Methotrexate Self-Injection Update

I talked a few months ago about moving from the oral form of Methotrexate (MTX) to a higher dose of the injectable form. As I reported before, I have a significant needle phobia which was making the situation both physically and emotionally difficult for me.

I was not able to do my first two shots. I was home for Thanksgiving, so my mom did them for me, after about two hours of trying to get the nerve to do it myself and not following through. For my first shot back in my apartment, I had a nurse from my volunteering post at the hospital on standby.

Ultimately, I didn't need anyone to help me because I found a gadget that takes my fear and anxiety away. I realized that what was really getting to me about injecting myself was seeing the needle. I wasn't worried about it hurting - when my mom gave me the first two shots, I barely felt them. But even the thought of the needle going in made me nauseous.

I scoured the Internet, first to see if you can buy an injection pen that you can fill yourself (since MTX comes in a vial that has a four month supply and not just a single dose). That does not exist. But I did find the Needle Aid (

Needle Aid is a product out of Canada. It is made for people who are needle-phobic, but need to self-inject. It's this little plastic contraption that basically hides the needle away, so you don't have to watch it go into you. You push down on part of the device and the needle goes in - but you don't see this happening. Then you push down the syringe all the way, and then you are done. The NeedleAid is spring-loaded so that once you're done, you let go, and the needle is safely back up and out. Basically, this device tries to mirror the actions of an injection pen.

So I have a routine Saturday morning, shot day routine. I put on Christina Aguilera's "Beautiful", I prep my syringe and all of my other paraphernalia, load it into the NeedleAid, and that's that. The thing that's great about the NeedleAid is that once you push down and the needle is in, you just plunge the syringe and it's all done.

When I tried to do it myself the first few times, I would literally be probably 1/16th from my skin, but I couldn't stick the needle in. So once you get far enough using the NeedleAid, it's too late to chicken out.

I think another part of my reticence towards self-injection is that given that I had an experience where a medical professional administered a vaccine incorrectly and it almost killed me, I wasn't able to trust myself in being able to do this to myself, given my limited knowledge on the subject (and the seriously poor education about self-injection provided to me at my rheumatologists office).

My injection time has decreased from nearly two-hours of hemming and hawing to 30 minutes, now down to 15 minutes from beginning to end. For me, this is a huge accomplishment. And the fact that I am able to do the shot on my own is a huge bonus.

My mom was right about one thing. I am at the point now where I just want to get my shot over with. I don't want to sit around wasting a ton of time on something that in reality takes only a few minutes.

The other lesson I've learned, which has been a bit more difficult to swallow, is to see that this is a health-inducing activity rather than some form of violence against my own body. That might sound very melodramatic, but I think that was something that was holding me back, too. I had this thought cycle running through my head: "Normal" people don't have to give themselves shots. Most people my age don't have to do this.

And I guess there may have been a little bit of "why me" in there, too. Because from the very beginning, I have been very clear with my rheum that I did not want to give myself shots. But ultimately, I will concede that the side effects are significantly less than they were with the oral form. And I do think that this change in treatment was the right choice. There, I said it.