A Tale of Jubilation...

Hello and welcome to our April celebratory blog post. Of course it's Trevor here, bringing you all the juicy and pawmazing facts. 

This past Tuesday, Brenda celebrated two significant events in her life. One being, working with CreakyJoints, (don't you just love that name?) BOL 9 years ago. It was the 1st time working with this great organization and it wouldn't be the last. At the time, we were not aware of that pawmazing fact, but things started transpiring the following year, all centered around Brenda taking a biologic. We are not going to get into that for this particular post. This is going to be all centered around her milestone that she also celebrated on April 20th. Here we go! BOL

Brenda had her first injection of the biologic, Enbrel (etanercept) on April 20, 2001. Now you see where we are going with this tale. As our readers know, Brenda has been living with rheumatoid arthritis (RA) for almost 30 years. After almost 10 years, Brenda was offered a gift to start using this pawmazing type of medication, which falls under the class of biologics. A biologic is manufactured through a rigorous process. Brenda's is considered a TNF (tumor necrosis factor) inhibitor. The TNF factor was discovered by a scientist, Dr. Gale "Morrie" Granger. He is no longer on this earth, but Brenda is forever grateful for his research and discovery, which made it possible for so many to experience what Brenda has. See why Brenda believes in science? 

Back to how things were in the beginning of this pawmazing journey. The FDA allowed you to inject 50 mg. but it had to be spread out in 2 injections within 72 to 96 hours, which consisted of each vial containing 25 mg. See why Brenda had to keep a diary? How would you have possibly remembered, is it now the 3rd or almost the 5th day to administer it? Also where it was injected. Your choices were the upper arms, abdomen, or the upper thighs. It was considered subcutaneous or underneath the skin, so you had to pinch with one hand and inject with the other. For the upper arms, she needed assistance. By the 4th injection, she was doing it herself, so she took her kit home. 

I forgot to mention the process of getting these injections ready. Of course you had to set it out for at least a half hour to allow it to reach room temperature. Now comes the challenging part. There was a tray where you would place the vial, on one side, which had a pink cap to pull off. You would then place the syringe on the other side and slowly insert the medicine from the vial into the syringe. You see why someone with arthritic fingers, would have a hard time drawing it up, like nurses and doctors do? Brenda always used the tray. As mentioned before, when it came to the upper arms, especially the right arm, that is when her mother would do the injection. This would be after work and this whole process took about an hour. The kit with the tray was used until December of 2003. 

Brenda's mother helped with getting her set up for this change. The FDA now allowed 50 mg. to be injected the same day, but not in the same spot. That meant 2 injections of 25 mg. to be administered. I see where she really needed a diary for all of this. It's fascinating to hear about all these facts and what patients have to go through to live a normal life. Whatever normal is? I digress! BOL Felt like John Corey in one of Nelson DeMille's novels for a moment there. BOL 

Brenda was now using what was called a vial adapter with plunger, so it would be much easier to administer, but there were about 14 steps and you had to do them in the correct order. This is where Brenda's mother wrote out on a piece of paper, step by step. Brenda got proficient at administering them and was not even referring to the instructions after a time. It was great to only have to do this process once a week, but again, it was long and had to be done after work. 

In 2005 there was another change, Brenda could now inject one FDA approved 50 mg. to be administered once a week. This was going to be so great, right? Not so much, Brenda struggled with her 1st injections and had to contact a nurse at Enbrel support. Even though it was one injection, the process was setting it out for at least 20 minutes now and then administering. 

In 2007 there was another change and this was has been to present. Brenda could start using the sureclick autoinjector. You still had to set it out at least 20 minutes before administering, but now all you had to do was find your spot aim straight down, no having to do it at an angle, like the syringe. Push until you hear a click and wait until you hear another click about 15 seconds then release at the same angle and you're done. 

The FDA now allows Enbrel to be set out at room temperature for 14 days, so now Brenda sets it out the night before her injection, so it is not cold and does not sting as much. It may, but it's only for a few seconds and it's worth it in the long run. 

WOW, that was quite a journey, am I right? BOL Now when you jab yourself that much and for so many years, you're entitled to some kind of reward. Brenda commemorates special occasions with jewelry. This one was no different. She treated herself when she reached her 1,000 injection, so why should this be any different. She did her research and found that the gemstone for a 20th anniversary was Emerald, so that would be it. She found a beautiful pendant. She received her recent box of Enbrel on Tuesday, which marked her 20th year of injections and on Thursday she administered #1,171. She still keeps a diary and we must mention that if you're experiencing any type of infection or the flu, your biologic should not be administered during that time. We are not giving out medical advice here. Always check with your rheumatologist, if you're unsure. 

Brenda has been asked if she was able to take her biologic around the time of her 2 COVID-19 vaccines and yes, she was able to stay on her regular schedule. Both vaccines were on Monday and her regular day now for Enbrel is Thursday, so it worked out great. 

We hope you have enjoyed going down Enbrel memory lane. BOL 

I will leave you with her beautiful Emerald for you to admire. Someone said it sounds like Enbrel. Thought that was cool. Here it is. 

                                                          Shown larger than actual size

This has been another T Man Production. Barking off now. ~T Man~