Doing my first methotrexate injection 

Hy Emily , l made my injection ,with nordimed metotrexate, it was ok,it s easy but when l remove the injection ,l mean the needle ,a little bit of the liquid went out ,it is ok? My MTX it is not a pen .Thank you.

The advice I've had for spillages is to wipe with a tissue then rinse with plenty of water, disposing of the tissue in a clinical waste bin so that the liquid doesn't come into contact with anything else. Was it ok?

Thanks for your message! I'm so glad it helped and really hope it works well for you.

Thank you for your message, I'm so happy to hear this! Will keep my fingers crossed for little or no side effects for you too!

Thanks for your lovely message! I'm so happy the video was helpful to you and glad to hear your injection went smoothly x

Thank you so much, I'm really glad it was helpful to you.

You are so welcome! I hope it went smoothly for you x

Thanks Geraldine, your comment made my day! It's so lovely to hear that seeing my first attempt helped with yours x

I wasn't scared at all (in fact, I was somewhat excited), but now that I'm about to do it (even after watching the video), I'm terrified... 🙈 I've had quite a large fear of needles before, but that's mostly gone now but I'm still scared sometimes, haha (for example, blood tests don't scare me at all and this is probably even less painful than that)...

Thanks for leaving a message! How are you feeling now? Have you managed to do the first one, or isn't it time yet? I've spoken to loads of people who were really nervous the first time, it's natural, but they've tended to feel a lot better after getting that first one out of the way. I hope you're doing ok.

@@aslightlyatypicalpresentation Hi, sorry for not responding, I didn't get a notification, since it wasn't a direct reply to me (and thanks for responding)! I just did my second one (my mom did it last time, now I had to do it myself)! Last time it hurt quite a bit afterward (pretty sure it was due to the medication), but this time there was only a slight funny feeling afterward (no pain). And it was very easy to do myself the second time! So no worries, I'm sure I won't even be scared of it from now on! 😁👍

@I Hate Myself I'm so sorry you didn't get a notification, hopefully this one comes through. So happy to hear how much easier it was the second time around for you! Long may that continue :)

you're so welcome! and thank you for letting me know! :)

Thanks for your message Susan, I'm so glad you're feeling better. It's quite a thing to start injecting medication but it's honestly never hurt. Crossing my fingers for you too.

Good luck, Tom! You've got this one. And thank you for your kind comments too, they're very appreciated.

Thank you so much for your message! I'm so happy to hear that the video offered some reassurance about the injection pens, they really have been easy to use from the start - and I hope the switch to methotrexate works well for you.

Thank you for your message, I'm so glad it was helpful. Wishing you all the best for when you get started :)

You did so well .cn you share pic of that sheet plz.. Luckett have the pen form❤

Thank you so much for watching! Here's the instruction booklet with the diagram I was using: metoject.co.uk/app/uploads/2022/09/metoject-adult-admin-guidelines.pdf

You're so welcome, thank you for your lovely message :)

Thanks Jimmy!

Thanks for your kind message, I'm so glad it helped ♡

I'm so glad the video was helpful, thank you for your message! My doctor thought I might have PsA too at first, so I know the symptoms can be quite similar. I really hope the injections are effective for you.

Thank you for watching, I'm so glad it helped. Hope it goes smoothly for you on Saturday :)

I hope your first injection goes smoothly for you, Richard. Good luck! I've heard a lot of people say they find the side effects are fewer with the injections and I hope that proves to be the case for you too.

Oooh I hope it goes well (or has gone well) for you! And thank you for watching :)

thank you, so happy to hear that!

You're so welcome, I hope it went well for you!

Hi, thank you so much for your message and kind words! Yes, I think the technique is different for injections with a syringe versus the pre-loaded pens. Gradually it does seem to be having a helpful effect on my symptoms so I'm glad to have tried it. I really hope the switch to injections works out well for you too.

Thank you! I hope you're doing ok, and with that first solo injection under your belt. I'm finding MTX ok, it does help with symptoms though took a while to take effect initially - and am definitely better with the injections than tablets.

Thanks so much for your message Eoin. I did have an increase in some side effects when I switched to the pen actually (which was not the plan!) - wooziness and queasiness which I hadn't really had with the tablets, and the cognitive effects lasted an extra day or so although were possibly slightly milder. Its a few months down the line now and they have all decreased, so hopefully they will for you too. As I understand it the injections are effectively a dose increase from tablets because more methotrexate is absorbed that way, so I guess there can be a period of adjustment. Thanks for the tip re showering too, appreciated!

Hi Jay, thanks for your kind comment, that made my day! I'm so glad you found the video helpful. I do still take the folic acid, same dose as with the tablets. From what I've heard a lot of people find the side effects milder with injections, so I really hope that's the case for you too.

Thanks for replying. I’d best still take them then. Good luck with everything 😊

Thank you - you too :). As far as I know the purpose of the folic acid is just to help with mtx side effects, so if you find those improve with the injections you could always chat to your medical team about reducing them if you'd rather not have them. Must admit I haven't tried it myself so far but taking less medication would be good!

Also it is recommended that you don’t take folic acid on the day you have your injection. You can take it the following day. Also you can research this or ask your doctor but if you have a one or two MTHFR gene variants you might have to take a methyl folate so it can be absorbed. One gene variant means a 40% chance of not bringing able to absorb and two genes is more like 80% you can’t absorb folic acid . If you have done 23 & Me you can check the data for these variants. As always do your research with legitimate peer reviewed publications and ask qualified professionals if any of this is relevant to you.

thank you for this!

Hi Cydney, thanks for reaching out. That sounds like an interesting project. Could you tell me a little more about the research you're doing and what would be involved please?

Hi, thanks so much for your message! I started the same way as you with MTX (although with tablets at that point) - 20mg for a few weeks and then moving up to 25mg. I think that starting with a slightly lower dose gave my body a chance to get used to it and helped with side effects. Are you prescribed folic acid as well, as that also helps. The injections were quite a thing to get my head around at first! But honestly I've found them straightforward in practice and haven't had any problems since that very first one in the video. It definitely helps my RA symptoms. I really hope the injections go okay for you and you see benefits for managing your health conditions too. Fingers crossed for you ♡

Thanks for your message! Yes, the methotrexate is still an important part of my treatment, and I still take the same dose as in this video. Since then, I've added a third anti-rheumatic medication, sulfasalazine, which also helped. My RA symptoms have improved a lot since then, but do still affect me. Maybe I should do an update video - a lot has happened in the past year!

Only reason for starting there was plenty of padding at the sides! Thought it might help. I actually mostly inject into the belly area these days, which I was hesitant to do at first but actually find it easier. Sorry to hear it's so sore for you :(

That sounds rough, has the injection pen or mechanism changed at all? I occasionally get a little bruising if I get a blood vessel by mistake, but it's been pretty minor so far. Do you have a rheumatology helpline or nurse who might be able to help or advise?

That sounds concerning, I do hope you find a medication that suits you better

@@aslightlyatypicalpresentation thanks

Hi Carlos, they're both the same medication but the injections are methotrexate in a liquid form that you inject using a pen or syringe, whereas the pills are solid tablets that you swallow with water. In terms of effects, some people find that injections are more effective than tablets at the same dose, because they enter your system directly rather than needing to be digested first, which can reduce the amount of methotrexate that is actually available in the body. Is that the kind of thing you were wondering about? Please let me know if there's anything else and if I can help I will!

I totally understand, this condition throws up so many new things to deal with doesn't it. New treatments being a big one! If this isn't something you would usually feel anxious about it, would it be possible to try just doing it without thinking about it? That might help to confirm what you already know, that the needle is very small and it doesn't hurt. Once you've done it one time, the next time may feel better. Or could you get some help from a nurse or friend/family member? I know lots of people find it helps to have some support with injections at first. I really hope you find something that helps with this ♡

Personally I've occasionally had minor bruising at the injection site, but nothing else from the injection itself. It'd be interesting to hear what other people's experiences have been. Did you have anything yourself?

Thanks for your message! It's great to hear you've got that first one done. I'm not sure why there'd be about half left inside but yes, best to discard it. If you have any concerns maybe you could take a photo of the used injection pen and show your rheumatology nurse or pharmacist next time you see them, just to check it's working ok? It might just be something about that pen.

Para mim, é para tratar a artrite reumatóide, mas também pode ser usado para muitas outras doenças autoimunes. (I hope this is a good translation!)

Hello, thank you so much for your message though I'm sorry to hear that you have this diagnosis too. I found it daunting as well at the start, but it has got much better in time, the shock passes. It took probably about 3 months to start noticing the methotrexate working, and longer for the full benefits to show. It was hard to tell exactly when because I was taking other medications too. I found the injections more effective than tablets. If you've been taking it for a month there is still a good chance of it working more than it is now. Since being diagnosed I've added other medications and things have improved more. I don't have pain like I did at diagnosis, it's very manageable, and I can do so much more now. Everything is far better. It is really hard before the medication starts working properly, but I hope that offers you some reassurance - it really can improve but sometimes takes a while. If you have any other questions I could help with please just ask, always happy to share. Are you taking methotrexate alone or any other medications with it? There are many options for adding more. Keeping my fingers crossed that the methotrexate works well for you, and soon.

@@aslightlyatypicalpresentation Thank you so much, l am takink metrotexate 1.5 mg. Injections by week, next day folic acid by 5 mg, and avery day i take prednison wich is cortizon ,for pain ,l have a knee that hurts and that all for now, l am going to the doctor when l have a month of tratament. I ' ve been diagnoise early february and they say it is the debut of desease,that l have a chanse of a normal life. I am 42 years old.How about you ,you still working and do the things you did before the illness? Thank you so much for you response ,l was a verry sad ,l was afraid of depresion.

I'm sorry to hear how low you've been feeing, it's natural I think with a health condition like this. It can affect everything and there's so much to take in - the effects of RA but also medications, side effects and changes to daily life. It's really good that your doctor has caught the disease early though, lots of people are treated successfully and get back to doing the things they used to. It can take some months, for some people longer, but there are many treatment options and sometimes it's a case of trying a few before you find what works for you. My journey has been quite difficult but I had a very rapid disease onset, and by the time RA was diagnosed many joints were affected and I was very limited in what I could do. That has improved hugely though with treatment. I had to take 4 months off work when it was worst, but I am back at work now - not quite full-time hours yet but 4 days a week - I will get there! I take prednisolone too, it's essentially the same as prednisone, and hydroxychloroquine and sulfasalazine which are RA medications like methotrexate. It really helped me in the first few months to hear about other people's stories and reach out for support from organisations that help people with RA - it can make you feel quite alone when it's so difficult. Do you have support around you, while you adjust to all of this?

@@aslightlyatypicalpresentation Hy ,Emily, yes i have suport ,my husband and my son are very cloused to me, really help, l have only one knee with pain and a little bit the right jaw was painfful but not so bad ,the other knee swallou but not hurting ,now is ok, l have these little bag with liquid on my both knee ,doctor said is sinovia ,but it will go back when the methrotexate will be install ,my hands were paintfull but now they aren t , l just hope that will not go any longer,to other joints, it is a huge help to talk to someone like "us" ,you know what i mean,and about you, you don ' t take MTX anymore,why?thank you for answering me.

Ah, so glad you have your family around you to help and support. Hopefully the MTX will start working very soon, and the prednisone reduces the swelling and pain while it's starting to work. I'm still taking MTX, but added HCQ and SSZ as well - triple therapy, plus prednisolone. Sorry that wasn't so clear! The extra meds definitely make a difference. Always happy to talk, hoping for a good result with the MTX for you x

It is quick! Was it ok other than that?

Now it's my turn for the first time, thank you

ahh, good luck!

@@aslightlyatypicalpresentation done it, didn't feel a thing, really didn't expect that. thanks for the video.

that is great, so happy to hear it went so well