Wednesday, April 21, 2010

Methotrexate Dart

I have no idea what's going on, but tonight I just couldn't seem to bring myself to do my Methotrexate injection at first.

I'd had trouble loading the syringe – this is the second time a syringe has leaked on me.

The first time, I started off thinking I was being clever: I'd noticed that I'd often get a big bubble in the syringe, so I decided to do things differently. I'd just been sticking the syringe in the vial, then inverting it and drawing the medication, which is what my rheumatologist had shown me to do. But she'd also given me some written instructions, and on those it said to draw half a dose of air into the syringe first, inject that into the vial, then draw the medication into the syringe. So that's what I did.


Methotrexate everywhere! It all started dribbling down the syringe onto my hands and then the floor.

OK, not a good idea. Why it didn't work, I have no idea. So I've never done it that way again.

Tonight, I just had a big air bubble I was trying to get rid of. I know the instructions say bubbles really aren't that big a problem, but I still wanted to get rid of it, so I flicked the syringe and injected the Methotrexate back into the vial a couple of times, then drew it back out, when, tada!!, leaking again!!!!

Then the difficulty with the Methotrexate dart (hence the post title). Lately, I've been hesitating when I've gone to dart the syringe into my stomach. Not by much, but still.

Tonight, my brain froze and so did my hand. Stomach was all pinched and ready to go, brain and hand did not want to cooperate.

I seriously counted to 10 about 5 times, each time saying, OK on 10 I'm going to do it!!

Finally, I did do it (because, really, the alternative is what? pain? stiffness? not moving at all?). But I did it slowly, and I had to puncture the skin consciously – which I'm sure you'll all agree is not the preferred mode of injection – but I did it.

What is up with that?????????????????????????????????????


  1. I think it's instinct, Laurie, that's what's up with that. It's simply against our instincts to purposefully puncture ourselves (which is probably a good thing). So first, it's that. Then, because we *know* this is going to hurt, even just a little bit, our brain works real hard to talk us out of it. Finally, I think there's a still, small, place in our minds that recoils from not only injecting a foreign substance into our bloodstream, but also from the fact of having a disease that requires such a drastic measure. And that's my two cent's worth.

    You may have had to force yourself to do this again tonight, but I want you to know that I think you're pretty cool and pretty brave -- as often as I read of others doing this, I'm not entirely sure I could do it myself. Now my fingers are crossed that the MTX will make you feel a whole lot better -- the reward for perseverance and guts.

    Hang in there. I'm out here cheering for you.

  2. Thanks, Wren. Wow, can you say astute! Yes, I'm sure it's exactly all those reasons – sigh...

    Now to keep it from becoming a real issue...

    Lordy! (Ha, love that word! One of my fave words. Will some day share my other fave words, although might offend some with one of them lol!)

    ;) L

  3. Laurie, that is exactly what I did last week! I hesitated, and ended up with the needle sitting against my skin and had to poke it through sooooo slowly! Ouch! I don't know what's wrong with me, either.

    I'm going to try again tonight. Glad to know it's not just me!

  4. Awful, isn't it, Helen? I hope you're able to do the dart tonight! Let us know how it goes, and I hope your sore throat is better and your appetite has picked up!

    :) L

  5. I have never given myself injections but just wondered, what do you do if your fingers are stiff? Are you always physically able to give the shot to yourself?

  6. Hi Cathy,

    Luckily I've never been too stiff to give myself a shot. When I started doing the injections in the first place, I was on Prednisone and that was masking my symptoms pretty well and by the time I tapered off that, the Enbrel/Methotrexate combo had kicked in re taking care of the stiffness.

    I know in the instructions I linked to in the post, it mentions ways you can adapt holding the syringe, etc., if you are stiff, although I can't imagine it's easy. I get sore holding a position too long, but that's not a problem in this scenario...

    :) L

    P.S. Thanks for dropping by!

  7. Temporary freak-out? The quite reasonable instinct not to self-harm taking over from your brain?

    It's interesting that you're injecting meth yourself. When I was on it just 6-7 years ago, I had to get it done by a doctor. Not a nurse, a doctor. And now people are doing it at home...

  8. OOOWWWW!!
    I sure hope this is a very short phase for you, Laurie. That sounds hard.
    Oh, and congratulations on doing it anyway :D

  9. I hope so, too, WS! And thanks!

    :) L

  10. Yes, Thursday was a success! I seem to go through cycles like this sometimes - it'll be easy as pie for a few months, and then suddenly I'll begin to hesitate. Hopefully I'm back to quick-and-easy now. And you, too!

  11. Laurie - I've gone through the same counting, bargaining and pleading with myself for my Enbrel injections. I didn't know that MTX could come in an injction - I have only taken it orally. Is there a greater benefit to taking it by injection?

    Next time, try promising yourself a small bit of Toblerone - it might not help with the injection, but it will bring a smile when you are eating it afterwards!

  12. Excellent, Helen! Glad to hear it! Hopefully it will be the same for me next week!! :) L

  13. Hi Megan,

    My understanding is that because subcutaneous injections of Methotrexate are entirely absorbed by the body, the injections are actually better, with no increase in adverse reactions.

    Check out this link about a study of the efficacy of subcutaneous injections of MTX versus oral MTX for more info:

    Here's an article explaining the results of the study:

    I'm sure these is even more info on the Net; I just did a quick search for you!

    :) L

  14. Hi :-)

    I have had ra for 20 years and been on mtx for many years now.

    I was on tabs but after feeling increasingly sick decided to try the injections. Here in the UK the doses are already measured, (much easier), and I just put the needle on to it.

    Six months later I just stopped injecting as I couldn't bring myself to do it anymore. I simply could not hack it :-( Needless to say I thought I would be well . . . wrong . . . but atleast I knew just how much I needed the meds.

    Back on tabs now. I take them with food; how I wish they were sugar coated! Then spend 24-48 hours in bed.

    Good luck with your injections. If you can, do try to tackle the slow stab etc now. You CAN do it if you sort the issue early on and not like me allow it to grow.

    Good Luck. Sue Nicholson, (I don't blog anymore but I am on facebook)

  15. Hey Sue,

    Thanks for commenting. What a great idea re the pre-filled syringes!

    I'm sure I can get over it (I say with fingers crossed!). I think it was just the stupid buildup with syringe difficulties and least I hope so. And I know the oral stuff would make me feel worse, and I really don't want to go that route, so not a lot of options. Anyway, we'll see next week!

    Take care and hope to see you back!

    :) Laurie

  16. Big hugs! Been there! Though not with methotrexate (I start the pills tonight, was dx on Wednesday)... I have had type 1 diabetes for 17 years and during the first few months of having it I had the same paralysis with the shot- the dart-too much anticipation and I'd just freeze up completely. It got so bad that I would avoid taking my insulin, which was dangerous (thankfully I was in a honeymoon period so I didn't die!)... I found that jabbing myself quickly and smoothly, but not darting it- more of a fluid and slower than darting motion, made it easier. I wear a pump and another medical device now, and I still can't dart... I also don't know what syringes are used for methotrexate- but I know BD makes an auto-injector gadget that fits around some syringes -that way you just press a button and it does the darting for you (and then you press the plunger)... Might be worth asking the pharmacist... Big hugs! I'm really enjoying your blog!

  17. Thanks for the info, beclever.

    I'm so sorry to hear about your diagnosis – and on top of diabetes, too. Keep in touch and let me know how things go for you!

    Take care, enjoy the weekend, and may the sun be shining where you are!

    :) Laurie

  18. Late to the conversation, Laurie. AND...I appreciate your post on Methotrexate injections. Good news: my RA, Lupus & Sjogren's are quiet due to the medication--woo hoo. Bad news: I. Just. Can't. Do. It. Ack--I'm a wuss. Luckily, my husband has no problem stabbing me with a needle into my stomach. My rheumatologist freaked me out by telling me that the medication is so toxic, I can use the needle over and over. Again, good/bad news. :^) Ah well. I hope things are good for you--I'll be following!

  19. Thanks for dropping by, Debbie, and sorry for taking so long to respond... Last two times, friends have done a countdown for me. Seems to have helped! :) L