Gr8 Expectations

Day 80

When I was in my early 20's, a co-worker, a very centered, spiritual artist gave me the best piece of advice I think I have ever been given.  I was constantly being hurt by the actions of a close friend - I was feeling slighted and screwed over.  Emotionally, it was really eating at me.  This co-worker aptly pointed out to me that the problem was clearly mine and not my friend's.  She told me that I was setting expectations for my friend, based upon how I would react and that I needed to stop having expectations of this friend.  Better advice was never given.  I stopped expecting of this person.  I had known her a very long time and I knew who she was and what she was not.  When I stopped expecting her to react the way I would, I stopped getting hurt by her.  And every so often - especially when the chips were really down - she would come through in a way that was simply sublime.  It was those moments that superseded any trivial disappointments of the past.  And our friendship has survived over 40 years.

Late the other night I was watching TV and an Enbrel commercial came on.  It was about a woman with Psoriasis and she was walking out the front door of her house in a long-sleeved sweater and was pulling the sweater close around her neck.  I suppose the action was meant to show her trying to hide her psoriasis.  It then showed her walking out of the house (I think maybe with less clothes), but she still was pulling the sweater tight to her neck.  This really caught my eye and my thought was that psoriatics are generally not trying to hide their shoulder into neck area and it really annoyed me that they were off base.  By the end of the commercial, the woman was in a short-sleeved sweater and no longer tugging it closed to hide herself.  I get the point, but I think the depiction was off and it's small things, like "details" that are off, that really bother me (such as when watching the movie "Up in the Air" with George Clooney, in the opening sequence they show him at the airport retrieving his TravelPro luggage.  Well, if he really was a Platinum level flier, he would not be toting TravelPro luggage, which does not hold up well to very frequent travel.  Members of the Elite Flier Caste would be traveling with Tumi or Hartmann or at they very least Swiss Army.  This "detail" annoyed me and detracted from the authenticity of the character for me for the rest of the film).  But I digress ...

At the end of the Enbrel commercial, they began citing timeframes and statistics on when and what percentage clearing patients with Psoriasis experienced.  I was still obsessing over the woman trying to hide in her sweater (and it was very late at night), so I didn't really catch all the stats, but the one thing that did stick out was a 4 month marker for it to seemingly "fully kick in".  As I sit here, just shy of 3 months, I realize that I put a timeframe on expectations that I created.  I acknowledge that reading the post by the woman who claimed to see results after one day on Apremilast really messed with my head.  Yes, intellectually and having studied human physiology, I know that is ridiculous.  I know that even if she did not have a placebo, that after one day, her miraculous results were, in fact, the placebo effect.  But I certainly had expectations. I was comparing my skin results to what I had experienced after 6 weeks of a Remicade/Methotrexate combo therapy.  And that is not apples-to-apples as I have chosen not to do Methotrexate combo therapy with Apremilast.

Many years ago, when I first started Methotrexate, it had wonderful results for my joints, but did not significantly impact my skin.  I actually had one dermatologist tell me that I should not have the Psoriasis I had taking Methotrexate and that it was my fault that I didn't moisturize enough (oh puhleeze!!).  I also know that when on Remicade, when I stopped taking Methotrexate along with it, that more Psoriasis would present.  I knew this, so I adjusted my expectations accordingly.  I also knew that the best way to control both my joints and skin, was to take both drugs in concert.

I've unfortunately had expectations here with Apremilast, when in reality, I had no clue what to expect; and therefore, should have no expectations at all. 


Day 80 - Left forearm and right forearm

Here's where we are as of Day 80:

Skin
- Thickness of flake build-up significantly decreased.
- Several new patches
- No patches have disappeared
- Am able to see skin (and freckles) though more patches
- Patches on extremities show more improvement than patches on trunk

Joints
- Let elbow and wrist bugging me a little
- Blow out right knee, but it's getting better
- Overall, joints are pretty darn good

Other
- Stomach still wonky, but sometimes I get a good day or two
- Both my hairdresser and I have noticed my hair thinning - not sure if that is an Apremilast side effect, but it's been significant in the past month or so.

So, I will try to have no expectations, see what results time brings and enjoy the experience of those positive and Gr8 results.