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02 February 2009

I Can Haz Massive Immunosuppression! [More:]

Lady Enbrel has arrived this morning, encased in a mysterious cold pack and styrofoam and festooned with eerie dayglo medical warning labels.

So now my refridgerator is filled with turkey, cheese, yoghurt and a phalanx of auto-injectors loaded with biologics.

Tea party, anyone? Mr. Whiskers is going to delight us all with a self-injection seminar!
Oh, fun.

Subcu or IM?
IBD? Rheumatoid arthritis?

I self-injected (subcu) a similar drug (Raptiva) weekly for about a year and a half. I admit it made me feel just a little bit badass. Actually I still have my biohazard box here full of sharps -- never bothered to take it to a pharmacy to dump it.

I'll have to go back to self-injecting once the study I'm in goes open-label, in June. For now I have to go in once a month and they inject it.
posted by loiseau 02 February | 12:04
Oh, autoinjectors -- does that mean it's premixed? I had to mix mine. It came as a powder and had to be mixed with saline. Then I got to do that exciting "draw back the plunger, withdraw from vial, flick syringe to bump bubbles to the top, inspect measurements while squirting out extra medication and air" thing they do on doctor TV shows.
posted by loiseau 02 February | 12:08
I have to inject insulin every day, twice a day. Diabetics can use fancy schmancy "pens" to inject (mine is nicer than those shown). I'm sure it's much easier than sticking a needle into a bottle or mixing powders. But I still do have the fun of squirting out extra medication and air.
posted by deborah 02 February | 12:31
Oh man, I've done both, Loiseau. Back when I popped Methotrexate, I had to do all the flicking and measuring stuff. Squicked my wife (now-ex wife) out fierce.

But yeah, badass. I got to realize very quickly on that regimen how the cult of the needle for heroin abusers gets so large in your mind.

But this stuff is all "one click, two clicks and dispose of your needle in the proper container." No mystique at all, which oddly, makes it all that much more eerie.

I had much fun this morning in MST3000-ing my little show-me how video, also. Nothing says Ripe For Irony like a nice man self-injecting in his enormous kitchen with a faithful Bordie Collie standing by.

posted by Lipstick Thespian 02 February | 12:37
Whoa, methotrexate. Respect. It's been brought up before but I've never gone for it. Thank goodness there are starting to be (seemingly) safer options these days.

I like the little clicky pens!
posted by loiseau 02 February | 12:43
Yeah, they're easier. I don't have any weirdness about needles, though. That's one good thing belly fat has going for it.
posted by Lipstick Thespian 02 February | 12:46
Oh well, if you have a Border Collie, you can get them to make up your medication and remind you to administer it ... :-) My BC organizes and critiques my whole life - she has that "you're doing it wrong" expression on her face for much of the day ...
posted by Susurration 02 February | 13:32
Suss - totally. Border Collies are the spiny quiz kids of the dog world.

Now see, a good Portuguese Water Dog, however, is what happens when you feed that same kid a nice brick of hash.
posted by Lipstick Thespian 02 February | 13:47
Sounds like heavy-duty stuff, bud. I hope this means you'll be feeling better soon, though.
posted by BoringPostcards 02 February | 14:32
Ugh.

I hate autoinjectors. The one I have is not exactly "foolproof" - there was one step in the process I often forgot resulting in the medication being squirted into the air instead of into me. I think the step I forget is to take of the red cap before pressing the big button on
This Stupid Device. There should be a mechanism that prevents the button being pressed if the stupid user hasn't removed the cap. Anyway, I find it much quicker & easier to forget about the autoject altogether & just do the damn injection.

Does each dose Enbrel come in it's very own autoject?

Good luck with your new drugs, may they be free of side effects and full of the intended results.
posted by goshling 02 February | 16:02
Hugs and whuffles, LT. What is your condition? I hope this helps dramatically with whatever it is.
posted by taz 02 February | 16:14
Taz - I have rheumatoid psoriatic arthritis. Too much TNF (Tumor Necrosis Fighters?) in my autoimmune system, which makes my skin and bone cells over-reproduce, effectively giving me lizard skin and powderized joints.

What the drug does is suppress the TNF function in my system, thereby getting things back to normal, but also leaving my immune functions open wider to infections.

It's kind of a crap shoot, but I'm reasonably assured that taking this drug is the best course of treatment if I want to walk normally and have normal skin.

Also - nurses that come to your very own home to show you how to self-medicate are by turns adorable and silly.

Also also - it felt weird sticking myself with fancy new needle insertion devices.
posted by Lipstick Thespian 02 February | 19:21
LT, I have P too, though fortunately not PA.

For what it's worth, on Raptiva and on the study drug I'm on right now (ABT-874 if you're nasty) I don't catch more colds/flus etc. I'm actually inclined to believe I catch fewer colds than I have in my life, but I'm a bit afraid I'll jinx my streak by saying so. On Raptiva I definitely bruised easier, is all (plus it never actually cleared me very well). This study drug has actually caused NO side effects whatever. This shit is the shit. (In fact I go in to the office in the morning for my next jab.)

A similar one has just been approved in Canada, actually: newly christened ustekinumab. Supposed to have success rates similar to ABT-874 and was studied for PA (though I can't quote statistics).

I am a fan of the belly injection too -- soft! painless! -- but the nurse has been delivering this one in the upper arm, which I find a bit more painful (and also a little difficult to give to myself).

To be honest I'm pretty happy not doing it myself for the past 7 months I've been in the study. I was always afraid I was going to forget a step. I know one time I forgot to pull back a bit before pressing the plunger, and then was terrified that I'd just injected this potent immune suppressant into a vein and was about to die. Plus I was giving myself a bruise like a full third of the time -- I guess I don't have any finesse.
posted by loiseau 03 February | 03:13
And... doing some reading I see that Enbrel isn't even a monoclonal antibody... so my Raptiva/ABT-874 experiences are not so relevant.
posted by loiseau 03 February | 03:27
Good luck with it, LT! Thanks for the explanation.
posted by taz 03 February | 03:36
And... doing some reading I see that Enbrel isn't even a monoclonal antibody


But it's been training real hard in the off-season and everyone associated with Enbrel says this could be her breakout year!

hee hee. Fun with potent proteins!
posted by Lipstick Thespian 03 February | 07:33
How do you feel about STUFF? || Looks like I owe the IRS $20.000

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