can u bring an old syringe? and maybe she can fill it with water and show you on an orange... when i used to be on Avonex,, they showed me how to do it with an orange.... i would think they would have syringes there.. mine did.. good luck

With medicine remember you always,ALWAYS have the right to refuse. They have the right not to treat you, the doc has the right not to write a prescription. Unless you have a gun to his head and threaten to blow off his head if he doesn't write the prescription,he can refuse to write the prescription. With a gun to his head it would be called under duress.

A nurse can refuse to train you to to self inject.--eventually she will lose her job and her paycheck. That's the consequence.

And YOU as the patient ALWAYS, ALWAYS have the right to refuse.

The consequence for you might be never learning to self inject so your MS goes untreated or the humiliation of having to admit you can't make yourself do by yourself.

Since you already are a diabetic and self inject anyway, i think those consequences are very unlikely for you.

I just refused to self inject with her there. Thats it. But avoiding humiliation is a powerful motivation in me. There was no way I was gonna admit I could not self inject myself after refusing. So I did the injection that night by myself..

What made me refuse, was fear of side affects & the fact I was going to a wedding afterwords. So she just had me inject into an orange, described how I would clean the injection site before injecting & wash my hands.

It was betaseron so she had me assemble an injection a few times to be certain I could do that , showed me how to use the self injector(which I never did use, I perfered to inject manually) had me point on my body the places I would self inject and had me tell her how I would rotate my injection sites.

Then she left. After the wedding I assembled the injection and injected myself. Potential humiliation of having to admit I could not do it myself is a powerful motivation in me.......the likelihood of being unable to inject myself was 0%

I was a CNA when I was in college, so I knew that all that is needed by the medical person is that they be able to document that treatment was offered and refused by the patient.

BTW, I was very worried about the side affects that I read for betaseron that other people had had. I did not sleep the night. I did the injection waiting for what my side affects were gonna be.

I'm a control freak---so I want to avoid them & sleep through them certainly, but I wanted to know what I was sleeping through!

They didn't happen suddenly. I heard for copaxone they might-do. But for me with betaseron, I got a headache the first night 4 hours after the injection.It was a bad headache that lasted until morning. The first week I got that headache then no side affects, that I could tell, after that first week.

With in the year I moved my evening shot to a morning shot. There are some articles supporting that for some. Because the interferons work in the immune system & the immune system is most active in the evening and less active in the morning, so its possible that side affects can be less in the morning.

I switched it because I am a morning person & I would fall asleep before my evening injection so I was missing many shots. That stopped happening when I switched to mornings.

Another example of the patients right to refuse....
I use Tysabri now, and it has that very irritating 1 hour wait. I wait, now only 1/2 hour. 26 trouble free infusions so far.There is another Tysabri user who is an RN. After years of using Tysabri without any issues with it, she signed a form refusing to wait that 1 hour.The hospital has it on file that the hour of observation was offered and refused.

She's an RN so she knew she could do that. The infusion center could have refused to do her infusion after she indicated she would not wait. But they didn't feel that was necessary.

A patient always has the right to refuse. Legally they don't have the right to refuse treatment if it is life threatening, but if its not life threatening they can refuse to treat. Also if someone is mentally incompetent they can over ride a persons refusal.

Rights & consequences.

it is common for the first dose of the medicine to be taken in the presence of a nurse. this way they can watch you for an allergic reaction and they can visually verify that you know how to give yourself the injection.

experiencing the side effects the first time can give you a good baseline for how the medicine makes you feel. you will understand exactly what is normal for you and the medicine.

after you take the first dose then you can set your schedule and take it at night like you normally would.

I agree with all ofthese replies, however I had one difference BUTwhile taking Avonex.
I wasnt self injecting, my hubby was doingit forme. MY FIRST injection DID NOT set a baseline for side effects. In fact the first 4 or 5 didnt.
I was only AFTER a month or so that I started getting very ill from my meds. Awfully ill for at least 2 days after it, sometimes 3.
I dont want to scare you, but be aware that ANY med, even OTC's can have delayed side effects at any time.
I take Copaxone now, self inject with an auto injector. Im good with it.
It DOES NOT have side effects for me, so far so good.

My first Betaferon injection was with the nurse present. She came to my house and talked me through it. My side effects hit me about 2 hours later and I felt like I had 'flu. After that, I took painkillers at the same time as my injection and that really helped lessen the sensations.
I changed to a bedtime shot so that I could sleep through it all and still took painkillers each time for a few weeks, then realised I no longer needed to. Now, if I forget in the evening, I can take the shot the next morning and not notice any side-effects.
Your reaction, if any, will probably be different, but if you're worried about the shot in any way, having someone there will be a help. However, if you're already injecting yourself anyway, it's only the mixing of the meds you have to be sure about. I find it very straightforward and I'm sure you won't have any issues with it. I like the suggestion to use the orange and inject yourself at bedtime, but if you're prepared to go with it and have a quiet day to recover, it's not that bad.

With Rebif you start with a low dose and gradually increase to the 44 mcg if I remember correctly they have you start with the 8 mcg dose which is quite low. You could speak with the nurse about taking tylenol or your preferred pain reliever prior to giving yourself the injection.

With the low the first dose of Rebif I did not experience side effects. I also met with the nurse in the afternoon. Of course everyone is different and I think if you prefer the nurse can train you on the injection and you can give it to yourself later in the evening if you prefer. I just wanted the nurse to watch me the first time to make sure that I was using the autoinjector correctly. Later though I quit using the autoinjector and just manually injected anyway since I got bruises and worse site reactions from the autoinjector.

Hey

I did inject with the Rebif nurse present, it was early in the day on a day I was off work. I didn't notice any major side effects. I did do the injections right before bedtime after that first one, and yes, there were ocassional chills and flu-like symptoms, but there were times when I had to inject earlier for various reasons, and it was okay.

I actually was happy to inject the Rebif while the nurse was there, I wanted to know how things really worked, really felt. So I guess it is just really what you are comfortable with.

Good luck! Make sure you get her to show you exactly where the injection areas are, not just hand you a picture. Be sure that right from the beginning you keep track of the rotation...write it down. It seems like you just won't forget where you did it last time, but, seriously, for me at least I would. The massaging the area after you inject is really important

Okay, well, Good Luck again.

Just remembered you posting before about your type 1 diabetes. I guess you probably already know how to do subcutaneous injections so this should not be a big deal other than managing side effects. You may want to wait and give yourself the injection in the evening. I use to take my Rebif injections about 2 hours before I went to sleep. It seemed like that way I slept through the side effects and always woke up feeling pretty okay. I work full-time and I never missed work due to side effects. In fact after about 4 months I didn't even need to take Aleve or Tylenol any more. I'm on Tysabri now because I had too many relapses on Rebif, but I really didn't mind Rebif I just wish it had worked better for me. I don't really like the PML risk with Tysabri.

1st) They (the nurse) should be coming to you for teaching injections and NOT you going to them. They get paid to come to your house to teach you how to do it. They get paid WELL. They get paid for total hours spent with the patient.

2nd) My experience w/ shared solution and copaxone was that you were "required" to inject yourself before the nurse could leave. Of course, you have the right to tell them to go away and that you will do it on your own. But, the point of the "practice" is to learn how to inject.

3rd) If you have been injecting insulin for a long time, then you know how to inject yourself. The nurse will go over patronizing information about how to look at the syringe and make sure there is no cloudiness or particulate matter. She(or he) may have practice syringes. The nurse will tell you to always check the expiration date.

I would suggest calling the nurse seeing if they can give you more specific information about rotating injections given that you are on insulin already.

Does your insurance cover the new oral medication?

My experience w/ the nurse from Shared Solutions was not positive. I found her incredibly patronizing and not very smart. It was clear the job was to earn extra money.

Thanks to all who replied. I am going to be in Memphis and thought it would be easier if I just went to her while I was in town. I have decided to go ahead and take the medication and some pain killers. And go on.

After taking Rebif for many years, I have scar tissue that the nurse never told me about. I did not notice hard scars until after I stopped Rebif. Anyway, now that they have learned from their many mistakes, I think that they have some tips for that. But I learned the hard way re the scar tissue. I do not get scar tissue from Avonex because it is in the muscle, at least that is what I am told and I have not noticed any.

I had the Avonex nurse come after they sent me the DVD to show me. I did not want to do the shot during the day, so I just practiced on an orange. I am glad because as it was I did suffer the next day after the Avonex shot, as I had on the Rebif.

Drink lots of water, I was told as well as aspirin or ibuprofen.