Maureen, the mom of an HBV+ child, offers these tips for handling the difficulty of administering drug therapy at home.
Our little one (19 months) just finished up her six months of interferon injections. I think you’ll be pleasantly surprised at how well your child handles it. The needle you use is quite small so it really is not too bad. Our daughter would only cry for about 15 seconds and then she was into the tub (which is something she really loves). The specialist at Hopkins provided some suggestions to us for giving the shots:
Try to dedicate one room for giving the injection. By changing the location of where you give the injection, or giving it to them in a place they really enjoy, it can cause them a lot of stress. Of course, this is more significant with a very young child. We did our injections in the guest room where our daughter rarely goes, that way she felt safe in every other room of the house.
Do not give the injection in your kitchen or bathroom—too many germs.
Minimize the number of times you put an individual needle into the vial. Our nurse told us it dulls the needle. This was particularly relevant when you needed to draw serum from two vials. If there was only a very tiny bit left in the bottom of the vial, we didn’t use it and went to the next vial. But, we really were not wasteful.
The emla cream wasn’t recommended for the 3x per week injections. It takes at least one hour for the cream to work and the specialist said this tended to make the kids more anxious because they spent that entire hour worrying and anticipating the shot. We did however use the emla cream prior to her blood draws (recommended by a PKIDs mom!)
Don’t bring your child into the shot room until you are ready to swipe with alcohol and inject. Our little one would cry as soon as she crossed the guest room threshold. Minimizing her time thinking about the injection made a HUGE difference. My husband and I switched on and off—one would prepare the injections and be waiting for her in the room and the other would bring her up, leg bared, and hold her for the actual injection. She was in and out of there in less than one minute.
For blood draws, call your lab ahead of time and make sure that someone with pediatric experience is working that day. I even had our doctor’s office call the first day because we’d had a terrible experience with a blood draw done on our older daughter. Once we found someone we liked, we always had the blood drawn when she was there. Even then, we had a system. The lab tech would have everything ready to go—tubes, gloves, and assistants—prior to our daughter entering the room. This extra effort minimized her stress associated with the whole procedure. Between that and the emla cream, the blood draws became much more tolerable. To me, they were the hardest part of the whole interferon protocol.
We traveled quite a bit while our daughter was on interferon. My husband would take the interferon box (without the vial) and put it in a seal able baggy. Then he would put water around it and freeze it into a block. When it was time to travel, we would put the vial back in the box/bag in the plastic container. The first big trip, we forgot about the sharps container, but we found a Rubbermaid seal able butter dish, which was small and convenient for holding the used needles until we could dispose of them properly in the sharps container.
That’s it for my tips! I hope some of this helps. We were very fortunate in that our little one did not get very upset about the injections themselves. We were also lucky that she did not appear to have many side effects, with the exception of being more tired. I wish you and your family much luck.
Important disclaimer: The information on pkids.org is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.
In the final analysis, the question of why bad things happen to good people transmutes itself into some very different questions, no longer asking why something happened, but asking how we will respond, what we intend to do now that it happened.