HEALTH & WELLBEiNG: Humira/Adalimumab

Many moons ago, some time in my mid teens, I think when I was fifteen, I developed a strange spot on my inner right thigh. It looked like some devilish bug had bitten a small chunk out of the flesh. That was the beginning, I was soon to learn, of my psoriasis.

As the years passed the condition worsened, spreading all over my body, and even affecting my internal workings; I developed psoriatic-arthropothy in my mid-twenties. As I understand it, psoriasis is an immune-system malfunction, in which the body kind of attacks itself, and ends up overproducing skin cells, which form the lesions/plaques.

The way it affects one, or at least the way it affected me, winds up being as potently toxic psychologically as it is physically. As time passed and the conditions deteriorated, it took an ever increasing mental and emotional toll. By the time I’d reached my late thirties, early forties, I was severely depressed over it.

I’d tried numerous treatments, mostly under the auspices of the NHS, but some self-administered. The NHS treatments were predominantly topical steroid ointments. Years of daubing oily unguents on various parts of my anatomy had very minimal effects physically, but were profoundly depressing, as they were messy, time-consuming, and not very effective.

My own interventions were either dietary, or attempts to address the possible psychological angle; the latter chiefly via meditation, to de-stress. It has long and often been alleged that stress plays a role in these diseases. In my own personal experience this doesn’t really ring true.

The dietary angle was based on desperation in the face of the ineffectiveness of the NHS treatments. I’d read up about psoriasis, and/or the related form of arthritis, once that had begun to compound matters, and frequently read about people who believed there is a dietary cause for the diseases. I tried a number of exclusion diets: cutting out dairy, avoiding the nightshade family (potatoes, peppers, chillies, etc.), and various others.

Some of the exclusion diets, for example gluten-free, I only tried for a few months, others, like the dairy-free and non-nightshades, I tired over many months, or even years. None of the dietary stuff made any discernible difference whatsoever.

With me it wasn’t  case of a fluctuating condition, getting better sometimes and worse at others – hence my scepticism about the stress-related factor – both conditions, once established, simply gradually encroached further and deeper, spreading over more skin and into more joints as time went by.

It had got to the point where I was regularly thinking about how I might end it all. What was the point in continuing to live if I was always ashamed of my appearance and in an ever increasing amount of pain? I couldn’t enjoy myself either in company or alone.

I’ve known some folks with psoriasis, even pretty bad cases, who appear relatively unfazed by it. Are they just putting up a better front? Or are they genuinely less bothered by it? I suppose both things are equally real possibilities.

Anyway, I was, by this time, on antidepressants, to help me cope with the psychological aspects of the conditions. And I was making my state of mind as abundantly clear to the health professionals I was seeing as I could. These people were mostly dealing with the physical aspects, but I was also occasionally taking various forms of state-sponsored counselling as well. And I let them all know just how seriously it was affecting me.

And so it was, that finally and mercifully, Dr Norris, of Addenbrookes Hospital’s  dermatology department, finally suggested, almost every other avenue, including light/photo-therapy, having been tried unsuccessfully, that I be tried on a ‘biologic’ treatment. This turned out to be Humira,  or Adalimumab. And this medicine, injected fortnightly, has totally transformed my life.

For the first time since my teens, my body is pretty much entirely free of the plaques/lesions caused by psoriasis. And the aches and pains, and lack of joint mobility, caused by the later development of the arthritic component are also almost completely gone.

I’d say the lesions are 99-100% cleared up, whilst the joint pain is 97-100% clear. In other words I do occasionally have some joint pain – I have some now, particularly in my right hand, on account of all the painting I’ve been doing in the last few days – but it is nothing compared to what it had become at its worst, some few years back.

Skin wise, its is a constant source of joy to me to be able to not worry about shedding a constant snow-fall of dead skin flakes, or fear the disapprobation of folks that I always assumed would judge me to be a scabrous leper.

I believe that humanity has a deeply in-built sense that illness is a form of outward manifestation of inner evil. This may sound ridiculous, perhaps. But it isn’t at all. In art and movies, and so on, heroes are beautiful, villains are ugly.

It may be primitively minded and related to our legacy of superstition and religion, but it’s still completely normal, even for folks like me, who believe themselves to be rational ‘naturalist/free-thinker’ types, to think of disease less as a form of mechanical physical malfunction and more as a form of divine punishment for moral wrongdoing. Rather like those American fundamentalists who believe that catastrophic weather is God’s tool for punishing the ungodly!

This may be rank nonsense, but it’s deeply ingrained in the human psyche. So, to be free of the anxieties that come from that whole nexus of primitive ignorance is unspeakably wonderful.

And further, I think I’m someone who naturally gravitates towards not just naturalism in philosophy and science, but naturism. I don’t find the naked body offensive. Rather I find the way in which human culture has made the naked body taboo far more deeply offensive. I’m a naturist at heart. And now, thanks to this effective medicine, I can be one in practice as well.

This is, funnlily enough, also related to one of the most notable side-effects of the medication itself, at least as far it affects me. I used to be someone who ‘felt the cold’. I’m now someone who feels the heat. The change in my body-temperature metabolism is, along with a few other things (bouts of dry-retching, and some very intense headaches), amongst the most notable of the side effects of my current regimen of medicine.

It frequently happens that I’m ‘boiling’, and I will be literally sweating, when others aren’t warm at all. Indeed they may be, as Teresa often is, feeling cold. This can lead to some, I guess, reasonably comical scenarios. Such as me repainting the kitchen last night, in the nude, whilst Teresa watches TV, under a fleece-blanket in the lounge, with the electric heater on full! And bear in mind that we’ve both just had a hot bath, and the kitchen is very draughty, on account of the door to the back garden being very poorly fitted/insulated.

Now I’m no Adonis. And whilst I’m not fat, I have a somewhat bloated paunch. But, frankly, I don’t care. Sure, I’d like to be in better shape. And I have at times past made differing degrees of effort, exercise wise, to try and improve things in this area. But, truth be told, now that I’m free of psoriasis and arthritis, I’m happy enough with my body as is. Indeed, I enjoy it. And that’s how it should be, in my opinion

The culture of body-shame that we perpetuate through our media is an awful thing. It still effects me to some degree. But to a massively lesser extent than it did when I was worst afflicted with psoriasis and the related arthritis.

Writing this reminds me of a thought I’ve had many times over the years since I began my current successful treatment. And that’s that I ought to thank Dr Norris, and perhaps even the developers and manufacturers of the drugs themselves – although here we run into the thorny issues of big-pharma profiteering from the ongoing sufferings of countless millions – for the incalculable improvement this treatment has brought me.

So I’ll say it here; thanks Doc Norris, and thanks also to the developers of Humira/Adalimumab. I feel like I’ve got my life back.

I’m happier now than I’ve ever been since, oh, my early/mid-teens. Indeed, I’m as happy at times at present as I ever remember having been, even as a child. And that’s really saying something, given that now I have the innumerable cares of adulthood to deal with, which I didn’t have back then.