A lesson in subcutaneous injections

By Monday I was feeling somewhat better. When I woke up, I felt well enough to cook breakfast for Mike and I, so I knew that things were looking up. However, in the middle of my cooking ordeal, I began to feel extremely weak and my stomach suddenly began to churn once again. I sat on the floor and attempted to regain my strength--but it didn't appear to help. Mike took over and finished cooking the meal, which I no longer felt I could eat. I forced down half of the omellette and was able to drink a glass of apple juice. This was still an accomplishment in comparison to the previous day.

It was now approx. 72 hours following the second treatment, which meant that I was soon scheduled for my very first shot of Neupogen. If you've been reading all along, you will probably remember that my first round of chemo had to be extended due to my low white blood cell count (white blood cells are essential for immune function). The white blood cells need to be at a certain level the day before each chemo treatment, otherwise the treatment must be extended to give the cells a chance to replenish themsleves. Because mine were not at the required level last time, the doctor decided that I should be taking shots of Neupogen from now on to ensure that I will recieve the remaining treatments on time. Neupogen is a drug administered through subcutaneous injection (or injection into tissue) that stimulates the production of white blood cells.

Mike and I headed to the cancer unit at 3pm, where we were to meet with a nurse at the cancer unit to receive a lesson in administering the Neupogen at home. This time, I arrived at the hospital looking and feeling UNwell, unlike three days previous. I wore only my funky little hat and joggers and still felt faintly nauseated and very tired. As soon as I arrived, I was taken into the chemo room and was again mauled by the chemo nurses, who were wondering how I was handling the second treatment. I told them about my awful weekend and they immediately wanted to help. I must add here that the nurses in the chemotherapy room at the CBR hospital are amazing. They are extremely compassionate and helpful and have created a kind of family-like atmosphere within the cancer unit. You always feel cared for and "looked after" when you arrive and all the nurses act as though they've known you for years. It really eases the pain associated with visits to the chemotherapy room.

So, being the kind women they are, the chemo nurses immediately ran off to fetch Dr. MacCormick and see what kind of medication they may be able to give me to ease the nausea and provide me with some comfort. The result was an IV full of steroids, which was supposedly a great cure for nausea. Soon enough I was being poked once again with needles and fed once again with drugs (did I mention that I HATE drugs?).

While I was being fed steroids, one of the nurses gave us the lesson in injecting Neupogen. She first gave me a fancy zippered pouch in which she placed needles, alcohol swabs and an ice pack, which was meant to keep the medication cool. She then taught us how to draw the 1ml of fluid from the vile and into the needle (puncture the top of the vile with the needle, pull out the liquid, push the tip of the needle in until a tiny bit of liquid seeps out the end, then tap to rid of any air bubbles). We were then told that we should administer the needle in either the top of the legs, in the stomach, or in the back of the arm. We were to pull up a piece of tissue, quickly stick the needle into the tissue at a 45 degree angle, release the tissue from the grip, and then very slowly inject the fluid into the tissue.

The very thought of all of this made me want to cringe. How did I get into all this mess??? I never minded needles in the past, but this experience has made me come to hate them. Although I thought that the more needles I got, the easier it would be become, it actually seems to have become more difficult with each needle. This is likely because I have had some rather painful needles of different varieties throughout this experience and have come to fear them.

The next step in the lesson was a demonstration. Eeeeek! The nurse would administer the first needle at the hospital and I would wait an hour to ensure no reactions would take place. When the needle was overwith, Michael and I were left to practise drawing fluid from viles with needles for an hour ... a wonderful way to spend Mike's first day of Christmas vacation!

When our hour's wait was up, were sent off with our little blue bag of needles and drugs in hopes that the steroids would give me a more comfortable evening.