So Monday (30th) was the day that I finally began
my cimzia treatment. I was mixture of nervous and excited. Even though the
treatment is due to take 3 months to start taking any effect, it was good to
know that it was finally starting and there would eventually be a point 3
months down the line where I can hope to feel some relief by (if the drug
works).
I met with the nurse from BUPA on Monday. I had took the
packet (containing 2 syringes) from the fridge 45 minutes before the
appointment. This was to bring the liquid inside to room temperature. The
liquid is very thick and gloopy and it is difficult to push the plunger
regularly, impossible if the fluid is nearly frozen.
The nurse was lovely and talked me through the treatment
from the beginning. We also went over the usual questionnaire about feeling
well, taking medication, are you pregnant, do you have a pacemaker, etc. The
nurse had her own set of example syringes for practicing injections and a model
to practice injecting on. There are two sites of injection recommended for this
drug: the thigh and the stomach. The injections are intramuscular so you don’t
have to worry about finding a vein. The needles are not long enough to cause
any damage to underlying nerves and blood vessels in these areas. I decided to
inject myself the first time in the stomach, which I was a little nervous about.
The thought of stabbing a needle into your stomach isn’t the most appealing
though, but my rationale was it was better to do the one I was more worried
about in the presence of the nurse. The packet contains some alcohol wipes to clean the area,
but the nurse advised they are particularly harsh. You don’t have to use them
if you don’t want to, as long as your skin is visible clean and you’ve showered
that day. Most peoples’ stomachs and thighs aren’t on show all day to get that
dirty anyway.
After removing the protective covering over the needle, the
initial step was the remove the air bubble from the syringe. Done by holding up
the syringe and watching the bubble rise to the surface, then gently pushing
the plunger to expel the air. This was accompanied by an obvious hissing sound
and obvious when finished as liquid began to slowly collect on the end of the
syringe. There is absolutely no harm in injecting the air bubble if you can’t
for some reason remove it all, or if you forget, which I pretty much did about
5 minutes later with the second syringe. This is okay for the intramuscular
injections in the thigh and stomach. It would be an entirely different and
potentially fatal matter – google ‘Air Embolism’. A large enough air bubble can
block blood supply to the heart or brain, result in heart failure or stroke. As
healthcare standards in the UK are high, air embolisms are rare. A special
shout out to any scuba divers out there, air embolisms are most prevalent in
scuba divers so be aware of the symptoms of the bends/decompression
sickness/air embolisms etc. It’s nothing to worry about for my injections and I’m
pretty sure I will forget to remove the air bubble on several occasions.
It took a bit of psyching up to start but it ended up being
quite anti-climactic. The skin model was quite deceptive, it took a lot more
force to puncture my own stomach than the model. The recommendation is to push
the needle in at a 90 degree again with speed. The slower you go, the more it
will hurt (as counter intuitive as it felt!). I pinched a bit of the skin and
pushed the needle straight in on the second attempt, after realising how tough
the skin actually was. It was entirely painless going in. Didn’t feel a thing.
The nurse instructed me to push the plunger down slowly. I couldn’t have pushed
it any faster if I tried as the liquid was so thick it was barely moving. The
liquid did sting a little going in the first time. It was noticeably stingier
injecting the second syringe but this is normal.
The nurse advised I may feel a lump at the injection site as
the liquid is thick and this should disperse in a few hours. I may also
experience whitening of the skin or redness at this injection site, all should dissipate
a few hours after injecting. I didn’t experience any of these the first time. I
removed the needles, wiped away the excess fluid and had two tiny puncture
marks to show for it. They were in fact so unremarkable it wasn’t even worth
taking a picture of them to show (I tried and even I couldn’t differentiate
them from my other skin marks/psoriasis etc.). I disposed of my needles in the sharps
bin provided and that was pretty much it over. The nurse advised I may
experience some side effects (detailed in the booklet in the packet) when I
first inject but she chose not to linger on the side effects too much.
So that’s me started. It’s quite a relief to have started
and hopefully in the coming three months’ time, I should see a difference in
the amount of pain I’m experiencing and my range of movement and flexibility if
it works. So for the next 3 months, I have to take two syringes for the next
two sets of injections, then one syringe every two weeks after. I also have to
have my bloods tested every two weeks for the 3 months to monitor any changes.
Now it’s just a waiting game but it’s good to be finally started and hopefully
sometime soon should be seeing some results :)
Robyn x
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