To SubQ, or not to SubQ?
That is a question many people living with chronic illnesses face at some point in their lives. For some, subcutaneous injection (SubQ) is the first, and sometimes only, option. For others, the crossroads to SubQ happens a while after diagnosis. Perhaps an initial pill treatment stops working or has some…let’s just say unpleasant side effects.
So what do you do when you’re given a choice: a pill, an infusion, or subcutaneous injection (SubQ)?
Well, to be honest, it starts sounding like a game of Chronic Illness Russian Roulette.
For me, this choice will happen at my next rheumatologist’s appointment. Do I continue with the pill I’m on, though I’m not completely flare-free? Do I switch to a biologic? And if I do, do I want to start infusions or self-injecting?
There are pros and cons to each one, and it really comes down to personal preference. But, it’s not always an intuitive choice to make.
When my rheumatologist laid out my options, she told me it was ultimately my choice. But, if the pill doesn’t control my flares, she would recommend the self-injection. Why? Because I travel so much it would be easier with my schedule.
My first thought was, “Give myself an effin’ shot?! Have you lost your mind? I freak out over every flu shot!”
And even though I don’t think I said that out loud, I’m pretty sure it was written all over my face. Especially since she suddenly started reassuring me, “But if you prefer the infusion, of course we’ll make that work.”
With those choices laid out in front of me, suddenly it all became so real. Somehow, the fact that all the pills I take aren’t enough to control my Behçet’s made it seem more sinister…more difficult to fight.
I know other people with Behçet’s take these meds, but I never thought my symptoms were bad enough for them to be a possibility. Just like I never thought Behçet’s would happen to me (because honestly, who does?). Somehow I didn’t realize I’d have to make this choice, too.
So, sitting in my rheum’s office, my instinct was “Hell no! I hate shots. Let’s infuse it up!”
But then this memory floated up and burst in my face. It was that time I had 10 vials of blood drawn. Yep, 10. (Isn’t trying to get a diagnosis fun?) About halfway through the blood draw, I became extremely anxious. I HATED having that needle in my arm and I wanted it out NOW!!!!
So then I started thinking…if I can’t handle a needle in my arm for a couple minutes, how could I do it for hours?
Suddenly, that SubQ injection didn’t look so bad.
My rheumatologist was right, as she usually is. With my ever-changing schedule, I wouldn’t want to worry about constantly rescheduling infusion appointments. And as a twentysomething with a full time job, who already has to miss work for doctor appointments, the idea of missing MORE work is not appealing.
But then we come to the sticking point: Can I really take that needle, or pen, and actually inject myself?
When push comes to shove, I know I’ll do whatever I have to do. But the idea is still daunting.