A Spork in the Road

Okay, so the details aren’t so gory, at least not in context, but what you are about to read may displease those who are not accustomed to discussing intimate medical details over a pastrami sandwich. In the future I will always tag these posts with the “too much information” tag so that you know when I’m delving into the details of treatment.

So if the topics of needles, bone pain, bowel movements, and the like are not your preferred reading, skip this post and wait till I talk about something like acting, the insanity of dogs, or Floridian bird life. You’ll sleep better.

Last week, as readers know, I had Neupogen shots Tuesday through Sunday. By Thursday I had asked my nurse to show me how to do it so I could go into the weekend feeling confident about self administering the shots.

Giving myself the shot was actually pretty simple, and the element of control compensated for the weirdness of sticking myself with a needle. I’d read in several places that administering the shot in the belly helped to diminish the bone pain side effects, and it’s also a little easier than giving it in the thigh.

The steps I followed were:
1. Pick a freckle as a landmark (I have plenty to go by).
2. Swab the area with alcohol pad and let dry.
3. Uncap needle and squeeze air out of syringe.
4. Pinch up some belly fat.
5. Hold syringe like a dart (to avoid accidentally plunging the syringe too soon).
6. Insert needle quickly into belly fat.
7. Slowly plunge syringe (Neupogen can sting if administered too quickly; this is where the element of control came in handy, because I could go slow enough that it didn’t sting at all).
8. Pull syringe out and cover injection site with Band-aid.

Ta-da!

I’ll admit it was a little weird on Saturday when I administered the shot, because I wasn’t in the safety of my oncology office with nurses supervising, so I had a brief panic that I’d done something wrong. Then I calmed down and felt better, and Sunday afternoon I was done quickly and without worry.

Not that I’d choose to do this as a pasttime.

The injection site was always a little sore for anywhere from 15-30 minutes after injection. I also discovered the Neupogen gave me diarrhea if I ate within two or three hours of having the shot. So I’d administer it about three hours after lunch and then wait three hours to eat dinner. Even when I did have diarrhea, it was only one or two bouts and then I was back to normal. In fact, I think the Neupogen may have help normalize my bowel movements over all, after the mild constipation caused by all my OTHER meds. Or maybe I was just far enough away from chemo and anti-nausea meds that things normalized on their own.

The joy of chemo: speculating about which of my oodles of meds are interacting in what way.

Anyway, other than the diarrhea, and occasional mild queasiness, I did have very minor bone pain. It usually kicked in within half an hour of the shot and twinged various bones very briefly (like a 2-second twinge of pain that then disappeared). For me, the bones that twinged were my femurs, pelvic bones, shoulders, and (oddly enough) the bones in my hands. I did wake up a couple of nights with a dull ache in my hip bones, but two Extra Strength Tylenol took care of that entirely.

(May all the gods and goddesses of every religion and era bestow their gracious blessings upon Extra Strength Tylenol, upon whose altar I stack sweet offerings of sugar-free applesauce and frozen Ensure. Amen.)

So my fears of excruciating bone pain with Neupogen have so far gone unrealized. Today I had my first Neulasta shot at 10:00am, and I’m waiting to see how my body handles that. The nurses said that, on average, people seem to have more side effects from Neupogen than from Neulasta, and that the body handles both more or less the same. I will say that so far the injection site from the Neulasta has not been sore, and I haven’t had the immediate bone twinging that I had with Neupogen. So we’ll see.

I know Neulasta has some potential long-term effects, about which I try not to think, but DAMN is it worth it. After being terrified that I’d have to go on Neulasta, now I’m overjoyed that my immune system is getting such an effective boost.