I feel really, really stupid. Yes, I used that word that in my family we try not to use at all.
When the nurse was training me on using my RebiSmart machine, instead of using the ‘training’ section of the equipment, he used up the first two 20% doses of the titration process (gradually increasing the dosage from 20% until 100% is reached). He didn’t even reset the titration setting when we administered my first 8.8 mcg dose. All my future woes could have been avoided if this simple step had been done.
This is what the schedule should have been and what actually happened:
#1 8.8 mcg: Went fine
#2 8.8 mcg: Went fine
#3 8.8 mcg: Went fine
#4 8.8 mcg: Went fine
#5 8.8 mcg: Machine indicated that it was going to inject 22 mcg. So I backed it out of the titration program and restarted it at 8.8 mcg. The rest of the injection went according to plan. I was aware that there are two types of cartridges for the RebiSmart, one being 22 mcg and the other being 44 mcg. In my naivete, I thought I’d just switch the settings over to the 22 mcg when the time came for the dose to be increased.
#6 8.8 mcg: went fine
#7 22 mcg: Backed the machine out of the titration program yet again. This time I changed the dosage setting to the 22 mcg cartridge. Picture me standing in my kitchen with the bottom part of my jammies top open to reveal my chubby tummy. My foot tapping with impatience as the machine unwound the plunger from the cartridge, then continued to whir as the plunger was wound back into the cartridge for injection preparation. Beep – I’m good to go. After the injection the screen displays some information: injection successful, dosage 22 mcg, time 9:25pm plus a visual representation of the amount of medication dispensed from the cartridge. Uh oh. A third of the cartridge had been used. My heart sank – my theory about the 22 mcg dosage hadn’t worked. I had just administered a full dose of 44 mcg (1 third of the cartridge volume). Oh no. It was a very rough night. I couldn’t sleep. I felt ill, sore, feverish, listless… At 2:00am I took a sleeping pill and an Advil. At least I got a bit of sleep before heading off to work in the morning.
Called the Multiple Support Program. Anita confirmed that I had indeed administered a full 44 mcg dosage and advised that I keep up with the Tylenol or Advil regimen to minimize the side effects. She’s couriering a couple of vials of saline for me to get back into the titration program at the correct dosage point. It was either that or begin the titration from the beginning or continue with the 100% dosages. I’m very glad to be able to use the saline and get myself back on track.
#8 22 mcg: This should go well tomorrow night. I’ll have my saline cartridges on hand to get my titration program back on track and I don’t anticipate any complications or problems with the actual injection. Whew. Maybe I’ll even feel a little better after the injection than I did last night/today. It’s been awful.