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Medical Still Life (1876) by De Scott Evans

I left the MS center on that day in April with a big packet of information about what was going to be my drug of choice.  In the days that followed, I was contacted by a representative from a company called Shared Solutions. They are apparently employed by Teva, the manufacturer of my weapon.  I was about to become armed and dangerous, ready to go to battle against my enemy, my foe; multiple sclerosis.  I weighed my choices carefully, Copaxone, Avonex, Betaseron, Rebif, Gilenya, Tysabri, Novantrone, the names all sounded rather innocuous, like teams on the reality show Survivor.  I chose Copaxone, which has been available since 1997, and seemed to have the least side effects.  Only Betaseron and Avonex have been available for slightly longer.  It’s a once daily subcutaneous injection.  I wasn’t sure how giving myself injections would be but I wasn’t nervous about it.  Shared Solutions was going to arrange home delivery through my insurance, as well as send a nurse to my home to teach me how to inject myself with an autoinjection device, the autoject.  This was sounding better and better.  I would get to use an automatic weapon.  Some of the medications had a less difficult mode of delivery.  Gilenya is an oral medication. That seems like a logical choice until you see that it’s only been available since 2010. I am not a gambler;  I didn’t even consider it.  Besides what can be more satisfying during a battle than pulling the trigger on your enemy?  The most common side effects listed in my glossy Copaxone brochure was injection site reactions such as redness, itching, pain, swelling and a lump.  In the Gilenya packet, I saw side effects like slowing your heart rate, lowering your number of white blood cells,  blindness and hair-loss, to name a few.  With Rebif, common side effects included flu like symptoms, depression and liver problems.  Every other option sounded really scary to me, while Copaxone sounded scary mostly to the MS.  Sure there was a list of undesirable “rare but possible side effects” included in the fine print, but I felt pretty good about the science behind this one. The way Copaxone works is that it stimulates a “protective immune response” by promoting the development of T cells in the central nervous system. The immune system then attacks these propagated T cells rather than attacking your body’s nerve cells (myelin). Brilliant!  Shared Solutions scheduled the delivery of my arsenal and I was very excited the day it arrived in a giant box containing a styrofoam cooler and three months supply.  I had to sign for the package because it contained $12,000 worth of weaponry, (war is expensive) 90 pre-filled syringes that needed to be kept cold.  Copaxone takes up a lot of space in the refrigerator, but I was determined to not let it take up a lot of space in my head.