Well, I've been on weekly dosing for two months now. Doing great. In fact, I went to the Burning Man Festival and did great there. Because I left on a Tuesdeay and came back on a Monday, I had to do some playing with my ENBREL dosing. I normally take my ENBREL on Saturday. But two weeks before, I switched to Sunday (went 8 days instead of 7), and then the week of Burning Man I went from Sunday to Monday (when I got home). Did fine. Then this week I shortened it to 6 days to get back to Saturday.

I've also learned a neat little trick. I find it inconvenient to mix two doses of ENBREL and then inject them. So at some point during the week, when I have a few minutes of "down time" I'll mix a dose (or both), attach the capped needle to the syringe, and pop it back in the fridge. Since ENBREL keeps for two weeks once it's been mixed, there's no problem with doing that. Then when I wake up on Saturday, I have two pre-mixed syringes in the fridge waiting for me. I wake up, take both syringes out and set them on the table to warm up, start my water for tea, go and shower/shave/brush my teeth, and then come back and give myself my shots before I get dressed.

So much more convenient that way!

Of course this last week, I messed the whole thing up. When I mixed my doses, I forgot to wipe off the rubber septa of the vials before I mixed them. I know that the resuspension solution is actually bacteriostatic, so I figured it was no biggie. Then, when I went to give myself the shot, I dropped the friggin' syringe into my hand right after I'd uncapped it. I just wiped off the needle with alcohol and injected.

Cavalier of me? Yeah. But it was yesterday and I figure that if I was going to get an infection, it would have showed up by now. But I really need to be more careful.

I've noticed a lot of people on ENBREL get really paranoid about infection (wandering around with alcohol gel and obsessively washing their hands and getting antibacterial EVERYTHING). It's important to remember that ENBREL is not an immunosuppressant, but an immunoMODULATOR. Other than TB, it does not increase your sensitivity to bacterial infections. It's viruses (particularly upper respiratory infections) that are the big issue. I was just romping around in the desert (which is admittedly a very sterile environment since it's so dessicating there), but I almost never washed my hands and I didn't get sick. I did an pediatric ER rotation and saw more sniffoos and sore throats than I can count. I just washed my hands before and after every patient and I haven't gotten sick once yet.

If you're just on ENBREL and not on any immunosuppressants (prednisone, MTX, etc.), you really can relax about it. A nose cold is not the worst thing in the world.

___________________________________________
-Mike
Certified Mad Doctor (in training)

___________________________________________ -Mike Certified Mad Doctor