My Experience with Trikafta Has Been More Difficult Than Expected

I’ve been fortunate to start taking Trikafta, a next-generation, triple-combination treatment for cystic fibrosis. My journey began in December, but it hasn’t been the easiest path to walk along, as I’ve encountered unexpected twists and turns.

How Trikafta affects someone’s relationship with their body varies from person to person. But I feel as though I’ve had a particularly rough go of it. It’s become a fragile balancing act in which I’m constantly scrambling to keep up with my body’s changes. 

First, the good: My lung function has improved and my mucus production has decreased. Many have talked about their renewed ability to laugh, and it’s strange not to have to worry about a sudden fit of laughter sending me into a coughing spasm. It still happens a bit, but not nearly as much.

On a recent vacation, I was even able to snorkel for the first time in years (with the assistance of a friendly pool noodle). It was something I had sorely missed, and while it was still difficult, the fact that I could reclaim an activity I once loved was amazing. 

Then there’s the bad: It’s difficult to talk about the side effects I experience while taking Trikafta. Others have been dismissive when I try to discuss it. Some suggest that my negative experiences aren’t from the medication, because my experiences don’t match theirs or because my particular side effects don’t have a documented history.

I’ve ruled out other causes through extensive testing and visiting more specialists than I care to recall, including a neurologist, a rheumatologist, and an endocrinologist. Bad behavior on social media in response to my comments that my Trikafta journey hasn’t been positive shouldn’t bother me, but it does. The truth is that we don’t know what some of the rarer side effects or long-term results might be. To discount my experiences seems deeply invalidating. 

The worst side effect for me is what many on social media have dubbed the “Trikafta munchies.” It’s a constant hunger. It doesn’t matter if I’ve just eaten, I’ll still be hungry an hour later. Sometimes the hunger is so bad that it becomes physically painful.

Though I’m pancreatic insufficient, I’ve rarely struggled with my weight. Eating whenever that bone-deep hunger strikes would result in more weight gain than a person needs. It also would irrevocably change the fragile peace I’ve made with my body.

During the first few weeks of treatment, I weighed myself every day, often several times a day. I cried in the mirror while looking at myself, fearing that those extra pounds would reappear. I worried that I would lapse back into the bad eating habits I experienced in high school, or that I would stop eating entirely. 

Digestion has become difficult since starting Trikafta, as has maintaining my insulin levels. I have cystic fibrosis-related diabetes. Before I started taking Trikafta, I knew exactly what certain foods would do to my glucose levels and how to address imbalances. Now, this changes day to day. Sometimes I need more enzymes or more insulin. The next day, I might eat the same meal, yet suddenly have too many enzymes and too much insulin. Every day I have to adjust and calculate. It’s exhausting, and eating has become an unwelcome chore. 

I’ve always suffered from harmless myoclonus jerks. But now they’ve gone from happening once or twice a week to several times a day. I drop things now. Despite reassurances from my neurologist, I worry. It’s just another thing to get used to, and another way in which my body has become a stranger determined to ruin everything. 

Part of becoming an adult is realizing that you must balance the good with the bad. On the days when Trikafta saps my energy, leaving me almost unable to get out of bed, I must recognize that I can still breathe. Others haven’t had this opportunity. I can also recognize that my side effects seem to be exceedingly rare.

I should also acknowledge that taking Trikafta is a privilege. Not everyone has access to it, either due to a lack of adequate healthcare coverage or because they simply don’t qualify. 

Still, I don’t know what else this new body has in store for me. Perhaps one day we will be in agreement with each other. For now, I hope to find a happy medium.

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Note: Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cystic Fibrosis News Today, or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to cystic fibrosis.