Thursday, March 4, 2010

Needle Me This

Today I got home from the pharmacy and went to put my next four doses of ENBREL in the fridge when I noticed that the box  they came in was blue. That's odd, I thought. The box is usually white. I looked a bit closer only to discover that the pharmacy had given me syringes instead of auto-injectors!

I called them right away. After all, I had been there only 15 minutes ago. Surely they would offer to fix the problem. But no. They couldn't legally take the medicine back. The pharmacist said there should be a diagram in the box that explained how to give the injection. When I said I wasn't sure I was actually comfortable using the syringe - that the auto-injector is tough enough for me sometimes - she offered to look up some instructions on the internet and talk me through it. No, thank you. I can look things up on the internet myself.

I think if I had continued to make a fuss about being uncomfortable with the syringe, the pharmacy would have eventually helped me figure out how to get the auto-injectors instead. But then the hundreds of dollars of medicine in the syringes - four weeks worth - would have just gone to waste. And when I started thinking about all the horror stories I've heard about RA patients without insurance or who aren't able to afford these expensive medicines, I just couldn't stomach the thought of throwing those expensive meds away just because the method of delivery made me a little uncomfortable.

After all, I deal with needles and things that make me uncomfortable all the time. I've been injecting myself with the auto-injector for months. I seem to get blood drawn every other week and I don't turn my head away anymore. I've had flu shots and Remicade infusions. And these past two weeks I've been all about my ability to take care of myself - so why not learn how to use a syringe on myself? I told the pharmacist I would figure it out.

But as soon as I hung with her, I felt shaky and nervous. I don't know why the syringe makes me feel so uncomfortable. It might be partly because you have to make sure no bubbles are in there, and I don't know how to do that. So there actually are some safety issues to be concerned about. It might also have to do with the yuckyness of actually watching myself push a needle through my own skin. But, strangely, though I'm not sure that this makes any sense, I feel sort of like knowing how to use a syringe confirms that I am a sick person. With the auto-injector all I had to do was push a button and look away, no skill involved. Anyone can do that. But only sick people (or medical people) know how to give themselves injections.

In any event, I think I will be fine. After the first time it will probably be easy. But I  think I need someone to be with me the first time. APL is no use because (a) he isn't here and (b) he passes out at the sight of needles going into skin! And a passed out fiance is not very useful to anyone!

Instead, I called Favorite Lab Man at student health to ask him about it, as I've struck up a comfortable friendship with him while going to get blood drawn every other week for the past year and a half. He is always super sweet to me and once said if I thought of anything he could do to help, just let him know. So here it is! Tomorrow I am going to go in and see him and he promised to give me some pointers on giving myself an injection with a syringe. And I'm so grateful that he agreed to talk me through it, not as part of his job but just because he cares.

But I will still give myself the injection. So wish me luck!


Rebecca said...

I have to give myself methotrexate injections every week, and I have to draw the medicine into the syringe myself. That's actually the hardest part. Syringes are no big deal, you'll conquer it the first week and then be just fine!

~Mariah~ said...

REBECCA: Thanks for the encouragement! I know I'll be able to do it, the first round is just making me a bit nervous. But people do it every day, so there's no reason I can't do it too. ~;o)

Laurie Grassi said...

With the advice of health centre man, you will SO be able to do this! I have absolute faith in you! I've been doing both ways, and I was more nervous about the auto-injectors for some reason. With the syringes, you just dart it in (no hesitation is the way to go – you don't even feel it that way!) and it's done.

Best of luck – you'll be awesome!! :) Laurie

~Mariah~ said...

LAURIE: Thanks for the support!! ~;o)

cory goldstein said...

as someone that was TERRIFIED of needles I can assure you that if i can do it you can do it. When I first started Embrel (i have since changed medicine twice) i did autoinjecters.. then when my dosage changed I made my dad do it... finally i decided that I had to have the strength to do it. First of all you should put it under your arm to warm it up... put it in your forarm to make it closer to body temp. Then just breathe deep and do it. It hurts MUCHHHHHHHH less then an autoinjector. good luck
ps. your blog has helped me so much. it makes me feel much less alone

Sarah Z said...

yuck i know how you must feel about this... but i know you can do it because you are awesome! perhaps you should research the college bars to see if you can find yourself a little jello shot in a syringe for after? :) jk LOVE YOU

~Mariah~ said...

CORY: I'm noticed that warming up the ENBREL helps a lot with the pain from the auto-injector - thanks for the advice about that! And I'm ALL for hurting muuuch less than the auto-injector too, so I'll look forward to that. Sometimes that sucker STINGS!!

I'm also really glad you've found my blog useful. It has been really useful for me to write and if it helps other people too then that's amazing because I know from personal experience that it's really hard when you feel sick AND alone. I'm always just an email away if you ever need someone to talk to about RA. Or, you know, whatever. ~;o)

SARAH: I clearly missed the part of college where jello shots come in syringes. That's DISGUSTING. ~;o)

Sylvia Zebrowski said...

I'll be there with you, giving you a great big hug and holding your hand---like I used to do when you were little.

Paris N. said...

I am so impressed. I would be utterly, totally, uselessly terrified. I'm more like APL when it comes to needles, and the fact that you're opting to keep the needles is awe-inspiring.

Helen said...

For some reason, the auto-injectors really scare me, too! I feel more in control with the syringe, especially after using it for seven years. Like Laurie said, just dart it in with no hesitation. You don't even feel it that way.

Good luck! You can most definitely do this.

J said...

Not sure if this helps, but I had to give my dad a shot, and he told me that the easiest way to do it is to pinch the area around it, and it doesn't even have to be like a painful pinch. If all you notice is that 'pinch' (and believe me, he pinches pretty solidly), you won't notice anything else sensation-wise. Your nerves/sensory neurons literally cannot register that much input simultaneously.

sherry said...

OK... Im totally terrified now! Im to start Enbrel in a few SHORT weeks due to psoraisis / arthritis and im scared about injector v/s needles..... what to do ... what to do?????I have given friends insulin injections and even my cancer stricken late husband HGH injections, but the thought of injecting myself has me panicked!!!so many questions, where to give shot? same place every time? bad side effects? warm or cold? i get steriod shots in my butt cheek and please tell me it wont hurt worse than those cause i still have briuse on bum a month later????? help me!!!!

~Mariah~ said...

SHERRY: It's ok to be scared - I clearly was! But for me it wasn't anywhere near as bad as I thought might be. Also, if you have given friends and your husband injections you have a head start over me - I had never even touch a needle before, which was part of what freaked me out.

Enbrel WORKS for me. It makes me feel SO MUCH BETTER - so whenever e get a little nervous about the shot I tell myself that it is WORTH IT. I may feel a little nervous, it might hurt or sting a little bit, but for me it is worth it.

After getting the syringes by mistake, I actually ordered them again a few times. In some instances, I found that they hurt less than the auto-injector. But, ultimately I found the auto-injectors easier and went back to them. I would recommend starting which the one that scares you least and they trying the other one when you are a little more comfortable with the idea.

Ask your doctor or nurse for help - they can do the first one for you. That way you can watch and learn, plus then you will know the physical sensations to expect and won't be as nervous about them.

I don't always use the exact same spot, but I always do the shot in my upper thigh, and I switch legs every week. Sometimes I get a bruise but usually not. You shouldn't let it get warm - the medicine needs to be refrigerated to work - but letting it warm up 10 or 15 minutes before the injection helps it not sting as much.

You can do it!! ~;o)