Back on January 15th, I took my first dose of Enbrel (injection) for my rheumatoid arthritis. Right away, I had a few minor side effects, and slowly, I had some improvements as well. I’ve now had eight weeks of injections, and according to the medication package details and my rheumatology office, most people see their best improvements in the 8-12 week window. I wanted to document where I’m at now, hitting the eight-week mark.

Initial side effects included:

• slight loss of appetite due to very mild nausea in the afternoons of the first few days after the original injection. Update: This happened again the second week, but went away after that.
• periods of increased swelling/throbbing of joints (especially feet, hands, fingers, and toes) – this was noteworthy because most of my symptoms pre-Enbrel were in my spine, not my extremities. Update: This also seemed to lessen after a two weeks, but then came back after week 7’s injection and got worse after week 8’s.
• less restful sleep combined with hyper-obsessive dreams for a few days after injection. Update: Like the loss of appetite, this happened after the first two injections but then went away.
• sudden and unpredictable stabbing pain in certain joints (ankles, knees, wrists) if too much pressure was applied, followed by the joint collapsing. Update: While this decreased after two weeks – mostly because I stopped doing yoga or any activity that required too much pressure on my joints – this does still happen at unpredictable times when there is pressure on a particular joint. And after Week 8’s injection, began happening at random times even when there was no pressure on the joint.

In addition to the side effects, I did begin to see some immediate improvements in back pain. I could go for a walk around the block without my lower back or hips seizing up, and eventually without pain at all. I still struggled with steeper grades or any kind of climbing, but it wasn’t too bad if I stopped and stretched my back out a few times while I  walked/hiked. The pain along my sciatic nerve dropped to be about 90% gone, and I hardly felt it sitting, standing, or lying down. Definite improvement, and it only took about two weeks to get there.

The downside:

Around six weeks, I noticed that the effects of the Enbrel began to decrease. I was more likely to get those sudden sharp stabbing pains. (I did mention them to my rheumatologist’s PA, who claimed that was a normal part of RA and it meant nothing at all that I never had them pre-Enbrel and they started literally the day after my first injection…sure. Did I already mention how awful the PA was?) The sciatic pain increase to only about 80% gone, and the neck/shoulder pain, which was like 99% gone, dropped to 90%. The throbbing pain and swelling in my hands and feet have gotten much, much worse, and sometimes it now takes over my entire body. I took a nap on Monday, and woke up with every single muscle in my body cramped and aching like I’d run a marathon, for no reason at all.

So to sum up: two of the initial side effects disappeared, two decreased for awhile but are reappearing, and my pain/inflammation/joint-issues/mobility all improved for a month only to start deteriorating again. I actually had a moment earlier this week when I told Jason that I wasn’t sure the Enbrel was doing much at all for me anymore. I’m still convinced that there’s something more going on beyond RA – a food intolerance or allergy or something. But we’ll see. I see the RA PA (ugh) again in mid-April to see where things stand then.