Monday, 14 October 2013

Enbrel My First Dose

Today I began using Enbrel and gave myself the first subcutaneous injection using the specifically designed pen for this. Before I could do this I was walked through what to do each time I use the pens, by the lovely Homehealth Nurse, who visited today, to tell me more about Enbrel, as well as training me on the correct use of the pen, pictured below.


To start with we talked about Enbrel itself, what it was, how long it can take to start to make a noticeable effect, what to avoid as it is an immunosuppressant, what times would I need to stop taking it, what medications I cannot take while using it and the side effects. Also what symptoms of AS do I have. So in this post I am going to discuss things in the same order, although I am going to skip the what is Enbrel out, as I have a page all about it on here already.

How long does Enbrel take to start working varies from person to person, some people notice a beneficial effect after two weeks of starting this therapy, others it can be up to twelve. With the average being four to five weeks. As with many medications for various conditions it takes time to get into your system and start working, so don't expect to notice instant results.

As it does suppress your immune system it is advisable to avoid contact with people suffering from a bad virus as you are more likely to pick it up yourself. This is why having the flu jab is advisable as it'll help you avoid catching it. You also must not have any 'live' medications such as the Polio vaccination and the Yellow Fever vaccination. Also if you need to go on antibiotics you must stop taking Enbrel until a few days after you have finished taking them, always remember to take the full course of antibiotics prescribed by your doctor.

If you are going to have any surgery, or major dental work such as having a tooth extracted you must stop taking Enbrel, two weeks beforehand, as it can affect how you heal. This also goes for having a bad, deep cut you should stop taking it until the the wound is dry and well healed, as Enbrel could have a negative effect on the healing process, leaving you at risk of infection. Remember that if you have stopped taking it when you restart your treatment you must always inject your self on the same day each week, so if this has meant that you restart it on a Tuesday then that is now the day you must take it.

Ok the side effects, I'm not going to be listing them all here as there are a few and please note that I am not posting these to scare you, all medications have side effects. Go look at the leaflet that comes with a box of over the counter paracetamol and you'll see that even these, do have quite a list themselves, including can cause headaches, kind of strange as many take them to stop a headache. With side effects forewarned is forearmed,  as you will know what to look out for just incase you develop any of them, common sense really.

Where you inject you can develop a reaction that comes up much like an insect bit and just as itchy, on rare occasions this can cover a larger area, around the injection site. Antihistamines will help with this and it is best using a different area for your next injection, like the other thigh for example. You can develop a rash that covers a larger area of your body, this it is advisable to talk to your nurse, or GP about. You can get pins and needles type sensations, vision going blurry, the feeling of nausea and headaches, these only tend to happen in the early days of taking Enbrel. One of the rarest reactions is a full on allergic reaction, where you suffer from swelling and puffiness, not just near the injection site, if this does happen then you must phone 999 and get to a hospital as soon as possible. In all the years my Homehealth Nurse has been working with patients on Enbrel she has never seen this happen.

So what symptoms of AS do I have was the next thing we went through for her records. These are stiffness and pain in the morning, when I first wake up, which can last a couple of hours, although some days it does last longer than this. I have had the odd day where I have not been able to get out of bed, as it was far too painful to do so for about four hours after waking, those odd days haven't been good ones, as I'm sure you can imagine. I have pain in my knees, hips, in both lower and middle back, ribs, shoulders and neck. This ranges from a dull ache to exceedingly painful depending on the day.

Now for the steps you take to use the Enbrel injector pen are as follows:
  1. First check that the pen has the required doseage, for me this is 50mgs.
  2. The check the expiry date which is printed near the top of the pen, near the doseage.
  3. Make sure that the air bubble moves as you tip the pen, if it doesn't move tap the pen gently a few times and it should start to move.
  4. Make sure the liquid is clear and there are no flakes in it, as this will indicate that it is not mixed properly.
  5. Remove the end cap, which protects the needle and keeps it sterile.
  6. Gently press the pen down on the injection site until the needle guard tip retracts into the pen.
  7. Press the top button on the pen and you should hear a click and the needle will start the injection process. You might feel a slight stingy sensation as the injection takes place.
  8. Slowly count to 10 and the clear section of the pen will now be a purple colour.
  9. Place the pen and cap into your sharps bin, job done.

Next week my Homehealth Nurse will be visiting me again, just to make sure that I have understood all that we went through today and double check that I am doing the injections correctly. She is also just a phone call away so if I have any worries, or questions I can ask her and get the answers I might need.

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