I Gave Myself a Shot!

Yesterday I planned to write about my clinic visit, but I became too sick. Feeling better now.

Alyssa took so much blood from me yesterday! I believe it was 13 tubes. Things were going well until the last two. My vein was getting tapped out, and Alyssa had to move the needle around. Not enjoyable, but it was not terrible--I have had worse.

I had long series of tests, including one that I totally rocked (symbols representing number 1-9, you had to say what the symbols on the page represented using the key at the top--I memorized the key) and one that I totally bombed (a man saying numbers a couple of seconds apart--you had to add the last two numbers presented, like 1 4 (5) 6 (10) 1 (7) etc.). I also rocked the 25-foot walk, and I think I did a little worse than before on the peg test but probably still normal. I think I did fine on the vision test, but they did not tell me. A different research tech did these tests with me, and I like her a lot better than Michelle. Her name was Erica. She gave me a hug and said she would be praying for me.

I cried a little when Dr. Andy asked about cognition. He is so sweet and seems genuinely interested in how my symptoms impact me in the real world. He wanted to make sure that I am using what strategies I know, which I mostly am. He made me tear up again as he was leaving, when he said to hang in there, that he would be pulling for me and hoping I respond well to the medication.

I asked for a neuropsychological evaluation, which I will get. Apparently there is a neuropsych who was an SLP before going to medical school. Awesome! That is Dr. Holly. Hopefully I can see her, although there probably will be a wait.

And I asked for PT, which Dr. Rick did not seem inclined to write a prescription for. I am not sure I need one anyway. But I explained why I want PT, and he accepted that and wrote the script. Now I need to figure out whom to see. I emailed a PT I know who works with children; maybe she knows someone who works with adults.

Alyssa, the nurse, gave me the subcutaneous (under the skin, like diabetics) injection. Again, the subcu injection could be DAC HYP (daclizumab, the excellent-in-Phase 2-experiemental drug) or placebo. The intramuscular (IM) injection could be Avonex or placebo. I take both, but one is placebo and one is a real drug. I do not know which, and my clinic staff do not know which; the study is double blind. I am known by a number to the place controlling the study and sending out the meds/placebos.

So I go the subcu injection, which was fine until she pushed the medication in. It stung!! It stung for less than five minutes, but yowtch. Reminded me of when I have had the numbing medication injected into my face or neck to remove moles. This just lasted a little longer, since there was no nice numbness following it.

Then Alyssa taught me how to give myself the IM injection. The needle was long! I mean, not super long. It was 1.25 inches. It was not hard to understand how to give the injection: straight in, to the hilt. I practiced twice on a dummy skin thing. Wash hands, clean site with alcohol, open gauze, open needle package, pop the top off the syringe thing, screw the needle on, hold the skin taut (which Alyssa called taunt), push the needle in at a 90 degree angle, push the plunger down slowly, pull the needle straight out, put the gauze on, apply a band-aid.

Alyssa showed me a few ways to hold the syringe, and I chose what seemed like it would work for me. She showed me how to select a site. After practicing twice, I did not see what more I could gain from continued practice. I said I was ready for the real thing.

As I held the needle over my thigh, I began to move it downward, but something stopped me about three inches from my skin. Of course I stopped me. But it did not feel like I tried to stop. I had a little talk with myself. This is not going to get easier if I wait. Just do it. Go. Go. Go now. And then I did.

Just as Alyssa began to say that it was okay to take my time, I pushed the needle in. Quickly but not roughly. I wanted to stop or pull it back out, but thank goodness my intellect took over. That would have only made it worse. Even when I felt it go through different levels of resistance and I had a moment of panic wondering what I had hit, I kept pushing. Then it stopped itself. I pushed the plunger down slowly. I checked with Alyssa that I had injected it all and could remove the needle. I pulled it straight out. I quickly put the gauze pad over it. Then I cried.

Alyssa was exclaiming over my perfect technique and how she should have videotaped that, how she had never seen a patient give a perfect injection the first time. She stopped when she noticed me crying. She got me gauze to use as a tissue and rubbed my back, trying to get me to talk to her about it. I did talk a little.

I did not really know why I cried. But I told her that I am overwhelmed by having MS, that I am not finished grieving it, that I go through different stages. Lately I have been in more of a denial phase, saying that I do not want to have MS, that maybe it is a mistake, etc. She said that it is okay to feel whatever I feel, that I am doing the right thing by being involved in the study and taking my medications. She said there is no better place to be for MS care.

After my shot victory and minor breakdown, we went to another building for my MRI. That was the best MRI ever. I got to watch the cooking channel! Rachael Ray and Ina Garten--not my favorites, but beggars definitely cannot be choosers.

I was feeling kind of run down by the time I left, but all in all, it was a good day. I am grateful that I am in the study and that I live near a world-renowned MS center.