Living
Taking the sting out of injections
by Emily Wojcik
Stacey Max remembers well the first time she couldn’t
face giving herself her weekly
injection of Avonex, the disease-modifying therapy (DMT) that
she takes to manage her multiple
sclerosis.
injecting myself,” she says. “But
that night I called my mother
and my boyfriend, asking them
to help me.”
For many people using
injectable therapies, Max’s
story is familiar. Until very
recently, DMTs were only
available as injections—
either an intramuscular
shot, such as Avonex, or
subcutaneous injections
like Betaseron, Copaxone,
Extavia or Rebif. Research
has shown that DMTs
help reduce the incidence
of relapses and slow the
progression of the disease,
but adherence can be
difficult for a variety of
reasons.
advice and support for people
living with MS. “We’re not built
to do this. We don’t wake up
and say, ‘Oh, I want to inject
myself today.’ ”
But there are ways to
overcome the challenge. With
the help of healthcare providers,
people taking injectables can try
a number of physical and mental
management techniques.
“It was exactly a year after
I started taking it,” says Max,
46, a real estate broker in New
York City. “One night, I just
couldn’t do it. It suddenly
seemed so violent.” Max was
diagnosed in 1999 and had been
on a DMT ever since. “I never
had a problem with the idea of
Not built to inject
Many people with MS
call it “injection fatigue”
or “needle fatigue,” while
healthcare providers
may call it “adherence
resistance.” It can result
from skepticism about a
medication’s efficacy or from
fear of pain involved with the
injection itself.
“From the first injectables,
we have faced this problem,”
says Pat Kennedy, RN, CNP,
MSCN, a nurse-educator and
programs consultant for Can
Do MS, which provides lifestyle
A purpose to the plan
Part of the problem is related
to the way DMTs work. People
with MS don’t feel or see the
immediate effects of their
injections, which may make
it difficult to stick with their
dosing schedule.
For Christine Osborn,
30, a stay-at-home mom
in Lawrenceburg, Ind., the
connection can definitely be
hard to make. Her mother
took insulin for diabetes and
“if she missed a dose, she saw
the consequences immediately,”
says Osborn. With Rebif, a
subcutaneous injection that
Osborn takes three times per
week, missing a shot seems not
to matter. “Honestly, I can’t tell
the difference when I take the
meds. I don’t know if that means
they are keeping me healthy or if
they don’t have an effect.”
Kennedy says that doubts like
Osborn’s can be a signal that it’s
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