The words on the page looked like they were written in some foreign language. I stared at my laptop for what seemed like hours, trying to make sense of what my doctor was telling me. “… zero presence of COVID-19 antibodies… new medicine may be available… FDA emergency approval…” Zero antibodies? Zero?! Did I read that correctly? Let me look again… You can imagine my surprise. I had just received a third shot – a full third dose of a two-shot COVID-19 vaccine just a few weeks prior. I had been so careful to choose vaccine dates that corresponded to the timing of my infusions — attempting to find a “just-right” date on the calendar when my body would recognize the spike of protein in the vaccine and create antibodies. I felt certain that my body would be able to create some antibodies. Just a few was all I needed. To make it safe to buy groceries. To hug my family. To see friends. To live a full life. I have two autoimmune diseases: Hashimoto’s thyroiditis and rheumatoid arthritis (RA). To keep my body functioning properly, every week, I draw bright yellow liquid into a syringe and find a soft place on my belly to inject my medication. Every six months, I open a vein at a clinic in Portland so that a powerful B-cell depleter can be drawn into my body. I take pills for my thyroid condition and supplements to support my nutritional health. I’ve had injections in numerous joints (including my fingers — ouch!). I have regular blood tests, which are required to monitor liver and kidney functioning. Controlling chronic health conditions requires a serious commitment. It is what I must do to control my body’s impulse to dysregulate my immune system and mistakenly attack my body. When I was first diagnosed with RA, the pain and inflammation in my joints made it impossible to dress myself. I limped when I walked. I lost strength and struggled with fatigue. And look at me now — I am in remission! Sweet remission. But there is a dark side to remission no one told me about. Although my medications have helped my body stay inflammation-free, they have also left me defenseless against viruses, COVID-19 variants, germs, and diseases. Both “new” threats and “old” threats are still threats to my health. Until I read my doctor’s email with my antibody results, I was unaware of how devastating my medication had been to my immune system. Sure, I knew that the meds I took lowered my immunity, but I did not fully realize that I may not be able to create antibodies. I remember the moment when it slowly began to sink in that I am truly immunocompromised. My immunocompromised state could be even more dangerous to my health than my RA and hypothyroidism. Processing this new information has taken a long time and has been fraught with questions. How do I live in a world of germs without any defenses? Will I be able to live through another pandemic? Will I ever be able to travel abroad? Can I hug my grandson without the fear of catching an illness he picked up at daycare? What invisible danger is lurking around the next corner? And the big question: Is remission worth it? This new diagnosis has come with the grief, anger, bargaining, and acceptance stages of a major life change. As I did when I was diagnosed with RA, I am learning to make new adjustments to my life. Masking, handwashing, and being careful about close contacts will be an ongoing part of my life. Despite these health obstacles, I still feel gratitude. Although I don’t know what my health will look like in the future, all that I can do now is focus on this moment. At this moment, my body feels good. At this moment, the sun is warming our home. At this moment, my dog is curled tightly in a circle of sleepiness. At this moment, I feel loved. All is well. I wish you well in your journey towards remission and good health. Feel free to tell me about your journey too.