Novel Drug Tanezumab

Courtesy of my OA Google Alert.

"Sometimes pain is good in protecting you."

So this is kind of cool.  Pfizer is developing a drug that inhibits something called Nerve Growth Factor.  NGF is something that helps your nervous system develop but is also released where there is inflammation, like in an arthritic knee.  The NGF binds to the cells which cause pain.  Inhibit NGF = less pain.  (As I understand it)  Neat idea.  It's novel therapy, meaning no other drug works this way so obviously I'm interested.

Not so neat is the FDA halting Phase III because too many people had to under go TKRs.  I'm thinking that if you are that desperate for pain relief, you are headed down the path to the TKR anyways, it's just how fast you get there.   The linked line above is why I don't really push it... I want to preserve what I have for as long as I can.  At 33, every day counts.  I'll need to read more to see what the FDA's issue is.  Perhaps there is more to the degeneration than what the drug company/researchers are saying.   They believe that the degeneration is due to more activity because the knee doesn't hurt.  I totally get that.  But maybe there is some other sort of damage going on?  Like I said need to read more as I am totally interested in this possible treatment.  But having worked in Pharma I know it's still years down the road if at all.

Less than three weeks till my next shot.  My current 11:11 wish involves it lasting the 6 months...  I do worry though that when my knee doesn't hurt that I am doing damage.  You use it without thinking about it, like it's "normal" even.  But it's not.  Only when the pain wears off and you cringe with each step to you think, hey, my body is telling me something.

Original Article in the New England Journal of Medicine.

Midterms

Already?

Biochem on Wednesday.  This stuff is seriously interesting.  But dense and time consuming.  School is like a job.  The seminar class I take for NUTR really tried to impart that on the room this evening.  Varied success I think.

Lots of my mind.  Can't wait for the 20th!

New pain in my repertoire

One thing I can't change is my osteoarthritis.  I can change how I deal with world when I hurt though... And I do hurt currently.  On a scale of one to ten I'd say it's a seven with no pills.  A manageable five with ibuprofen and blissfully calm three right after I ice.

This time when the Synvisc wore off it came with a bunch of fluid that is sitting around my knee cap.  As the fluid built up my knee cap started hurting more and more.  I've never had any OA pain behind the patella before but I suspect that's what this horrible achy burny grinding is.  It's not like the OA pain in other compartments probably because it's a non weight bearing part of the joint.   Regardless it's new and different and I need to add it to the list of all the other places and ways in which my knee pains me.  What's one more right?

Except...  I'm not sure I can take much more.  I'm a bit of a grumpy gus right now.  Blog is place to vent as I don't self medicate with food or drugs.  If only I could talk about it and somehow that would lesson the ouch.

Interesting to compare and contrast this OA pain in the patellofemoral compartment as opposed to the medial and lateral compartments.  I wonder if this cartilage is degrading in the same way as the rest of it. Interesting to me how it just hurts differently.

I think about pain too much. 

Just saying

Instead of expecting/wishing/hoping others will change.  Focus on changing yourself.  That way YOU get to decide which way things go instead of whatever direction someone else kicks your heart or your will power or what have you.  It's not as easy of course but at least you get to call the shots.

For example...  my husband is out of town this week and over the weekend he went out and bought a bunch of sugary snacks.  I could sit around and lament the fact that he brings this stuff into the house, I can ask him to please not to but in the end I can't expect him to change.  We've been together for over 8 years now and I have had to make peace with this.  The only thing I can change is how I react to his behaviors.  That way I am in control.  It might be hard but I have no one else to blame but myself and I am not living with constant disappointment.  Disappointment sits on your heart and makes you miserable.  Misery loves company but I have no interest in bring other people down.  So I take charge to avoid making myself miserable.  Make sense?   You can apply this to all sorts of aspects of life.  

Capable to Cripple

I think all this feeling of inadequacy is simply because I hurt again.  Pain manifests itself in so many ways in my head.

It's hard to feel positive about life, yourself and interactions with others when all you want to do is cry.  Or cut your own leg off at the knee with a butter knife.  That might actually hurt less.

My cane is back in the car.

You know that feeling?

That one that where you feel like you are watching people interact around you?  But not with you?  That feeling of being excluded because of your weight?  How much of that is self fulfilling?  Is it actually real or just in your head?

If you were a fat kid maybe it was obvious on the playground, never being part of the gossipy girls clique, but not able to play with boys.  In high school maybe it meant that all the best seats were taken in the dinning hall or you were never invited to hang out in other peoples rooms.

So much of who we are as adults comes from our past.  Growing up hassled & fat is something I am still trying to over come.  I guess I like to think that if I put on a happy face (which I've always done) and a nice dress everything will be okay, but in reality, I think those wounds might be deeper than I realize.  I still feel like I need validation, which is totally stupid & silly, but is in fact the truth.

People make judgements on limited information

I had dinner with my former boss the other evening.  I have no doubt that our friendship and mentor/mentee relationship (and it's so not Sienfeld) will continue to grow.  It was like no time had passed at all.  The title of this post... is what she had to say about why she gets dressed up every day.

I couldn't agree more.  It's human nature to judge...  I prefer to give less ammunition than others.

I wore this last Friday...  Jeans are Banana Republic with JCrew braided belt.  On top is black silk cami from Ann Taylor, brown velvet track jacket from JCrew and the leather vest is something I thrifted, size medium from Neiman Marcus.  It's one of my favorite pieces for this fall.  I never leave the house without jewelry and here I am wearing one of twin sis' antique crystal necklaces.  Same day, but later, hair has been cut and I'm out for beers.  I was struck by how freaking tiny my thighs look to me in this picture.  Subtle yet noticeable difference I think.

This is something I wore last week maybe?  Felt a bit bold wearing stripes and spots, but it worked!  Dress is wrap from JCrew and sweater is from Banana Republic.  Earrings are screwbacks, pressed base metal with milk glass beads.  This was an outfit I wore to class.

I take A LOT of pictures of myself.  I am addicted to my iphone but after having avoided myself for so long... I dunno I guess I expect the novelty to wear off but it doesn't.  I look at pictures of myself sometimes and still feel unreconizable.  I was trying to get a picture of my knee here.  I swear it changes shape on a daily basis. I wish I had a better picture of this outfit.  The jacket is vinatge and wool.  It's has a very simple military look and fits great.  Underneath is a silk shirt from a label I can't recall...  scoop neck with a big bow at the collar.  Skirt is Calvin Klein and yes, it's leather.  I wore this to class.

This past Thursday I finally wore jeans for the first time to UNH.  Six classes in and the girl who sits next to me in Nutrition Education & Counseling (who also works at JCrew Outlet) said she was glad to see I was capable of dressing it down.  ;)

Storage Bins

I will be sticking to my 5 years surgery free policy but I just have to say that when I gain any weight right now it so very OBVIOUSLY shows up in my arms.  Natural systems tend toward lower energy states.  It's much easier for my body to puff up an already existing fat cell than to create a new one.  I noticed this last year after the tummy but it's more pronounced that I don't have those fat deposits in my thighs.

Now my arms are fat.  I'm still sitting at 162ish but those extra pounds are sitting only in my arms.  I cried the other morning when I couldn't comfortably wear one of my most favorite long sleeve button down shirts.  My husband bought it for me when I was newly thin, button downs weren't something I ever really wore.  This color and fit was perfect ( I <3 Calvin Klein btw) and I've even replaced the buttons when I lost two.  Nothing I can do about the arms however.

Well, lose a few and lift.  I've been to the gym this week.

The body is so weird.

Naked Expectations

What do you see when you look at this picture?

Screaming Fat Girl

Ack.  You're gone.  :(

********Edited to add********

Thanks for putting it back up, like I said, I think they are important.

***************************

I've started school again and two weeks in and I am a bit overwhelmed thinking of myself in their terms.  These need to become my terms.  I know I'll get there, but the education is going to be a bit bumpy while I reconsider the past 10 years or so.  I did it my way, but to help other people help themselves I have to do it their way. With their jargon, not just the ADA's, but all the phycology that goes along with it.   My exposure seems woefully limited to this one class.

Your blog was incredibly insightful... you think about yourself in their terms.  I need to get there.  I've been thinking about it all week.  It's a nice change of pace from thinking about my knee actually. /blogress

I was hoping to go back and read some more of your archives.  Totally selfish and I admit it-- but I wish you didn't have to go private to go dark.  I'd hate to think that you would be one of those blogs that just disappears.  Perhaps ironically because of your success instead of failure?  I have no idea why you've gone, but I wish you well.

Stages of Change

I wish I knew why.  Up until this week I was unaware that Stages of Change is actually a behavioral model or framework with which you can measure someone's readiness to change to healthier eating habits.  Apparently I have reached the final stage, Termination, in which a client (or in this case me)  has maintained their changes for more than five years.

When I read that all I could think about was the blog I used to read and how the community is aware of a different kind of termination.  I hope that he found peace.

Fat & Lazy

I wonder if I'll be able to escape the fat & lazy mindset completely.  Takes over when I am in pain.  The only thing that keeps me from self medicating with food is more pain.  So I guess now it's pain that makes me lazy.

One foot in front of the other.

I'm making a commitment to do some volunteer stuff.  Been called out on my fat & lazy ways and it's true...  I need to be doing more.  August ground to a halt when the shot wore off.  Can't live my life like that.  Can't let pain dictate who I am.

Thinking mornings a couple times a week at the Greater Boston Food Bank.  It's nearby, easy to get too and at a ground level I want to know what people are getting to eat.  Classes have my mind all over the place.  What do I want to be when I grow up?  I know I come from privilege (contributes to my fat and lazy ways) and some education on what's it like for so many should come from doing some good I think.

Okay, back to the school work.