I think that's a lot of it, but it goes further.... I feel trapped in a cloud and separated from what is around me.  .  . not just "down".  And it leaves just when the Enbrel would be wearing off.  I need to be in touch with those feelings (and i did know they were there) but I can't 'deal' with them or do anything helpful when I'm 'under the influence'.  There has to be another way....

    There's also vice-versa - being depressed makes you more susceptible to pain. Sometimes symptoms jump around so much, it's hard to know what to act on, other than the immediate necessity minute-to-minute, because, for instance, I'll make an appointment to get a slip for PT for my back (or knee, or shoulder), and then by the time I am able to get there, it's a different part of my body.  Although I have 'accumulated' quite a few 'regular' customers at this point.  And the problems are finally showing up on the left side as well as the right (I think Enbrel kept it in check for a period of time and it has done what it can do without further problems...)   Now it's not just my right shoulder, but my left also; not just my right foot, but my left also. Etc. Etc.

    It's one thing to cry .... and another to implode instantaneously yelling at my husband and crying uncontrollably without warning (to me or to him!)   That's not acceptable.

    So - after thinking about this, I think I probably need a medication I've used a few times for short periods in the past to get myself over this hump.  This time of year I am always thinking about family I can't see (too far) for the holidays (or almost ever) and also typically lose energy due to weather changes, plus we are in the thick of it at work...I always struggle in the middle.  Not necessary because of being busy every minute, but because everyone I work with (the faculty) are overloaded and it rubs off on me....my antennae pick up the stress, whether I choose to or not.

    some times you have to lose the battle to win the war.

    and then I read what I've written and think: why am I so whiny when I have it better than so many?  I'm still working and walking and.... etc.  but self-condemnation doesnt' help either.  But just to get perspective.

I may get a second opinion one of these days if things don't ease up.  But the truth is, it could be scary starting something new too, not knowing what would happen.  I am 70 miles from my rheumatologist, which does not make it easy to check in with him.  There are NONE in the county.  There is another one who comes to Malone (in the other direction) from Burlington, VT.  There are several in Syracuse.  But the other thing is (and dr. brings this up too), at 61, it's not all RA, there is also OA which won't be helped by the biologics anyway.  Last time my SED rate was checked it was 29.  So I think there may be something else going on.  He said last year he thought my blood markers indicated my body might be morphing toward MCTD (mixed connective tissue disease) and asked me if I had symptoms of Raynaud's.  I didn't then but there have been a few instances since then which might qualify...The only med I know of for MCTD is prednisone - and I can tell you that in September when I had the major flare, the prednisone was a godsend.   Not to keep taking it, but it did save the day.  And so much seems to be dependent on stress.  An acupuncturist I go to periodically (I have been meaning to make an appointment) told me, "You stress easily but you heal fast" - i.e., a fast responder in both directions.  But I can tell you inbetween is misery.  My brain is way ahead predicting the worst possible 0- at the same time it knows that 'outside the box' focus is often helpful and gets me off the roller coaster - if I can just step back. So I am also cautious about making a major change until push comes to shove.  But _ I am just about there (I think!) being calm at the moment.  My doc talked about Orencia at one time as being less apt to trigger infection (but you sure wouldn't know it from the ads and info available!)  And he said, "you can get the infusions in my office! " with this smirk on his face (but my PCP said, I could have them there - 2 blocks from my work place).  They are 15 minutes long. Why should I have to drive 70 miles each way to get a 15-minute infusion?  The hospitals here don't seem to do it (no rheumy around to set it up, I guess).  Things get a bit tortuous in a rural area.

That's a really good point, I did hear it was now available self-injected.  I am always onthe verge (or more) of sinus nifections with Enbrel, so I know what you mean.   I think I needed to hear this from someone who has been through the switch.  I did call the doc's office today and they said right now they have no openings before my appointment in January, but if he approves, they will squeeze me in somehow.  And he will do that.  A few weeks ago when this all started to come apart and I called, they wanted me to drive right down.  But it didn't feel like a good idea to me at the time, so I said just let me talk to him, and he thought my idea of trying a half-dose after waiting as long as possible was a good idea.  I thought, I have to give it one more shot to make sure I should switch to something else now.  I am convinced!   Even though he says they all have similar risks (except infection with Orencia, based on his experience with one other person where they got an infectious disease specialist involved), I know they all work through different mechanisms, and I think the Enbrel path is just bottomed out with me. 

I think you just hit the nail on the head, friend!  For some reason, I sense the Orencia choice might be better for me than Humira. Time will tell.

    How often do you do the shots?  Is it once a month?  Do you feel yourself slide toward the end, or what?   And how long since you started?

     THANK YOU!

NOw that is really interesting!   Friday the 13th has always been a good day for me (my one child was born on Friday, April 13, how could it be a bad day?)   Enbrel worked fast for me - but you know, I had a major panic attack for two hours the first injection I gave myself at home.  And it had nothing to do with being afraid of it, that time.  I thought I'd never do it again, but by 3 days later, something told me, it's good.  The side effects for the most part were relatively mild as long as I did the shot about every 5 days (not really twice a week).  After several years, I began to get less benefit.  But having fibro as well, sometimes it's hard to tell what is what.  But I actually got more tired and achy after the shot for the first day, better the second day, and back to 'normal' on the 3rd day.  i was able to go without it for 4 - 8 weeks when necessary (for surgery, etc).  in fact, if I did 2 shots a week, I would end up with infection within 2 months or less.  I went last winter with only 4 shots in 3 months.... but I paid for it later.  Still I don't regret it.  I would just get sick so fast with sinus or several skin infections, on and on.  Then I got a MRSA abscess on New Year's Eve 2010, just before a 4-day trip.  It required surgery, even after antibiotics (I could tell it wasn't superficial from the start).  I got one skin infection on my areola one time, in my groin area another time (OK, Lene, I won't say 'weird' again!).  I loved it while it worked, because I could determine the schedule myself and not be tied to any doctor's office schedule (even aside from travel).

So - this sounds better and better...I would have switched last year but doc wasn't sure.   And he has an excellent reputation and track record.  I talked with one woman in the waiting room (great place to trade stories when you're waiting for a LONG time!).    She was at death's door when he diagnosed her with sarcoidosis, no one could figurer out what was wrong.  After an initial period that was kind of a wrestling match, we did seem to understand each other and both listen.  So that is good, especially because of geography - there is not a lot of choice!  After the Remicade fiasco, I went on my own for about 6 months, talked with a lot of people and read up a lot and decided on Enbrel.  I went back and told him that was what I wanted to do and he said fine, the nurse will set up you and show you how.  So I think he trusts my instincts up to a point, and I trust his expertise up to a point.  Good combination.