10/14 -- Ready, Aim, Inject.
The lobby of the Reston Medical Center always has a peculiar, cloying, sweetish scent. I think the cleaning crew must use some kind of potpourri air freshener; I walk in and smell cinnamon, vanilla, and cloves.
It's probably supposed to be pleasant and reassuring, but I've come to associate that smell with Very Bad Things: MRIs, spinal taps, being told you might have MS, and being told you do have MS. Bill and I enter the building and that scent hits my nose and my heart instantly sinks. Abandon all hope, ye who enter here. Or something like that.
We went there on Wednesday to learn how to give me my daily shot of Copaxone. The medication finally arrived a week ago; Bill picked it up from CVS on the day we left for Baltimore. It was a nasty little reality check. I'm used to returning home from the pharmacy with little prescription bottles. Bill brought in four big blue boxes: one with vials of sterile water, one with a month's supply of one kind of syringe, one box with the other syringes and alcohol wipes, and finally the box of Copaxone itself, which had to go right into the fridge.
He put it away and we both stood in the kitchen feeling glum. "This makes it a lot more real, doesn't it?" Bill said. Yes. It did. Nothing like a production like that to drive home the point: You're sick. You've got a big problem. We escaped to Baltimore pretty soon after that and forgot about it for a little while longer.
Before the appointment, we watched the video supplied in my little MS care package, which talks all about the modern wonder that is Copaxone and features a very attractive young woman (an actual MS patient) preparing and giving herself the shot. The process looked a little complicated, but I guessed that once Fran coached me through it, it wouldn't seem like such a big deal. I guessed wrong.
You open the vials of sterile water and Copaxone and clean off their tops with an alcohol wipe. You open the first syringe, draw it back to the 1.1 ml mark, and inject the air into the sterile water vial. Then you draw the water out to the 1.1 ml mark. Then you inject the water into the Copaxone vial. But point the needle toward the side of the vial while you're squirting, or else you'll make too many bubbles. Bubbles are bad. Swirl (don't shake) the vial to dissolve the cake of Copaxone. (You swirl because shaking makes bubbles, too.) Then open the second syringe and draw it back to the 1 ml mark. Inject the air into the Copaxone vial. Draw the medication out into the syringe, checking vigilantly for bubbles and injecting the solution back into the vial if you see any.
No matter how nervous the idea of giving yourself a shot might make you, by the time you've gotten through all the above jazz, you'll be grateful that it's the only step remaining. You wipe off the injection site of the day with an alcohol wipe, pinch up a 2-inch fold of skin on one of the seven approved injection sites, and give yourself the shot, which I found far and away the easiest step of the whole process on Wednesday. Fran had to be somewhere soon after this appointment and seemed a little harried, and I couldn't stop making bubbles because I'd be so focused on drawing the syringes back to the correct mark that I wouldn't notice that the needle tip was above the liquid level and drawing air until it was too late. Fran kept saying "It's okay; you're not a nurse; it takes practice" but I felt like an idiot anyhow.
I got through the shot okay, but it stung a little afterwards and a red lump started growing on my thigh. (That's a fairly normal side effect, according to all my Copaxone literature.) Fran brought me an ice pack and then went off for her next appointment. I glanced over and saw a package of smelling salts on a nearby tray. "Ha! Look at that! They're really prepared in here, huh?" I chortled to Bill.
Stupid me -- I laughed too soon. A few moments later, the stinging and the nerves and the relief that it was over and the cramped heat of the little room got to me and I got woozy. I put my head down on the table until Bill hauled me into an empty exam room so I could lay flat. I didn't pull a complete lights-out-nobody's-home like I did in that dentist's office, nor did I attract an enormous audience, thank God. I recovered pretty quickly and we went home.
The next night, Bill coached me through the injection. I fussed over every bubble in the syringe and wondered why the hell they can't just sell this stuff pre-mixed and ready to go. Or put it in a pill. Pills would be nice. (Never mind that I hate swallowing pills to the point of near-phobia, but that's another whine for another entry.)
Last night, I prepared it very quickly and painlessly and Bill gave me the shot in the back of my arm. Finally, it's getting easier.
In other news: On Friday night, we went into Georgetown to see our friend Tom perform in a staged reading by a local theater group. (Tom, a fellow OLJer, writes about the rehearsals in this hilarious entry.) The readings were all from plays and literary works with appearances from evil figures like the Devil, witches, evil stepmothers and, of course, lawyers. (Shudder.) The show took place in an actual church, no less. The church has apparently donated its space and time to many arts groups over the years, but you couldn't escape the feeling that you were probably going to go to Hell for this, anyhow.
But it was a fun and well-done show, so it'll be worth it. I'll save Tom a shady spot if I get down there first.