Migraine victim afraid to give self shots


January 04, 1994|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Contributing Writers

Q: My 17-year-old daughter has bad migraine headaches. Recently, her doctor gave her an injection of a new drug called sumitriptan. It worked great! Although it comes prepackaged in a device that allows the medicine to be injected by her, she panics at the thought of doing it and we have had to give her the shots ourselves. Any idea on what we can do?

A: Since sumitriptan is not currently available in a pill form, we can certainly understand the urgency you and your daughter feel in her learning how to administer this effective medication herself. Our first response is to suggest that you sit with her (and perhaps her doctor) to try to identify what she finds most upsetting about the idea of injecting herself. Is she afraid that somehow she can hurt a vital structure while doing so or that she will give herself too much medicine? The first is extremely unlikely if proper technique is observed and the injector device is constructed to allow a fixed amount of medication to be administered.

Perhaps your daughter needs some practice at giving injections. Many individuals believe that it will be less painful if they gently apply pressure to force the needle through the skin. But in reality, a swift sure movement that allows the needle to penetrate the skin rapidly causes less discomfort and also allows for less time to think about what is happening. Your daughter may want to practice injecting an orange or a doll; if you are brave enough, perhaps you will let her inject you with a needle and syringe that contains a small amount of sterile water. Over time, this practice and repetition may relieve her anxiety or sense of panic.

Mental imagery or relaxation techniques may also help. Your daughter may want to identify some images or scenes that she identifies with feeling relaxed and then concentrate on these.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center. Dr. Joffe is director of adolescent medicine.

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