What to Expect During an Injection of A Biologic?

A few weeks ago I wrote, "What to Expect During an Infusion of A Biologic," so today I wanted to talk about injections. If you have Crohn’s disease or ulcerative colitis and you are prescribed a biologic treatment the only method of delivery currently is either by infusion or injection.

Like I mentioned in my previous post, the two most common question patients have about their biologic are:

1. Is it safe?
2. What will the experience be like?

Today I will be focusing on what doing a self-injection is like, though it’s important to keep in mind that your individual experience may be different.

The first injection of a biologic

Your first injection experience will most likely be a little different than once you start doing your injections regularly by yourself. First your GI doctor will want you to be tested for TB, hepatitis B, and possibly run some other tests. Once your results are back and you are cleared to begin treatment the fun can begin!

Initially, you will receive some sort of training on giving yourself the injection and most likely will receive your first injections (called the loading dose) in the clinic or at home from a nurse. This is a good opportunity to bring up any questions or concerns you have about the medication or the process of giving yourself the injection.

Sometimes patients do not feel comfortable ever being able to give themselves injections. If this is a concern of yours talk to your healthcare provider. It’s probable that you can come into the clinic to have someone give you your injection or you can arrange a nurse to come to your home and give them to you.

After training and with support most patients are able to feel comfortable enough to do their own injections at home. Check with the company that makes your medication to see what services they offer. Many offer injection training kits, nurse support, welcome kits, and phone number help lines that can make your experience easier.

If you’ve never received a biologic injection before, chances are you have a lot of questions about the experience. I have a lot of videos discussing thoughts and fears about medications, videos of me doing injections, plus more on my YouTube channel that you can check out.

Tips to prepare before the injection

Before you give yourself your injection you will need to do a little preparation.

I like to take my injection out of the refrigerator a few hours before I want to inject it so that the medication can warm to room temperature.

It’s a good idea to take a look at the syringe before you give yourself the injection. Check the expiration date and make sure that the injection hasn’t expired. Also take note of any unusual colors or cloudiness in the medication or damage to the syringe or pen.

If it doesn’t look like the medication normally does, then it’s a good idea to give your pharmacy a call and use a different syringe or pen if you have one available.

Once I am ready to do my injection, I set up. I make sure I have an alcohol swab and my sharps container and a clean surface to set my supplies on. Some patients like to have a band-aid or cotton ball handy in case of a little blood but I never need this.

Next, I wash my hands and choose the area of my body I will be doing the injection. I recommend rotating areas so that you are not giving your injection in the same spot each time.

Finally, I use an alcohol swab over the area of my body that I am going to do the injection.

What is a biologic injection like?

You will be giving your injection with a pre-filled syringe or an auto-injector pen. Some biologics offer the option to choose. For instance, if you are on Humira or Simponi you can choose either the syringe or the auto-injector pen.

Preferences vary from patient to patient. Some patients prefer the auto-injector pen because they don’t like the sight of needles or because the method of delivery seems easier to them. I like the pre-filled syringe because I control the speed of the injection and I find less pain with the syringe when I can inject the medication slowly.

There’s not too much to say about what happens next but this seems to be the thing that causes the most anxiety and what patients have the most questions about.

It’s time to inject the medication into your body and I’m guessing you’re wanting to know if it’ll hurt. The truth is I can’t really answer that for you. I don’t find that giving myself injections causes pain but other patients do.

I will say that for almost all patients that the pain or stinging is tolerable and isn’t enough to cause them to stop doing their injections. Once you are trained you will know what you’re doing and what to expect.

What to do after a biologic injection

Dispose of the syringe or pen in your sharps container.

Give yourself a high five!

You might bruise or see some redness at the site of injection. After you are trained, you will be able to distinguish normal side effects (like a small bruise) from abnormal side effects. Always report any abnormal side effects.

Tips for injecting biologics

Some patients report that icing the area of your body that you are going to do the injection in before doing it helps reduce pain or stinging.

Set up a reminder system that works for you. The company that makes your medication may also offer reminders. I prefer to write them down in my planner and on my calendar. Others set reminders on their phone. Do what works for you to keep you on schedule.

If the thought of doing injections gives you anxiety, perhaps it might help to set up an atmosphere that is calm and relaxing to you. Make a ritual out of injection night by putting it in part of a routine.

Light candles, take a hot bath, wear your most comfy pajamas, listen to music. Whatever works for you in order to put your mind at ease.

What has always helped me ever since I was a child in the hospital when I had to get IV’s or get injections was putting myself in the right frame of mind. The more I tell myself that this is no big deal, it’s just a few seconds of discomfort, “I got this!” the more I have believed it. I have been able to tackle injections and even bigger medical procedures by having an ‘I can do this’ attitude. Today injections are just part of my life.

So there you have it! This is a basic rundown of going through a self-injection. What tips or tricks do you have to make the experience better? Comment below and let us know!