summer's gone...

I was determined to leave work reasonably early today.  It was a little crisp on the cycle to work this morning, but it soon became another one of those beautiful autumn days. I sat at my desk, looking out of the big window behind me, and decided that it would be nice to get home and to squeeze another run in down by the river whilst the light still held.  There won't be too many more of them this year.

By the time I actually left the office, the day was already closing in and, to be on the safe side, I put my rear bike light on to blink gently at the traffic behind me.  I was still going to go out for that run, obviously, it's just that I was now going to be doing it on one of my winter routes and wearing a fluorescent top.

As it turned out, after cycling home, I decided that I'd wear a beanie too.  I do have a tendency to wrap up too warm when I run, but I greatly prefer that to being too cold.  For now, I'm still running in shorts and leaving my gloves at home, but I broke out the woolly hat and I'm not ashamed to admit to it.

In summer, I'm able to run along the River Trent and the canals around Nottingham after work.  As the season turns, I'm forced to pound the mean streets around my house.  I don't mind these routes; after all, it's here that I did the bulk of my marathon training over the last couple of years; all those Thursday night ten-milers after work.  I don't really mind the cold and the dark either, and one of the things I love most about cycling to work every day is that I really get a chance to see the seasons as they change.....It's just that, well, I don't think I'm quite ready for winter yet.  I'm not ready to let the summer go.

I was planning to do my 4.5 mile Compton Acre route, but the mile up the hill on Musters Road told me that my poor old body simply wasn't feeling up to it.  I injected last night, and it was a long day at work.  Besides, my knees felt a bit stiff, and the exercises I've been doing to strengthen my left leg and to work on my balance have left me feeling distinctly lop-sided.

It seems I have all the excuses.

Anyway, I thought 5km would be a respectable compromise on a cold evening and set my sights on my cut-off route.

At this point, my watch (which is very clever and reads my heart rate and things and probably knows how I'm feeling better than I know myself) beeped at me.

I glanced at my wrist.

PERFORMANCE CONDITION: -4.

Well, everyone's a critic.

these things will change...

When it comes to the management of my MS, I tend to agree with my neurologists.... everything seems to be going along okay at the moment, so why change anything?  When treatment options seem to be rapidly expanding, this is maybe occasionally a bit frustrating: why am I still sticking myself in the thigh every week with a huge needle when there are oral treatments available?

Well, the reason why is actually very simple: Avonex was my first-choice treatment option in 2009, and although we'll never know if it's the drug that's been making the difference, my MS has barely progressed since that point.  When you add in the fact that my body tolerates the side-effects very well, you would need to have a pretty good reason to rock the boat.

If it ain't broke....

Then I got a call from my MS nurse this morning.  Apparently they're going to stop manufacturing the particular variety of Avonex that I use.  I use the bioset version: this comes in a vial in powdered form that you rehydrate with the purified water in the syringe before injecting.  I chose this for the very simple reason that you don't need to keep it in the fridge and I was about to go travelling in the southern hemisphere for the next few months.  The convenience of not having to keep this stuff cool was a massive bonus.

There are two replacement options: one is a pre-filled syringe and the other is some sort of injector pen thing.  The change probably isn't that big a deal because it's ultimately exactly the same drug in exactly the same dose.  But it's a change.  Both the other options need to be stored in a fridge, for starters.

So, how long do I have to decide?  Well, apparently they're discontinuing the one I have in April... so not long.  In fact, the nurse made an appointment for me on Friday this week to discuss the options and to make my decision.

I wouldn't say that I was the kind of person who was particularly unsettled by change, but somehow this news has ruffled my feathers a little bit.  I wouldn't say I like injecting myself all that much or was even particularly attached to the way that I do it today.... but this somehow feels like a change that I'd instinctively rather not make.

Well, the pen injector apparently has a significantly smaller needle... so maybe there are some upsides, after all.