“Humira: How to Handle”
I started taking Humira around the end of my sophomore year of college (circa 2009) after having a partial response to Remicade and stopped therapy in June 2014. I actually was SUPER EXCITED (all caps excited) to start Humira as I was not a Remicade fan boy. Even though I was excited to start, I was nervous for my first injection which is but experience is the best teacher (and you need the meds no matter what) so you will be fine. This was going to be my first time giving myself an injection and truthfully I wasn’t scared so much as I was excited to be trying something new that would be more convenient with my life. I think patients with Crohn’s, even young teenagers, are definitely able to handle the responsibility of giving themselves a shot.For instance, I know a girl who started Humira injects at 16 years old by herself and has had no trouble. Crohn’s makes you grow up faster than your peers I think because you’re always considering your surrounding and options. If I need to use a bathroom, how will I get to one? If my stomach starts hurting during my high-school dance what will I tell my date? How will I get through the day with this pain? This is the kind of stuff that runs through our heads all the time and for some of us it started at young ages.
By the time of starting Humira I was super comfortable with needles, so I had no problem with the transition of injecting myself. It is a very small needle that is deployed from a pen (See right) so you can’t even see the needle. It is a subcutaneous administration, similar to like an insulin shot, however (as mentioned in the quick tips page) the injection can sting like a B**** (or maybe I’m a wimp). To avoid unnecessary stinging make sure you allow the medication warm up to room temperature! If you are in college you need to explain to your roommates not to mess with those shots. You never know where the Friday night festivities may go but they cannot go near those shots. Each Humira shot costs over 2,000 USD so its not a joke to lose/break one. On that note, I ran into a situation once where I took the maroon cap off the pen and the medication basically auto injected. I felt terrible about wasting that medication and even teared up, it was a really weird/sad moment I had. I don’t think I will forget it, it was in my families living room on a Saturday morning and the medication just shot out in a slow stream, I felt super hopeless seeing it wasted. I was out of luck at this wasted injection was my last on hand and had to scramble to get more meds. I would recommend talking to insurance etc about being able to have extra Humira so just in case you do have an accident you have additional medication.
So I started this medication when I was 19 and I loved it. Unlike Remicade I had no disruption in my daily schedule and I started to feel more like a normal college student. I could administer it in my dorm room and it didn’t wipe me out for several hours after injection. I could literally take the Humira out of the refrigerator, wait a bit, clean my leg and go. I love the simplicity and convenience, especially as a college student (at least it was for me). The people with Crohn’s who I know personally that take Humira have all reported positive experience and I would do the sameI am the only treatment failure that I know personally (which happened after several years). Humira brought me into real remission for the first time I think and I was super bummed when I started to flare while taking it b/c I would have to change meds (this shouldn’t happen to you I think it’s a rarer thing).
You can inject Humira in your upper thighs or stomach (around the belly button) just by pinching a little fat and deploying the pen. Super easy but everyone has their own preference about where to inject…I tried both sites and preferred the upper thigh (this is where I inject Cimzia as well). The worst reaction I got at the site of injection were sometimes bruises and soreness (that would go away later in the day). If you alternate injection sites between legs or sides of the stomach you should be fine or at least I was. Make sure when you inject not to pull the pen off your skin too quickly because it takes a bit of time for the medication to inject into you.I would hold the pen on longer then necessary probably just to make sure it was all in. As I said one time the pen just went off or I may have deployed it by accident so be careful once you take the caps off.
***PATIENT + PARENT TIP – The Humira will come in a Styrofoam box and inside there will be one or two ice packs. Save two of these ice packs in your freezer in case you need to travel with Humira. These are much easier and cleaner to use in a cooler than loose ice. I also kept a few of the shipment boxes specifically for travel purposes.
IMPORTANT POINT- Do not leave the Humira out of refrigeration too long because it can ruin the medication. All the biologics (Remicade, Humira, Cimzia etc) are so named because they are proteins. These proteins rely on a 3 dimensional structure or ‘conformation’ to have any biological effect in your body. If this conformation is not maintained (by not refrigerating the drugs or leaving them out too long) they will be ineffective and you won’t get any real benefit from the meds! The trick is just not to leave the shot outside of the refrigerator before you inject. I would wait about 15-20 minutes tops of leaving the pen at room temperature before injecting (30 mins would be way too long for my comfort). One time I left the Humira out about 25 minutes by mistake before injecting and I had no peace of mind just thinking about whether the pen I just injected would even do anything. So stick to 10-15. Also, you may see some fluid come out of the injection site, as long as you held the Humira pen against long and firm enough against your skin its normal the doctor told me.
*PATIENT TIP – If you are taking immunosuppression you CANNOT get live vaccines (no mist flu vaccine) so ALWAYS ASK BEFORE YOU GET A VACCINE IF IT IS LIVE. You need to be careful about what goes in your body! You should talk to your doctor about the side effects obviously of any medication but I never experienced anything serious during my long time taking Humira.