A few weeks ago, I had my regular three month check-up with my rheumatologist. As per usual, I came armed with a bunch of questions. This time, most of them were of the hypothetical nature since my RA is (so far) staying within some reasonable boundaries.
I'm fortunate in that my rheumatologist is happy to take his time to really talk through all of these questions. He gets that RA impacts my life- not just my life right now, but my future life, and he's invested in making sure my treatment plan supports my future goals. Even so, I was pretty sure I knew what the answer to one of my questions would be: a big fat NO.
As I've written about before, I love to travel. I have ever since I was a little kid, and as I've grown older and matured, so have my adventures abroad. In high school and college, I was pleased as pie to visit Europe, but by the time I graduated, visiting wasn't enough; I wanted to live there. And so I did- in London and in Prague, and it was one of the best times of my life.
After being diagnosed, my determination to keep traveling only increased as a way to rally against what my body was doing to me and exert some control over what I feared was inherently uncontrollable. My trips became two and three week adventures that involved feats I hadn't even attempted before I had RA (think punishing, high-altitude hikes on island mountains and desert peaks). I've always said that if I won the lottery, I would spend at least one year traveling around the world, seeing as much of it as I could. It may not be everyone's dream, but it's definitely mine.
Happily, I've found someone else who feels exactly the same way. My boyfriend's travel chops are more impressive than mine, and we both fantasize about traveling to the ends of the Earth, quite literally. Recently, we began talking about how amazing it would be to take three or four months and travel around Asia and Australia. It sounds blissful, but before I could escape into the fantasy too far, reality came along to check my wanderlust. I realized it probably isn't possible for me to do something like that. After all, I take two shots a week of a medicine that has to be kept cold- something that would make traveling for that amount of time pretty darn impossible. Maybe this doesn't seem like a big loss to others, but to me, it felt like a depressing barrier imposing itself in my life. My boyfriend could take off on this type of adventure that I would love to do, but I can't. He can do it, but we can't. It felt like being left behind.
Stubborn RA gal that I am, I decided it was worth talking over with my doctor before I resigned myself to never being able to take this type of trip (though I'd also have to overcome more mundane obstacles like money and time off from work for it to ever be realized).
Sitting down with my rheumatologist, I prefaced my question with 'I think I know the answer to this, but humor me.' And then I asked if it would ever be possible, given my RA and the medications I'm on, for me to travel the world for three or four months.
Without blinking or missing a beat, he replied, 'Of course.' Uh, really? How?
So we talked about what the obstacles would be medically, and what some possible options could be. His main suggestion was to think about switching to a drug that can be taken less frequently for the duration of this hypothetical trip, and to arrange a few points during the trip for a 'drop off.' In other words, arrange with someone back here to pack the shot appropriately and fedex it to a particular city for a particular day. Obviously, that would cost money, and it would take a willing cohort on this side of the Atlantic and some serious planning, but somehow, it did make it feel more possible. More than that, the fact that his answer had been yes made that barrier feel much more penetrable.
I'm not planning this trip yet, so there is no need to switch to another medicine, especially since Enbrel is still working like a charm for me (knock on wood). But, we did decide that I'll move to taking both of my shots at the same time to see if I still experience a drop off at the end of the week. When I first began taking Enbrel, I took one 50mg shot a week, but I got majorly scary injection site reactions and felt like it wore off by the end of the week. That was two and half years ago, so I'm hoping that I won't notice the same effect this time around. And then maybe, if all goes well and the other obstacles can be overcome, maybe I can actually travel around the world. Even with RA.