goin’ to shot-town USA

by tinglyfeeling on July 3, 2009

Friday night is shot time for me. My drug of choice is Avonex, which I’ve mentioned before. I’m not sure how helpful it is to document this process for other people suffering from this disease, but perhaps for my friends without MS who read this blog (I think there are a few of you), it will be a helpful illustration of what I have to do once a week.

shot step 1

Step 1! Get the dose out of the fridge. It needs to sit out for about half an hour to get to room temperature, but it can't sit out for more than 7 hours. I don't know what happens after that, though. I usually do my shot late at night, between 10 pm and 1 am.

shot step 2

Step 2! Set up shop. I drink some water (it's important to stay hydrated to combat the flu-like side effects), take two Advil, and set out my ice pack, alcohol and gauze pads, band-aid, needle and pre-filled syringe.

Step 3! Record the date, time, injection site (right or left top thigh, alternating weekly) and any notes about how I’m feeling, what I’ve eaten or anything else that might affect my next-day side effects.

Step 4! Ice my thigh while getting the rest of the stuff ready. The shipments I get every three months come with a bunch of ice packs, so I will never be without. I try to push ice packs on my friends (They’re great for camping! Take some!).


Step 5! Needles. Avonex comes with a 1 1/4" needle. I special order the the 1" needles because, seriously, I don't need that much poking.

pre-filled syringe

Step 6! Make sure the syringe contains the correct dosage of .5 ml.

syringe end

Step 7! Snap the end off the syringe. This part used to make me nervous. I was afraid I'd break the glass syringe when snapping off the end.

needle + syringe 2

Step 8! Affix the needle to the syringe.

Step 9! Clean the injection area with an alcohol pad. The injection site is the part of my thigh between one hand-length from my knee and one hand-length from my hip.

Step 10! Dry the area with a gauze pad. If alcohol is left on the surface of my skin when I do the injection, it will sting. Lots.

Step 11! Stall. I usually count, “1, 2 … 3! …1, 2 … okay, this time I’m going to do it. 1, 2 … for real, this time… 1, 2 …”


Step 12! Suck it up and do it. I like it to be quiet when I do the injection. I think it helps me face what I need to do. It doesn't really hurt that much, unless I screw up, but the anticipation sucks.

Step 13! Apply pressure with gauze to staunch any bleeding.


Step 14! Done! Affix a band-aid.

Step 15! Curl up on the couch and continue watching whatever I’m watching on the TV until I doze off. Tonight it’s “The Machinist.” Christian Bale really needs to eat a sandwich (or 12) and get a grip. Jeeze.

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  • SwissToni

    I think it's helpful to share. I inject the bioset avonex that doesn't need to be kept in the fridge, but I do need to mix it myself. Seems ok, although the thing about this stuff is that you just don't know if it's working or not. I'm lucky though, and I seem to barely get any side-effects at all, bar a slightly fuzzy head and sometimes a feeling that I've been hit by a bus. It's all good though, right?



  • http://twitter.com/msbpodcast msbpodcast

    I hate self-injection. Its an absolutely “ick! I can't watch this!” feeling that comes over me.

    That's why I'm cheering from the sidelines for the aural/ingestion drug delivery systems.

    But I still think that inhalation therapies are truly the smartest way to go when it comes drug delivery. Think of how much stuff happens to things to the things you eat [apart from corn nibblets :] as they go from appetizing into the final product.

    If you sprayed a fine mist containing the few micrograms of drug we actually need, and inhaled it, you'd get it right into the blood stream and eschew all of the destructive digestive tract which take a good idea and turns it into [expletive deleted].

    Its the same trick that the tobacco manufacturers have used for centuries.

  • http://twitter.com/msbpodcast msbpodcast

    The lungs are a permeable membrane where air and blood are separated by the thinnest of materials.

    As asthma medicine manufacturers and the tobacco industry are well aware, air is not the only thing that can get exchanged.

  • http://Wellsphere.com/ Hua

    Great pictures- very detailed. I don't have MS so it really helped to me understand the diease more with the step by step pictures.

  • http://twitter.com/tinglyfeeling tinglyfeeling

    thanks for the comments, everyone!

    I'm glad this was helpful to some of you. It sort of felt like oversharing–along with the “ick” factor of showing the actual injection–but I don't think most people realize just how long that needle is. But it's not so bad now. I'm getting better at just sucking it up and doing it.

    I go for my 1 year check-up in August, with a fresh round of MRIs so hopefully the results will show that the Avonex is working so I don't have to change my routine…

  • http://twitter.com/tinglyfeeling tinglyfeeling

    an aural/injection drug would be a dream come true. let's hope they hurry that up so i don't have to be so cagey about the strange boxes i keep in my fridge. heh.

  • http://twitter.com/tinglyfeeling tinglyfeeling

    when was your last MRI and how long have you been taking avonex? i've just been doing a full dose for about a year now, and i'm happy to report that my side effects are pretty mellow–nearly non-existent these days, although it can depend on the week/day. and i hear you on the hit-by-a-bus feeling. the aches and pains i sometimes experience on saturday mornings can be truly unpleasant, but i take some advil and, placebo or not, they go away within a couple hours usually.

    and yeah, it's all good, or, as i like to say, it is what it is. :-)

  • swisstoni

    I've been injecting for about three months now, and my last MRI was in February this year. My first symptoms were in 2005, but until recently my neurologist could only see the one distinct lesion on my cervical spinal cord. As it happens, he found more lesions on my last MRI, but he had already decided that I should start treatment as it apparently has the best results when taken after as few relapses as possible. Everyone's different though, right, and it is a disease with 1000 faces.

    Ironically, the thing that has most clobbered me is the lumbar puncture I had a couw of weeks ago. I was poleaxed and had to spend the next 8 days flat on my back. I usually take two paracetomol and two ibuprofen before injecting my avonex, but after the LP, was advised to stay off analgesic. You know I said I had few side effects? Last week, without those tablets, I woke up in the small hours of the morning with a SENSATIONAL headache. Never underestimate these drugs, eh?

    You're so right: it definitely is what it is. Little point crying about it as it won't change anything! I've become quite the stoic.

  • http://twitter.com/camdenevelyn Evelyn

    I'm planning to start beta interferons next month, having been diagnosed formally yesterday, and it was really, really awesome to find this post and see what the process entails. Thank you!x

  • http://twitter.com/camdenevelyn Evelyn

    I’m planning to start beta interferons next month, having been diagnosed formally yesterday, and it was really, really awesome to find this post and see what the process entails. Thank you!x

  • http://www.tinglyfeeling.com tinglyfeeling

    Hi Evelyn! Sorry about your diagnosis. I hope you’re adjusting okay since getting that news (apologies for the month-long delay in replying).

    The Avonex injection process has only gotten easier for me since I wrote this post a year ago. I really just go for it now. I’m still not a huge fan of the needle, but when weighed against other things I could be doing, poking myself once a week isn’t so bad.

    Best of luck to you with processing everything you’ll be dealing with now. Please stay in touch and let me know how you’re doing. I’m on Twitter @tinglyfeeling.

    Take care. :-)

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