Neupogen

I hated the sight of needles growing up. I would always turn my head away as the sharp metal went under my skin for a vaccine shot. Even as a 24 year old, Nurses would have to remind me to exhale as I would unknowingly hold my breath during a routine blood draw. About 2 years ago, there was an incident at an injection clinic when I almost fainted. The room got very dark and my ears were ringing. I had to lie down and drink some water for a few minutes. I wouldn't say that I was deathly afraid of needles, but there was just something unnerving about the whole process that would cause an elevated beat in my heart, cold sweat to form in my palms and my mouth to dry up like I had just swallowed a spoonful of sand.

(Side note: I totally understand why people who are afraid of needles refuse to register to become donors. I never said it was easy to become a donor. It is a huge sacrifice and a very serious commitment. However, if you could overcome your fear of needles, YOU COULD SAVE SOMEONE'S LIFE....)

Never did I imagine that I would one day have to give myself daily needle injections.

This entry is about how I give myself shots to boost my white blood cell count. It's been about 2 months since my last shot of Neupogen (10/30/07) so I want to write down my notes in case I ever need to give myself one again. It's pretty amazing how fast I forget things these days. I'm just writing this down for myself. Maybe it will help some other patient who wants a refresher from the training he/she received in the hospital, but please note, I am not an expert. This is what I learned during my training session and I would recommend using the instructions your doctor gave you. I was considering taking pictures of me giving myself a shot, but I didn't want to gross people out.

How Michelle shoots up -
1. Get all of your supplies ready. I take my vial of Neupogen out of the fridge for about 15 minutes before my shot because I heard it can sting when the medicine is cold. Open up about 3 packets of alcohol pads for cleaning. Also open the package that the syringe is in. Lay the syringe on the package until you are ready to use it.

2. Give those hands a good scrub with antibacterial soap. When you are done try not to let the water run down your fingers. Stick your hands upward so the water runs down your arms. Dry with paper towels NOT cloth towels because the cloth might carry bacteria.

3. Remove the cap of the Neupogen vial and use an alcohol pad to rub the rubber top. Rub for about 30 seconds.

4. Take the syringe, with the cap on, and make sure that the needle is secured tightly on top. The needle I use is a twist-off so make sure it's on tight by twisting the top part with the cap on clockwise.

5. Remove the cap on the syringe. Draw the syringe plunger back to fill it with air equivalent to the same amount of neupogen you will be administering. I get 2mls per shot.

6. Pierce the rubber top of the vial at a 90 degree angle with the needle. It's okay if the needle doesn't go in perfectly straight. Just don't bend the needle.

7. Push the plunger so that the air in the syringe gets pushed into the vial. This will cause air pressure so that the medicine will easily flow into the syringe.

8. Turn the syringe upward (the vial will be upside down). Pull the plunger back so that you get 2mls of the neupogen. While you are filling the syringe make sure the needle is always submerged in the liquid to avoid air bubbles. To do this, you will have to slowly move the needle downward.

9. If you get air bubbles flick the side of the syringe with your fingers so the bubbles go to the top. Push the plunger to push the bubbles back into the vial. Continue the pushing and pulling until you get the right amount of the medication. You may not be able to get all of the air bubbles out, but try your best.

10. Pick an area about 2 inches away from your belly button. Clean your skin thoroughly with an alcohol pad.

11. With one hand, pinch your skin with your thumb and index finger. With the other hand, hold the syringe like a dart. Insert the needle into the skin at a 90 degree angle. Sometimes the needle may not go in at first, you may need to add a little force. After the initial puncture it should slide in easily. Only push it until the needle is completely inserted into your skin. Don't push it too hard.

12. Let go of the pinched skin and then slowly push the plunger inwards until all of the medicine goes in. I've noticed that doing this slowly reduces the amount of bruising. (At this point, remind yourself to breath!)

13. Pull the needle straight out of your skin. Do not put the cap back on (so that people know it's been used). Disposed the open needle in a coffee can or yogurt container.

14. If the area is bleeding, gently wipe with an alcohol pad.

Seems like a lot of steps, but it becomes quite routine after the first couple of times. It takes me only 2 minutes to perform the whole process now. I still have to get myself mentally fired up everytime I give myself a shot, but it's a piece of cake.