out.  After nearly four months of being on broad immunosuppression while I waited and fought for my more targeted medication, I have finally gotten sick.  I have an absurd cold or something that has me feverish and voiceless.  Meanwhile, Humira is a medicine that some people have adverse reactions to, so when I start on it any side effects need to be closely monitored. Unfortunately, one of the common side effects of starting on Humira is…wait for it…cold-like symptoms.  So until I’m over whatever I have, it will be impossible to isolate my health variables sufficiently to safely start my new course of treatment.

But hell, I’ve only been waiting to start this treatment for all of 2009.  What’s another week at the outside?  At least I have my drugs now.

Know Your Foe: TNF-alpha

The following is a classified communique, smuggled across the blood/brain barrier from counter-insurgency leaders in the cortex.

—————

*URGENT MESSAGE FOR PARTISANS OF THE DEFENDERS OF THE DIGESTIVE TISSUES*

It’s been a long battle.  No one knows better than we do how entrenched and seemingly unstoppable are the rogue forces within the immune system that persist in waging their psychotic war against the innocent cells of the alimentary canal.  And no one knows better than we do the sacrifices our allies have made in the ongoing effort to protect and preserve the digestive tract for future generations.  Up until now, our only weapon against the autoimmune offensive has been the cortisol flood.  Our adrenal compatriots have been valiant in this matter, but we all knew it was never more than a stopgap measure.  Overproduction of corticosteroids takes too much of a toll on us all to be a long term solution.

But soon we will have a new weapon.  Our enemy’s weak point has been identified, and we are poised to attack.

tnfa_crystal_structureThis is our target: tumor necrosis factor alpha.  This cytokine has been identified as the molecule the enemy is using to regulate its illegal inflammatory actions.  Without TNF-alpha, the insurgents will be unable to continue clear-cutting our villi and ulcerating our viscera.  Their hidden macrophages will be rendered impotent, their detestable engines of apoptosis will grind to a halt.  We have the intelligence we need to end this war.  And, soon, we will have the means to act on it.  But we can’t do it alone; to strike this blow, we will need to accept help from an unusual source.

Your tireless counter-insurgency leaders have for some time now been in communication with extra-corpus agents.  We are aware that the idea of opening our borders to mercenary elements may be unsettling to some, but the reality of our situation is that such an alliance is our only path to victory.  The negotiations have been long and difficult, but, thanks to these efforts, we will be able to mount a new counter-offensive within one diurnal cycle.

humira-moleculeThe operation, code named “Project Humira,” will involve the introduction of an extra-corpus produced molecule called adalimumab.  It is an antibody designed to target TNF-alpha directly.  We currently lack the means to manufacture this antibody ourselves, but we have negotiated what we believe will be a steady supply, to be introduced into the circulatory system from without.  It is our belief that, with this antibody at our disposal, we can downregulate the insurgents’ inflammatory activity and finally end their destructive madness.  The unique and irreplaceable tissues of the digestive tract will be preserved for the appreciation and benefit our daughter cells and their daughter cells after them, down through the generations.  We will know homeostasis in our time.  Victory will soon be ours.

—————

Not for distribution within active inflammation zones.  Denature after transcription.

Sick and Tired and…Happy?

Yesterday I had a tickle in my throat that metamorphosed in the night into something more akin to a forest fire.  And I’m on day 2 of a weird, intermittent nose bleed.  And as I mentioned a little while back, I’ve lately been suffering from an increase in the severity of my Crohn’s symptoms.  But for all that, I’m feeling pretty happy today, for the following reasons, listed in ascending order of importance:

  1. Magic robe.
  2. I had an appointment with my gastroenterologist on Monday, and he decided that the backwards progression of my symptoms called for several aggressive steps to be taken on my behalf, including giving me stronger pain meds.  So now I have a magic robe and a big bottle of hydrocodone.  Even at this level of pain, hydrocodone seems to be strong enough to keep Zelazny’s Toothache at bay.
  3. If you have clicked over to the “Writing” tab since last night, you will have noticed that there is now a firm publication date for the story of mine that Strange Horizons is publishing.  I’m going through the galley now.
  4. I’ve spent the last three months on prednisone (which I was only supposed to be on for a matter of weeks) due to a protracted and ridiculous battle with my insurance company.  As of this morning, that battle is over.  I am finally going to be allowed to start on one of the class of medications my doctor first prescribed for me back in January.  If things go as planned, I will finally have a gleaming syringe full of specially tailored monoclonal antibodies delivered to me on Friday.

I’ve been putting off writing up a long, detailed account of The Harrowing Tale of E. J. and the Crohn’s until the insurance issues were resolved one way or another.  If I actually get my meds on Friday, that will give the narrative enough closure for me to be willing to commit it to text.  I expect it will be somewhat cathartic to write, though I can make no promises that it will be particularly pleasant to read.  And I might wait a little while to post it, as I’m not convinced that thousands of words about misery and blood and pain are what I want on the front page of this site when my first published story goes live.  But if my discussion of my health issues up to this point has, to borrow a phrase from Neal Stephenson, sounded like the terse mutterings of a pilot at the controls of a damaged plane, know that that has been more or less by design.  For the last 2/3 of a year, my life has been awfully one-note; limiting the degree to which I let it dominate my conversation has been an intentional coping strategy to force me to pay attention to more positive things.

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