Injection Tips

We've been doing home injections for Natalie's JRA for almost two months now.  We have inconsistent results.  We have some questions for the nurse when we go to Natalie's follow up appointment next week (Why does it bleed more sometimes than others?  Why does some medicine leak out sometimes?).  I'll update, but here is what we've learned so far. 

• Keep a log of all medicines.  This is a great idea for any medicine you give your child ever.  If you write it all down, then you know if you missed a dose or not.  This is especially important if more than one person administers the medicine!
• Keep all your supplies in one place.  We have a plastic box with the  alcohol wipes, medicine, syringes, band-aids, numbing cream, covers for the cream, Rx warning sheet, stickers, and a pen.  We keep this box way out of reach on a high shelf in the bathroom linen closet. 
• If your injections occur at set intervals, attach a note to the packaging with the dates you need to do the injections for as long as that vial will last.  (For us, its ten weeks).  When you give the injection, cross off the date.  This can help you make sure you give the medicine on the correct day.  Also, it can help you see when you are running low, thus reducing the risk of not having your medicine when you need to give it.  
• Ask your doctor how flexible the injection time and day are.  We have a weekly injection, but we can make it a day early or late if we have to. 
• If possible, choose a day and time that works best for you.  We do Wednesday nights.  This day is best for us since we are pretty much never out or away.  I'd recommend avoiding a weekend injection day because weekends tend to be less structured.  Also, its not a night we are rushed with other chores, like taking out the trash.  We chose evenings because my husband can be there to help.  The doctor's office recommended choosing a calm time of day, such as bath time. 
• Set a reminder alarm on your cell phone.  We have one set to remind us to put on the numbing cream an hour before the shot.  This reminder makes sure that we don't forget what day of the week it is if we get busy with the every day chaos of having two kids under 3. 
• Get everything ready in advance.  For us, I set out and open the alcohol wipes for Mike, lay out the band-aid and stickers, and fill the syringe while he plays with the kids in the living room.  When I'm done, I go in the bedroom with the syringe and he takes her in the bathroom to get her leg ready.  This makes it so she doesn't see the needle until I come to give her the shot.  Doing this lessens her anticipation of the shot. 
• If your child is very young, see if you can get a numbing cream to help with the pain of the shot.  
• If possible, make it a two man job.  Mike holds Natalie on his lap and makes sure she doesn't move.  The one time he trusted her not to move her leg, she pulled away before I could depress the syringe, and we had to do it again.  
• When I was a kid, I had to get three allergy desensitization shots once a week.  I got really used to getting shots.  (Maybe this is why I am able to give Natalie shots without getting too upset about it?).  So, while the doctor was preparing the needles, my mother would put one of my father's handkerchiefs over my eyes held in place with my glasses.  This worked great to help me feel less anxious and not have to watch the actual shot.  For Natalie, I just ask her to look the other way or shut her eyes when its time. 
• Another distraction tip I used as a child was to count really fast during the shot.  Natalie is still too young for that, but we are experimenting with other distractions like singing a song.  
• If you are going to give injections at home, you will get directions from your doctor.  Here are the most important points we were given:
• Make a target for yourself by pinching the flesh
• Use a 45 degree angle
• If you can't reach your thumb back easily to depress the syringe, its okay to take a second rearrange your hand once the needle is in.
• Pull the syringe out while you still have it depressed
• Don't put the cap back on the needle; that is when you are most likely to stab yourself
• If you have trouble with the injections (either physically or emotionally) see if you can give the shot at your pediatrician's office.  I asked ours and they said it would be okay for me to come in to do the first couple shots supervised if I felt uncertain.  (We didn't go to the specialists because they were an hour away). 
• Fun band-aids are a must.  I let Natalie pick out our first box.  She picked Sesame Street.  I particularly like how she says Elmo is saying hello to her because he is waving. 
• Natalie really enjoys getting stickers right after her shot, too.  Currently, her stickers match her band-aids.  The first time we did a home injection, she covered her leg in stickers all around her band-aid. 
• If removing the band-aid hurts, try letting it fall off on its own in the bath.