Pat’s Place: Overcoming My Life-Long Fear Of Giving Myself An Injection
Isn’t it amazing what a multiple myeloma patient can learn to endure? I’m so much tougher than I was four years ago when I started my myeloma journey.
But despite all of the drugs, pokes, sticks, and tests I have been forced to endure, one thing I had yet to do was learn to give myself an injection—and the thought had always petrified me!
Let me back up a bit.
I have been taking Revlimid (lenalidomide) orally for over four years. Ever since I developed a pulmonary embolism (blood clot) in my lungs during my first summer taking Revlimid, I have also been taking oral blood thinners.
When it comes time to get a bone marrow biopsy or other surgical procedure, however, it requires switching my blood thinner from warfarin (Coumadin) pills to subcutaneous injections of heparin (Fragmin).
No big deal. The nurse lifts up my shirt, squeezes some belly fat between her thumb and forefinger, and does her thing. Sure, it stings a bit going in. But the needle is small, and the experience isn’t much worse than a blood draw.
Fast forward to the present. I have a bone marrow biopsy scheduled for next Monday. That means I need to discontinue my warfarin and start heparin injections once a day until after the procedure—or so I thought.
Turns out I will also need these once–a-day injections throughout my upcoming stem cell transplant process, until my own stem cells are producing a safe level of red and white blood cells.
In other words, I need injections for at least 45 days. At that point, I may be allowed to discontinue taking blood thinners altogether, unless I resume Revlimid maintenance 90 days following my transplant.
A shot a day for 45 days? The words inconvenient and a waste of time come to mind.
The most efficient way to get this done is for me to start giving myself the shots.
No big deal, right? Diabetics do it every day.
I have been taking Velcade (bortezomib), both the intravenous and subcutaneous versions, but my nurses have always kindly administered both.
But giving myself shots? Heck, I still look away when the nurse starts an IV or gives me a shot! And I had never administered an injection to someone else, let alone myself.
But in the end, common sense ruled the day. It was time to suck-it-up and learn how to do this.
So on Tuesday, a smiling nurse named Vicki patiently explained how to use the pre-filled and packaged syringes.
I had to admit, the needle was pretty small. “It’s like throwing a dart,” she kept repeating. “Hold the syringe at a 45 degree angle and simply throw the dart—using your wrist—then slowly press the solution in.”
The pressure! After three aborted attempts, we were both laughing so hard I went ahead and poked the needle in. I’m not sure if I used Vicki’s “dart throwing” technique or not. But I didn’t even feel the needle go in. I nervously laughed some more as I squeezed the fluid slowly into my belly. It did sting quite a bit.
But who cares! I did it! I had faced my fear and lived to write about it. I could do this!
I had conquered a life-long, silly fear. I was a warrior! I thanked Vicki and left feeling pretty good about myself, complete with a new-found bounce in my step.
Now if the stem cell transplant could only be so easy…
Feel good and keep smiling! Pat
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Congrats, Pat, for overcoming one of your fears. I can relate! I've always hated shots. As it was about to happen, I would grow cold and clammy. The.world would close in and I felt like I would faint. They didn't hurt, the medicine was good for me - I could not intellectualize my fear away. I said a prayer and the fear disappeared. Divine intervention or self preservation - who cares? It worked! Then MM arrived and I knew I'd better get used to the pokes and prods! Then came the Thalidomide induced DVTs and PEs and the self injected Lovenox shots in the stomach. My wife administered them and then she went out of town. It took awhile to summon my courage, but I stuck the pointy end in and, lo and behold, it wasn't too bad! Like you, this was small, but decisive victory! I was thankful, however, when coumadin pills replaced the Lovenox.
Who knows- maybe I have self injected subQ Velcade in my future, too?
We're saying prayers and have great excitement about your upcoming ASCT. Go get 'em! Sean
Don't worry, the auto SCT actually IS easy. If you're unlucky, it's like a bad (a very bad) 2-week flu with vomit and diarrhea. Nothing more, and maybe less. The worst thing is the boredom, I assure you (althought Giacomo Leopardi, the best 19th century italian poet, wrote once "La noia è in qualche modo il più sublime dei sentimenti umani" - Boredom is in some ways the most sublime of human emotions).
Greetings from Brescia, Italy!
Nicola
Hi Pat,
Pat,good for you! Some folks do have, what some might say, is an irrational fear of injections. This I understand from my own family, my sisters in particular, one of which has been known to actually faint at just the sight of the needle. Regardless, we all have our various "idiosyncrasies" and they are not to be discounted...I for instance insist on having my BMB's with concious sedation. My doctors think I'm a wimp but I say until you've had a few you really aren't in a position to say one way or another as to the pain involved. At any rate, the self-injections can get easier over time if you know a few of the tips for administering them. I'd be happy to share them with you...just send me an email and I'll share my own experiences. And best of luck with your upcoming SCT...many in our MM community will be watching your progress with considerable interest and best wishes!!! Steve
So Sean, sounds like you understand! I have heard at some point sub q Velcade may be available that way. After enduring some injection site issues, I could understand why docs would want more control, however. That is toxic stuff and left a nasty, red blotch--among other side-effects- Pat
Thanks for the kind words of encouragement, Nicola! I think I dreaded self injecting my blood thinners more than I my upcoming SCT!
Steve-
I have been a big proponent of sedated biopsies since the beginning. I have hard bones and the pain and pressure can be intense. Moffitt and Mayo only do sedated BMB's... Smaller clinics may not have the capacity to do them so they are selfishly discouraged. Small clinics also use them as a profitably revenue source. If they send you to the hospital for a biopsy, they lose out on their $100 profit.
Lori-
You are so right! The time saved traveling and waiting was all the motivation I needed to "get over it!" Except I forgot to do it this morning... Better go stick myself or I risk becoming a non-compliant patient! Pat
Haha! I learned to give shots for my mother in her cancer treatments. When I needed to give them to Dave, I was totally fine but Dave was not! He would tremble and query me and try to tell me what to do. When I was told he didn't need them anymore and feigned great disappointment as it was my most favorite thing to do! Grinning from ear to ear with Dave rolling his eyes, "Yeah right!" "No really, I loved watching you fall apart of me giving you a little shot." It was one of those marital things! On a more serious note, think of diabetics next time you do this and work darn hard to keep your sugar intake under control so it doesn't become something you have to do on a regular basis! (A side effect of Dex!) Not having to go in for shots is totally worth learning how to give them to yourself. There are many things I wish they would let me do myself!
Hi Pat, you might want to try injecting yourself in the thigh. I had less sight injection problems that way. My clot was from my central line placement, I did them for about 90 days. It did have one good effect; it has made my husband start to lose weight and try alot harder to get his diabetes under control. He really hates needles. I'm hoping your SCT goes well. For me it was worth all the bother. I feel so much better than I did this time last year.Dee
I might just try that... My thigh sounds like it might be less sensitive... Thanks! Pat
Oh, I feel your pain...I had to give myself four injections a day prior to my transplant-no fun at all. Good luck!
Hi Pat, I just finished giving myself Neupogen injections in advance of my SCT. I will be going inpatient in Boston tomorrow. At first, my local Oncologist said they could give me the shots, even having someone on call come in on the weekend. However, my insurance and Dana Farber both said I would need to have the shots in Boston or administered at home, but not at my local doc. Since Boston is an hour away, I decided to tackle them myself. Funny, we have a family friend nearby who is a nurse and my family was sure if we asked, she would give me the shots. The first day of the schedule injections, my wife ran into the nurse who said she was meaning to call and offer to administer the shots. In the meantime I got two Neupogen shots ready, gritted my teeth, and popped them into my belly. It was not bad at all. About five minutes later, the phone rang, and it was our nurse friend. Despite her kind offer, I felt I was going to be fine doing the shots over the next 9 days. Sure enough, that was the case. Like you I have always hated needles. Can't help but think how much we have to adapt during this MM journey.
Pat -- Your blog echoed my "feared first self-injection" pre-SCT experience in late '99. The nurse first had me practice giving a few injections to an orange. Then humor also helped: When she said to "now put it into your fat", I looked at her from my emaciated 120# body and asked, "Fat? Where?". We both laughed, and so did my caretaker-wife. Wishing you all the best with the SCT procedure and its results.
Four a day, Sherri? YUCK! And thanks Denis and Phil... Nice to know I'm not alone- Pat
I have been injecting myself for the past three cycles since starting treatment and have hated every injection - there is something basically wrong about sticking a needle in myself every morning. The good news however is today was my last injection. I am now allowed to switch to baby aspirin instead. Except for the reduction in my cancer due to the treatment, this is probably the best thing that's happened since treatment started. On the flip side though, I just had a port put in this past week, and having this foreign object under my skin and feeding into a major vein has counterbalanced being able to stop the injections. Peace, and my prayers go with you for your SCT.
I'm glad you are finished needing to give yourself injections, Kevin! For me, the needle going in is no big deal. But I must admit the fragmin stings big-time going in--and I'm sore for a while after. But I will have lots of opportunity to practice... Maybe I will learn just the right speed to squeeze the stuff in! Best of luck to you- Pat
Pat,
Thanks, again, for sharing. My prayers and thoughts to you and your family during the SCT. My husband is in the induction phase, and we're scheduled for SCT consultations in coming weeks. I've learned so much from your writings. Cheryl
Good luck to you and your husband, Cheryl! Thanks for reading and glad I could help... That's how I find a way to keep going- Pat
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