16 November 2008

Now With More Preservatives!

It's been a while... which doesn't mean that everything has calmed down- it just means that I have been too busy (lazy), to sit down and report. There are a few things to report...

First, it seems, that there was a double failure in the process of not only filling my prescription, but also in the administration of the methotrexate. Walgreen's had accidentally filled my prescription with "preservative free" methotrexate, and the nurses at my doctor's office didn't pick up on it. Preservative free methotrexate is a one time use only; after it has been exposed to air, it starts to go bad. As I just mentioned, the nurses didn't catch that little detail, so I had two more shots with that vial of methotrexate. In essence, I was having a spoiled cytotoxin injected into my butt.

Then, to add insult to injury (quite literally), the nurses were not using a long enough needle to inject it properly. It is supposed to be an intramuscular injection, but the SPOILED methotrexate was being injected subcutaneously- which is sort of okay, but it is harder for the body to absorb. That might actually be a blessing in disguise, because if rancid methotrexate was being injected properly into my gluteus maximus, I can only imagine that it would've made me a lot more sick than I was.

These two things, though, do explain my curious reaction that occurred almost immediately after the injection. About thirty seconds after the injection, it feels like someone had just reared back and kicked me in the ass. It would throb like nothing else, and then after about a half-hour the leg supporting whichever cheek was injected would cramp up worse than I could've imagined. The nurses were concerned about this reaction, because they couldn't recall whether their other methotrexate patients had the same reaction. It never occurred to them to check to see if there was something wrong with the methotrexate. It also never occurred to them that the needle they were using wasn't piercing my considerable (yet hidden) layer of fat on my backside...

...Long story short...

Thank heavens for the head nurse at Dr. Afrasiabi's office. She has assumed that the nurses she oversees would know what "preservative free" means, or what size needle to use. It just happened that when I went in for what was to be my fourth shot, she was the only one available to give me my injection. It was also a coincidence that it was the visit where I had my prescription refilled- and Walgreen's once again filled it with preservative free methotrexate.

Immediately, the head nurse, Janice, noticed that it was the wrong methotrexate. I told her that was the same stuff her office had been using for the better part of the last month. I was actually pretty surprised, because she was really pissed. It was then that she revealed that they were using the wrong length for the needle. She said she would call Walgreen's immediately, and then re-train her nurses on what the difference between an intramuscular and subcutaneous injections are.

That injection went well. It didn't really hurt and there were very little side effects. By the time I made it home, there was a message on my answering machine from Walgreen's letting me know my prescription was ready for pick-up.

I have had two injections since then- with a longer needle containing "methotrexate- containing preservatives." No more pain after the injection, and very little side effects. Janice has decided that she will give me the injection from now on. I guess probably because if I really wanted to, I could've screamed bloody murder both on the part of her nurses' incompetence and the negligence on Walgreen's part.

The thing is, and I guess I could ask, or at least google it, is what exactly is a immunosuppressant containing hydrochloric acid to stabilize it using to preserve it? I wonder if it is the same stuff that Hostess uses to preserve Twinkies. I mean those things last forever.

It is sort of working, I am not as stiff, but then again, I am not ready for the Ironman triathlon in Hawaii quite yet...

No comments: