Shot Fatigue: The Battle of Taking Our Medication
Treatments for Multiple Sclerosis vary in their delivery methods. Many get their medication intravenously in infusion centers, some are able to get theirs via a pill (this is still pretty new), however, many still rely on self-administered injections. While I am now part of the IV crowd when it comes to my treatment, I spent many years doing injections. While I normally didn’t have trouble injecting myself, even I would often succumb to what I call “shot fatigue” now and again. Shot fatigue, to me, is when you’ve been self-administering injections for a while and suddenly, you can’t bring yourself to do it anymore. This often forces us to skip doses or mess with our injection schedule, which can have some very negative effects.
My treatment history
I spent many years with injectables. My first treatment was Avonex (once a week), followed by Copaxone (at the time, every day), then both Avonex and Copaxone at the same time (something my neurologist wanted to try, until insurance stopped it, but that was also 8 shots a week), then finally Copaxone again. All before moving on to Tysabri (an IV medication), a move because of efficacy. So many injections! Despite all those injections, overall, I never had an issue doing them. I’ve never been one to shy away from needles or blood or anything like that. Many people do though, and detest the idea of self-injecting.
Unable to inject
I can very much understand why some people can’t stomach the idea of self-injecting. Even though I normally did not have a problem with it, I would occasionally develop one. I’d be unable to drive that needle into myself. This would happen to me every once in awhile. Despite doing it routinely, or maybe because of doing it routinely, I’d be unable to inject myself. It would come on almost suddenly. I’d have my filled syringe in hand (yep, there was a time when we had to fill our own, even dissolve the medication first) ready to go, but as I went to proceed, I just couldn’t go through with it. I’d sit there for a while trying to psych myself up to do it, but in the end, would end up skipping it. At best, this would throw my schedule off, and at worst, waste the medication.
It's a mental block
This probably doesn’t make a lot of sense, unless you’ve experienced it. You may think, “you’re an adult, just do it!” I assure you, it’s not that easy. It’s a mental block that’s hard to break. Giving yourself injection after injection can really wear you down. Particularly when many have not-so-great side effects. Avonex would give me flu-like symptoms for 24 hours afterwards, while Copaxone would give me a flushing feeling and injection site reactions. I feel like my body would begin to expect those when I’d get ready to inject myself. All of that, along with the pain of actually driving a needle into yourself (that was certainly an issue for me with Avonex, which required an intramuscular injection, deep into muscle. I happened to take Avonex when I was in much, much, better shape, which actually made it even more painful).
The importance of staying on schedule
Shot fatigue, although it wasn’t a constant problem, was certainly an issue for me. I’d end up missing doses or doing them later than I should have, which harmed the overall efficacy of my medication. I was a bit younger and naive and really didn’t think much of it. I thought, “Well, I’m taking this everyday, can’t be too bad if I miss one. And I feel pretty good anyway, so what’s the big deal?” But it is a big deal. Staying on schedule and not missing doses is extremely important for these disease modifying drugs to work. It’s important to remember that these medications aren’t supposed to be helping you feel better each day, they are supposed to slow your disease progression over time. So feeling good and doing well is not a reason to stop or miss doses, the same way that feeling bad is not a reason to miss them.
Battling shot fatigue
I’ll always have that question in my mind, “Had I not messed up taking my shots, would I be disabled right now?” That, along with a period of time where I foolishly thought it was ok to not take a disease modifying medication are two of my biggest regrets in life. Shot fatigue and anxiety can be a serious issue. Don’t feel bad if you have trouble injecting yourself from time to time, but definitely work to get past it. Ask a friend or family member to help, ice the injection area, or even talk to a professional about how to move past your fears and anxiety. Battling shot fatigue is not only common, it’s a serious issue, that can profoundly impact you later in life.
Does your employer provide workplace accommodations due to your MS?