Good or bad, you never forget your first. First times forever hold a special place in your heart and mind. I can remember my first kiss, by Michael Moody in first grade. I remember my first bike ride, first best friend, and my first love. I can also remember my first scary movie, my first heart break, and my first pet loss…my dog Elvis. Well, yesterday I experienced another first. My first self-administered methotrexate injection.
Now, you are probably reading this wondering why this is a big deal. Well, I am so glad you asked. This first self-administered injection was also my first acknowledgement of being in some serious crohn’s denial. Yes, you read that correctly and I know you are very confused, so I will explain. I have always acknowledged the seriousness of crohn’s disease itself, but when speaking about MY crohn’s I always minimized it with “oh its not that bad because I am not on those next tier meds.” Despite going from 132lbs to 115lbs, developing mouth sores and severe fatigue, having previous skin manifestations such as erythema nodosum, and watching my doctors add medication after medication without significant improvement, I held fast that MY crohn’s was in check. I somehow managed to mentally put MY crohn’s off in a class by itself and make it different from the crohn’s suffered by others. Doing this meant I conceptually understood crohn’s, but did not fully invest in the treatment of my own crohn’s. I did the minimum…because it wasn’t that bad. Oh, the lies we tell ourselves to survive. When my doctors added remicade several years ago, I told myself that they were just being proactive and aggressively treating my crohn’s, because IF it got out of hand, THEN it would be bad but we were not quite there yet. But, after my recent flare and hospitalization this week, my GI said the words no crohnie (what we call each other) wants to hear, “your crohn’s is not completely controlled by the remicade, and we need to add a next level med because the other med we introduced did not work”. Those words hit me like a brick to the face.
Several months ago both my GI and Rheumatologist suggested methotrexate to address my crohn’s and inflammatory arthritis symptoms. But, after giving my stern “ummmm no”, we all agreed to sulfasalazine as a compromise. Unfortunately, after two months there was no improvement. In fact, it seemed as if my body became more upset. So, after much consideration and the brick to the face from my GI, I decided that Friday August 14, 2015 would be methotrexate injection day. To prepare for injection day, I purchased a sharps container from Walgreen’s to hold my used needles, alcohol wipes, cotton balls, band-aids, insulin needles, and picked up my methotrexate prescription. I also made an appointment with my GI’s nurse to learn how to inject the medicine. Every day until injection day, I sat at my kitchen table and stared at the supplies while watching youtube videos of people giving themselves methotrexate. As you can imagine, those videos scared me half to death. Friends, only google or youtube “people injecting themselves” if you have a great therapist. Despite being slightly traumatized, I held my ground that August 14th would still be injection day.
They say time flies when you’re having fun. If that’s true, then I am not sure why injection day approached so fast because I was having zero fun anticipating that day. In fact, I spent weeks wishing I could freeze time and delay it…needless to say I couldn’t. So, despite my attempts to freeze time, August 14, 2015 finally arrived. That day was a day of both excitement and dread. I was excited because it was remicade day and I was getting this disobedient body back under control. But, I also had this overwhelming feeling of dread because I knew after my remicade infusion I would have to give myself the methotrexate injection.
I arrived home from my remicade infusion around 6pm. Normally after my infusion I am exhausted, but after this infusion I was up and ready to rock and roll. It was almost as if my body was daring me to actually go through with the injection…because truthfully I was terrified. I slowly walked in the house, grabbed my bag of supplies from the closet and placed everything on the kitchen table. Overwhelmed by the site of all the supplies and the realization that the day was finally here, I decided to lay down and clear my mind for a bit. I managed to drift off to sleep but was awakened around 7:30pm by a call from my aunt. I told her 8pm would be go time, and I would call her back via FaceTime to ensure I did the injection right. I crawled out of bed, walked slowly down my steps, and with each step said in my mind “I am not afraid, this will be quick.” When I finally reached my kitchen table and the supplies, I noticed that the clock on the stove read 7:50. My heart started racing and I asked aloud, “how is that possible. It can’t be almost 8. This house is not that big for me to lose all that time.” As I started to ask myself another question, I heard my husband’s familiar voice say “you’re stalling.” He was right, I needed to just get on with it.
I walked slowly over to the sink and washed my hands. While reaching for a paper towel to dry, I got a sense of peace. I finished drying my hands and told my husband “ok, I’m headed to do it.” I hurried to the kitchen table and grabbed all the supplies, along with my ipad. I turned from the table and began running toward the stairs with supplies and ipad in hand. As I ran up each step, it felt like my heart would jump out of my chest. Despite the feeling in my chest I didn’t dare stop running. I knew if I stopped, even for just a second, I would lose my courage to do the injection. I ran up all the stairs and straight into my bedroom. Once in the room I slammed the door closed, and jumped into bed. I tossed the supplies to the side of me, and powered up my ipad. Once the ipad was on, I called my aunt via FaceTime and said “ok, let’s go.” My aunt smiled and asked “you ready”? To which I replied “no, but I have to be.”
I sat in the bed with my back against the headboard, and one by one opened all my supplies. I wiped the injection site on my stomach with a alcohol wipe, and filled my syringe with the meds while the area dried. Once the syringe was full and the injection site was dry, I took a deep breath and said “Lord, please don’t let this needle break off in my stomach.” As a finished my sentence, I felt a sharp pinch as the needle entered my skin. Surprisingly, it was uncomfortable but tolerable. I slowly pressed the plunger to inject the medicine and cheerfully said “wow, no burn”. Once the syringe was empty, I slowly pulled the needle from my skin and let out a sigh of relief. Once the needle was all out, I heard my aunt say “congratulations, you just did your first injection.”
I will always look back on my first time injecting methotrexate and feel empowered. I administered the medicine myself, and on my timing. Despite being scared to death, I did it. I will also look back on that day as a reminder that denial and/or fear will NEVER control my crohn’s care.