Don't Forget to Take Your Meds ...
I don’t need it to wake me up in the morning, though. Instead, I set alarms to remind me to take doses of my rheumatoid disease/arthritis medicines. I swallow a couple of handfuls of them each day as soon as I get up in the morning and when I go to bed at night. But I have a couple that must always be taken at the same time each day. Thus, the app.
The convenience of smartphone reminders
In the olden times (say, before 2005) this convenience, this small bit of technological genius, wasn’t available. It didn’t exist. If I wanted more recurring alarms than my morning wake-up screech, I’d have had to buy more alarm clocks.
Why smartphone reminders work for me
My little smartphone alarm app does this perfectly for me. And not only that, it doesn’t blast my eardrums when it goes off, like old-fashioned alarm clocks. Instead, it plays a gentle, refined snippet of cello music. It’s like warmed honey for the ears and the mind, but I can’t just ignore it. For one thing, it plays over and over for about five minutes. I can slap its digital “snooze” alarm and get another five to do whatever I’m doing, or I can live dangerously and turn it off entirely.
Best of all, I can set alarms to go off every day at the same times, or every week, every fortnight, or even every month. I only use the daily and weekly ones, though.
Smartphone reminders for RA medication management
Reminders for daily nerve pain medication
One of the meds I take treats nerve pain, a relatively new symptom cheerfully caused by my rheuma-dragon. It must be taken at the same time each day for maximum effectiveness. So, while I take the first dose at 6 a.m. along with all my other RD mess and supplements, I’ve got an alarm set for 6 p.m. each evening for this one. Just as I’m in the middle of making dinner, listening to Rachel Maddow explain current political issues to me from the living room, I hear my phone playing the cello.
I would absolutely forget to take that one little pill at the right time every day without that alarm. I’ve gotten so I’m like Pavlov’s dog: I hear the cello, salivate, drop everything, trot off to the bathroom where my meds live and pop my pill. And then I get back to whatever I was doing, feeling good and righteous because once again, I took my med on schedule.
Reminders for weekly biologic DMARD
My other alarm is set to go off every Wednesday. Actually, it’s two alarms. The first is for 9 a.m. It reminds me to take my weekly biologic DMARD (disease-modifying-antirheumatic drug) out of its box on the refrigerator door. I carry the ice-cold, colorful, toy-like, capped syringe to the bathroom and tuck it into a corner on the counter, well out of the way of playful cats or inadvertent elbows. The reason? So, it can warm up to room temperature.
This particular biologic can be left out of the fridge for several hours without losing its potency, so my second alarm is set for an hour later, at 10:00. When the dulcet tones of the cello sound, I once again drop whatever I'm doing and head for the bathroom. I close the door behind me. I bare my belly, wash my hands with hot water and soap, pat them dry on a fresh, clean hand towel, lay out a clean paper towel, and put the syringe, an alcohol prep pad, and a tiny, round, sticky bandage on it. There. All prepared.
And then I find a good spot on my stomach (let’s see … how about an inch or two below that mole, there, between the stretch marks…) and clean it well with the alcohol pad. While the alcohol is evaporating to leave my skin dry and sterile, I open the bandage packaging and set it out, ready to stick on.
Self-injecting a biologic DMARD
Now, the moment I look forward to each week: my shot. (R-i-i-i-g-h-t.) The drug inside the syringe has warmed up, helping to ensure that it won’t hurt as I inject it. So, I pop the cap off, and it really, really doesn’t look like a toy anymore. That needle, as thin as it is, is all razor-honed business. I hold it carefully, keeping the pointy end pointed away from me, and adjust my hold on it to allow for my ouchy, RD-stuff fingers and sometimes dicey grip. Then I point the needle-end at the right spot, take a deep, steadying breath and blow it out, and without letting myself think about it anymore, quickly poke the needle, at a 45-degree angle, through my skin and into the fat layer right below it.
Pushing through my dislike of needles
This is always a nerve-wracking moment for me, even though I know that the needle is so thin and so sharp it won’t hurt going in. If you’d told me 30-plus years ago that I’d someday inject an RD drug into my own belly once a week, I’d have laughed. Then I’d have limped away, as fast as I could, screaming. Like most people, I don’t like needles. At all.
But you know, there are things in life that require a steel spine and some courage. Self-injecting, on the same day and at the same time every week of my life, is one of those things, for me. And it’s worth it: this drug helps to make my rheuma-dragon sluggish and sleepy. That way he can’t chew on my joints or concentrate enough to attack other parts of my body, like my heart, or my lungs, or my kidneys. Take that, dragon!
Techniques for self-injecting DMARDs
Once the needle is inserted, I press the plunger down, injecting the drug in a “bolus” beneath the skin. This can hurt a little since our bodies don’t particularly like having fluids injected from the outside into them through the skin. There are all kinds of tiny nerve endings under there that can start yelling if things happen too fast.
Slowing down the injection process
So, I push the plunger down very slowly, injecting a little of the drug at a time. This is the best part about using a traditional syringe, rather than an auto-inject, “pen”-type syringe. I can control how fast I inject. If it starts to hurt, I stop until it stops (without withdrawing the needle). Auto-injectors force the entire dose in seconds. You get the unpleasant task over with faster, but it can hurt more.
In all, it probably takes me 30-45 seconds to self-inject my biologic DMARD using the traditional syringe. Once the drug is injected, the syringe automatically pulls the needle back up inside the casing, so it can’t be used again or pose a danger to anyone else.
Marking previous injection sites
I stick the little dot bandage over the injection site — not because it’s bleeding (that’s rare unless I accidentally clip a little capillary vein), but because if I don’t mark the spot somehow, next time I’ll forget which side I injected. The drug maker asks that you alternate injection sites from week to week, and I have an unfortunate memory even without RD brain-fog. So, new bandage in place, I peel last week’s, still stuck to the other side of my tummy, off and discard it.
Another jab done ...
I dispose of the syringe in the red plastic sharps box I keep under the sink, throw out the paper bits from the bandage and alcohol pad, and button my pants back up. I’m done with injecting for another week.
Without that miraculous little smartphone alarm app, I’d never remember to take these random medicines on time. It’s a brave new world, friends.
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