Undecided..Any advice?

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Undecided..Any advice?

Postby lesley823 » Thu Jul 02, 2009 12:37 pm

Well I have been betaseron for about 5 months now, it has been ok, I just hate how the injections sites look, they are horrible. Well my insurance at work has changed and they will not cover betaseron because I have not been on it for more than 6 months. So I have to choose either Rebif or Avonxe. Which is ok because I was going to talk to my dr when I go back and see him. I think I could hand the IM injection once I got use to it, a shot once a week would be nice, but I am not 100% sure, I have help giving the injections if I need it as well. But three times a week isn't so bad either. So any thoughts. And now on to my meds, my dr has me on Effxer for my depression and amantadine and Provigil for my tireness, I feel good most of the time, I have been feeling alittle more ran down. I have been reading many things on this site and Is the Low Dose Naltrexone something they would add in the mix of all of this...I kinda feel like I am looking for meds to help me feel better. I already know I need to change my diet and excercise, but I have no ambition to do anything. I feel drained by the time when I get home from work. HELP just looking for some insight to all of the madness...I know none of this is the end of the world but I am just looking for some insight from individuals who know what I am experiencing. Thanks
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Postby patientx » Thu Jul 02, 2009 6:15 pm

These health insurance companies are just crazy. They won't cover Betaseron, which is just one more injection (on a average) than Rebif?
This just sucks.

I talked to someone who, when just diagnosed, wanted to go on Avonex, since it was only once per week. Her insurance told her. no, you have to try either Rebif or Copaxone; we will cover the Avonex only if you can't tolerate these two.

Anyway, sorry for the rant. I think you can get used to the IM shot. I have to do it once a week. I do have to psych myself up, seeing the longer needle. But, if your muscle is relaxed (I do mine in the thigh), it's pretty much painless.

One caveat; Rebif and Avonex are exaclty the same interferon. I have heard and read that Avonex might be somewhat less effective than Rebif, since it is only administered once per week. Some of this may be based on marketing hype from the maker of Rebif. But, it might be something to ask your neurologist.

Sorry. i can't help you with the symptoms meds.
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Re: Undecided..Any advice?

Postby NHE » Thu Jul 02, 2009 7:25 pm

lesley823 wrote:Well I have been betaseron for about 5 months now, it has been ok, I just hate how the injections sites look, they are horrible. Well my insurance at work has changed and they will not cover betaseron because I have not been on it for more than 6 months. So I have to choose either Rebif or Avonex.


If you had bad injection site reactions to Betaseron, then it's likely that you will also have bad injection site reactions to Rebif since they are both administered via subcutaneous injection. I believe that it has more to do with the type of tissue the interferon is injected into then it does with the differences between the interferons.

I know that Avonex is a lower dosage. However, the absorbed dose from an intramuscular injection has been reported to be around 80% while the absorbed dose from a subcutaneous injection is only around 40%. This difference helps to compensate for the differences in dosage between the two meds.

Which is ok because I was going to talk to my dr when I go back and see him. I think I could hand the IM injection once I got use to it, a shot once a week would be nice, but I am not 100% sure, I have help giving the injections if I need it as well. But three times a week isn't so bad either. So any thoughts.


The intramuscular injections aren't so bad. In a couple of weeks it will be my 9 year anniversary with Avonex. Early on, I would get a small quarter sized bruise every once in a great while. I don't get these any more. I inject in the upper half of my thigh off to the side a little bit. You want to avoid the top center of your thigh due the presence of blood vessels and large nerves. Many times the injection doesn't even bleed and I have had to squeeze my skin a little bit to get a little drop of blood out so I know where to put the bandaid. Now, I just hold a finger at the injection site after I've removed the needle in order to keep track of its location.

PatientX is right, you want to keep your leg muscle relaxed. I had my thigh muscle spontaneously contract once while it still had the needle in it. That was annoying and not something that I wish to repeat. I lower my chair so that my leg is bent at 90° angles and make sure that there is no tension on my thigh muscle. This works pretty good for me. I find that I have to keep notes of which leg I've injected into otherwise I tend to forget. I alternate legs every other week. Once or twice I've mistakenly injected into the same leg two weeks in a row. I've noticed that my leg was a little more sensitive so alternating legs is a must.

Lastly, get the powdered form of Avonex if you can. It takes just a minute or two to mix up, but many people have reported fewer and less severe side effects with the powdered form as opposed to the prefilled syringes. I suspect that this has to do with the differences in the buffer. The powdered form uses a more physiological buffer at a neutral pH while the prefilled syringes use an acidic buffer around pH 4.3 or so to inhibit bacterial growth.

You may want to take a look at some of my posts on the Avonex forum such as the Injection Technique thread among others. Let me know if you have any questions.

By the way, none of the crab meds are a cure-all for MS. I would suggest taking a look through some of the posts on the Natural Approach forum for some ideas on supplements, for example, fish oil, green tea, turmeric, vit D, r-lipoic acid, etc.

NHE
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