Crohn's Disease Forum » Parents of Kids with IBD » Methotrexate injection--needle question


01-27-2019, 12:50 AM   #1
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Methotrexate injection--needle question

E decided to try methotrexate injections for her last couple of doses; she wanted to see if she would feel less nauseated, and that seems to be the case for her. She still feels a little dizzy and "off" the next day, but the nausea is better with the injection.

When I picked up the prescription, the pharmacist grabbed me a couple of syringes, and (based on reading here) I asked her if they were insulin syringes. She said yes, but when I got home I saw that they were actually 26G TB test needles. Luckily, my husband had some 30G needles in his first aid kit and we were able to use those. Looking online, I see that insulin needles are available in both 30G and 31G, and with different needle lengths ranging from 1/4" to 1/2". What size and length needle have you all used for methotrexate injections?
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Daughter E (16) dx with Crohn's 12/18/14 at age 12

Current treatment:

Remicade started 12/24/14 (9 mg/kg every 6 weeks)
Oral methotrexate restarted 12/2/16 (15 mg weekly)
vitamin D, folic acid, multivitamin, Prozac

Past Treatment
90% EN via NG tube 2/9/15 - 4/2/15
50% EN via NG tube 4/3/15 - 4/18/15
Supplemental EN via NG tube 5/7/15-6/19/15
Budesonide 3/3/15-6/30/15, 3/24/18-5/18/18
Oral methotrexate 3/13/15 - 5/14/16 (15 mg weekly)
Clobetasol for Remicade-induced psoriasis
01-27-2019, 01:36 PM   #2
Maya142
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We used a tiny, thin insulin needle. Definitely closer to 30G than 26G. I remember that the needle was so thin I was always a little worried it would break off!

My daughters found the shots pretty painless when they did them in their bellies. They were both very thin and both were nervous to try their bellies, but it actually was less painful. M now does a daily injection (different med) in her belly and S does MTX weekly in her belly.

They didn't bother to ice because they didn't think it hurt. And S tried Buzzy and said she couldn't feel the shot at all with Buzzy + ice. She still uses Buzzy, I think.
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Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
01-27-2019, 01:40 PM   #3
pdx
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Thanks, Maya. Do you remember the needle length?
01-27-2019, 02:59 PM   #4
Maya142
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I don't, it's been so long!! Let me text my older daughter, she manages all of her healthcare by herself now, so I don't actually know. I'll let you know what she says but I'm going to tag some other moms:
my little penguin
crohnsinct
Mehita
Pilgrim
Jmrogers4
01-28-2019, 10:34 PM   #5
pdx
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We just went back to the pharmacy to pick up the next round of supplies, and this time we were able to get 31G needles (5/16" length). I'll report back on how those work after we try them a few times. E says she's willing to try her belly too, so we'll see how that goes.
01-30-2019, 12:40 AM   #6
Maya142
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As long as she can pinch up some fat, it should work. I had a very thin kiddo at one point and she most definitely couldn't pinch up some fat... at that point she found the injection more painful.

But once she gained weight, she said she remembers the shot as being pretty painless. She now does daily injections for another condition, and honestly, she didn't even blink when it was brought up because she had already been through so much by then.

She thought ice helped and my older daughter agreed. The older one really likes Buzzy, says she doesn't feel the needle stick!! She does use 30G needles.

How is your kiddo doing pdx?
01-30-2019, 01:17 AM   #7
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Thanks, Maya--we'll definitely try the ice next time too.

E is doing well. Other than the obstruction in the fall, her Crohn's has been been almost unnoticeable this school year. She has a great school schedule where she's only taking 6 out of 8 periods and she starts at 9:45 every day (thanks to her 504 plan). So she's getting lots of sleep and her homework load is not too bad. She's still playing in the band and she's learning to drive.

She has still never really clicked with a psychologist or therapist, but she and I have been in a family DBT group together since August, and we are both learning some good coping skills. Her last 3 Remicade infusions have been easy and drama-free and her anxiety has been better, so it seems to be helping.

My only concern at the moment is the measles outbreak happening in our area. E is vaccinated, but I don't know how her immune system would do if she were exposed. I'm really hoping the outbreak gets contained soon.

How is your daughter doing? Any progress with her arthritis?
02-02-2019, 12:57 AM   #8
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Just did the shot--31G needle, ice, Buzzy, belly. She didn't feel a thing. Thanks again, Maya, and thank your daughters for their advice too!
02-02-2019, 01:09 AM   #9
crohnsinct
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NO WAY! She is NOT learning to drive! take that back! I can't believe how old these kids are getting!

Glad she is doing well even if it means she is learning to drive.

I heard about that outbreak. Good Luck!
__________________
Daughter O dx 2/1/12 at age 12
Crohns & Remicade induced Psoriasis
Remicade
Vit d 2000IU
Multi vitamin plus iron
Calcium

Previously used - Prednisone, Prevacid, Enteral Nutrition, Methotrexate oral and injections, Folic Acid, Probiotics, Cortofoam

Daughter T dx 1/2/15 at age 11
Vitaligo, Precoscious puberty & Crohn's
Remicade
Vit D 2000IU

Previously used, Exclusive Enteral Nutrition, Methotrexate (injections and oral), Folic Acid, Entocort,IBD-AID Diet
02-04-2019, 12:28 AM   #10
Maya142
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She has a great school schedule where she's only taking 6 out of 8 periods and she starts at 9:45 every day (thanks to her 504 plan). So she's getting lots of sleep and her homework load is not too bad. She's still playing in the band and she's learning to drive.
This is what my kiddo did too! It really helped and as soon as she has her driver's license, she was driving herself to school and back. She also had a study hall first period so it didn't matter much if she had to come in late and she loved having that "cushion" and being able to sleep in a bit later.

Personally, I think the sooner they start doing things independently, the better they feel about their lives. It's hard and scary becoming a young adult from being a teenager. There are lots of transitions (medical - from peds to adult care, high school to college, college to being a "real person" with a job and so on) and when a chronic illness is in the mix, it is a billion times harder.

Glad to hear E is doing ok and the MTX injection went well. She is a star!!! I'm so glad to hear DBT is helping. I had never heard of it before - had to look it up. Looks very interesting. Did you ever try CBT/regular talk therapy with E? I'm guessing you did and it just didn't help??

Curious because my daughter struggles with anxiety and depression.
02-06-2019, 11:18 AM   #11
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We did try a couple of therapists who used CBT, but it just wasn't a good personality match. DBT is really very similar to CBT, and this particular group just clicked with her. I think she really likes the group format (as opposed to one-on-one counseling) because it's made her realize that lots of other kids have big struggles in their lives. None of the other group members are dealing with chronic physical illness, but they all all dealing with something big. That's made E feel more "normal" (before this she felt like she was the only kid who wasn't dealing well with life). And listening to other kids' success stories has made her want to try to use the skills she's learning.
02-06-2019, 02:27 PM   #12
Maya142
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Way to go E!! I'm glad you found something that worked for her. I know she's been to Camp Oasis - did she like that? My daughters go to the Juvenile Arthritis Conference every year and they say it has been life-saving. It made a huge difference, especially to M, to meet other kids who are facing the same issues as her - who are as complex and unique, and those who have severe disease like her.

It has also made her passionate about helping other kids with JA - she is determined to go into research to make better drugs. And in the meantime, she is in touch with some of her JA friends who have dealt with similar issues, like joint replacements.
02-08-2019, 01:34 PM   #13
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It has also made her passionate about helping other kids with JA - she is determined to go into research to make better drugs.
That is really great--I hope that she is wildly successful!

And yes, Camp Oasis was good for E in lots of ways--it was so great for her to get to meet other kids and counselors with Crohn's--but it did leave her feeling like other kids were better at coping with it than she was.
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