Sunday, December 4, 2011

The Art Of Self-Injection

Saturday was shot day.  And I did it myself!

Over the past few weeks, I spent a lot of time online researching potential tools that would facilitate the injection process. 

As I puttered around, I was a bit frustrated to discover that Enbrel and Humira come in pre-loaded pens. 

Methotrexate is totally old school.  You get vial of medication.  I have to prep the syringe myself.  MTX is a DMARD, whereas the other two are biologics, so I’m not sure if that makes a difference.  Or if it’s just the fact that good old MTX is stuck in the old days.

Enbrel and Humira also come with very thorough instructions, and their websites also say several times that your doctor’s office should make sure you have self-injection down before you leave the office with a prescription.  My rheum’s office gave me a very brief crash course, in which my hand shook the whole time at having a needle and syringe in my hand for the first time ever.  How could I get self-injection down when I was so busy paying attention on how to prep the syringe and trying not to accidentally stick myself?   

For the first two, I sat there for almost two hours, getting an eighth of an inch from my skin.  But the thought of sticking the needle in made me nauseous, and by the end, I had sweated through my pajamas.  Ultimately, since I was home for 10 days for Thanksgiving, my mom gave me my first two injections, and threatened to be at my apartment every Saturday morning for the rest of my life to give me my shots. 

Sorry mom, I love you, but I went in another direction.  I found this cool gadget online.  It’s called a NeedleAid (*.  For me, I could tell that the part of self-injection that was weirding me out the most was actually seeing the needle go into me.    

Needle Aid is a product out of Canada that is made for people who are needle-phobic, but have to self-inject.  It is also made for visually impaired people and people who have unsteady hands.  Basically, the gist of it is that the needle is hidden away.  You push down on part of the device and the needle goes in – but you don’t see this happening.  Then you push down the syringe all the way, and then you are done.  The NeedleAid is spring-loaded so that once you’re done, you let go, and the needle is safely back up and out.  Basically, this device tries to mirror the actions of an injection pen.

So I put on Christina Aguilera’s “Beautiful”, I prepped my syringe, and loaded it into the NeedleAid contraption.  Ultimately, it took me about a half hour to prep and then get over myself and just do it.  And when I say a half hour, I mean about two minutes for the prep and do, and about 28 minutes of sitting there thinking about it.  Because with this contraption, once you push the needle down and in – which you can’t actually see happening, but feel – there’s no turning back.  Then you plunge the syringe and go.  I decided to put the coffee on and told myself I had to get it done so my coffee wouldn’t get cold.  Clearly coffee is a great motivator for me.

My one major hope was that when I released the syringe, that it was empty.  Please universe, that syringe better be empty.  Otherwise, I may have had to kill myself. 

I even had two nurses on standby in the event that I couldn’t do the injection myself so I wouldn’t chance missing a dose.

I wanted someone to idiot proof this experience for me.  Make it a bit easier on someone who really does not want to stick a needle in themselves.  But no dice.  So I had to make the experience easy for myself.  And that’s what I did.

I’m not gonna lie.  NeedleAid is definitely the best $20 I’ve ever spent.

Please don’t think I am being a drama queen here.  Before I got sick, I literally used to have a panic attack if I needed a shot or a tube of blood drawn.  But after four sticks and 27 tubes of blood during my first rheumatologist appointment, that fear quickly dissipated.

But the fear of sticking a needle into myself hasn’t.  And one of the chief reasons for that is the whole pneumovax debacle.  If a medical professional can administer a vaccine wrong and almost kill me, how can I trust myself?

I can only hope that as time goes on, I won’t need to contemplate, and my injection time will become only a few minutes.  But I’m already down from two hours to about 30 minutes, so that’s definitely an improvement.

I’m glad I am able to do it myself now because it would have been hard to always coordinate to have someone around on Saturday morning to do it for me.

Maybe one day I won’t be nauseous at the sight of me sticking a needle into myself, but for now I don’t need to worry, because I don’t have to see it.

And I’ll concede that there are definitely less side effects from the injection as compared to oral MTX. 

For me, conquering my fear of self-injecting is a really big deal.  It’s not something I wanted to do or thought I could do.  But, in the immortal words of Tim Gunn, I made it work.

And isn’t that what’s at the core of illness experience?  Making life as livable as possible despite the confines and limitations of our illnesses?  Like I’ve said before, the boundaries of what I can and am willing to do to be as healthy as possible, are forever fluid and changing.  If you would have told me a few weeks ago that I would be giving myself MTX injections once a week, I totally wouldn’t have believed you.  And I can only imagine that as I continually skirt the boundaries, someday, maybe even some time very soon, this will seem like a very minor state of affairs.

Stick a needle in me.  Oh wait, I already did that.

And maybe, just maybe, if you’re really lucky, I’ll vlog about it.

* I purchased the NeedleAid myself and am promoting it of my own free will.  I did not receive any type of compensation from the company.


  1. Leslie, I felt so much compassion for you while reading this--yet I also giggled with your sense of humor about it all. I was 24 when started my own injections and I think I just realized, as sharing your article with my husband, that I was too naive to have built up the fear, and I didn't think I had a choice. A home health person came by with an orange I practiced on in front of her twice and that was it. It was MTX and I have also taken biologics and B12 via injections (just wait until you go through the airports. Have everything labeled!)

    Hang in there, hon! I think it gets easier, and good for you for being so proactive on it too. if you would be willing to allow me to reprint it at I would love to share your insights!

  2. I've never heard of NeedleAid - I'm glad you found it and glad that it helped you!

    If it makes you feel any better, I actually really hated using the pre-filled Enbrel syringes and switched back to the do-it-yourself kind after about a year. When they pre-fill syringes, they have to add a preservative of some kind, and wow, did it ever sting going in. Like, a lot. I'm so glad you can still get Enbrel that comes separately!

    I hope the injectable MTX helps you! I did notice a bit of an improvement when I switched from pills.

  3. Lisa - Sure, feel free to share this post with your readers. Your orange tutorial was, believe it or not, more than I got. But as long as I can do it, that's what matters.

    Helen - It's a pretty cool gadget. Too bad more doctors don't know about it.

  4. Hi Leslie,
    I've been self-injecting 1 1/2 inch needles for about 5 years now. And I completely identified with what you were saying about sitting there contemplating it for a long time. At first it took me hours to get going. And I would sing songs (oddly enough-"Its raining men-hallelujah!" Not sure how that one came up. My husband was perfectly willing to give them to me in my hip but I was not willing to give him the control. I would wait so long that once I did give the injection, I would pass out. Once I was giving myself injections 9x's a week it became so much easier. But now that I let my husband give me injections in the hip, I find I have to psych myself out when I give them to myself and found the faster I go between all ready and injecting, the better off I am with the passing out feeling.

    I am rambling now, but my question is...I don't know anything about the medications you are taking or the length of needle. I am curious if this product would work for 1 1/2 inch needles plus syringe. It only talked about diabetic type needles on the website-that I could find. I have a friend who has avoided med options that involve needles because of her intense fear.

    Thanks so much and good luck with all your future injections!

  5. Wow, reading this makes me realize how fortunate I am not to have had any needle phobias. I have done multiple types of injections on myself, every day and more, for a long time. The preloaded ones are so much easier, it's true. But in time you'll get speedy with the vials, as well. I have a PICC line now for my IV meds, and it's very simple. I'm glad you found something that makes the process less difficult for you.

  6. I'm curious about whether or not longer needles would work, also. I'm EXTREMELY needle-phobic, so this might be something for me to really check into. Thanks for sharing this, and I'm so glad that it's helping you out so much.

  7. Kelly and Jamie - The product, as far as I can tell, only talks about syringe size - 3/10, 1/2, or 1 cc. My syringe in the 1 cc. It comes with several adapters to fit the needle, and it does seem to me that the others allow for a longer needle to be put in it. The box and website actually say that there is a separate model for injecting MTX, but the one I have works perfectly. Hope this helps!

  8. I emailed the company about whether or not this would work for IM injections. Here's their response: "Thanks for your inquiry. Unfortunately the NeedleAid will not work with longer needles. The maximum length would be about 3/4 ". Sorry to disappoint you. I wish we could have helped."

  9. Jamie - What a bummer! Thanks for following up on that, though. Not sure if this product might work for you:

  10. Hey Leslie,

    Having been through way too many needles and self injections, I say whatever works, right? Happy you found something that makes it easier and less intrusive (emotionally and physically) to get the meds you need. Hopefully it is a little better every day!

  11. That is SO cool that you found a product that helps you overcome your discomfort with the self injection!

    It's not something I've ever had to do. I don't have a fear of needles at all (I overcame it as a young kid thanks to 3x/week allergy shots), but I'm not sure how I'd feel about giving myself an injection. I suspect it's not something you know until you've got the needle in your hand, aimed at yourself.

    Maybe the inquiries from Jamie and others will encourage the company to adapt it for longer needles!