Frank, I have always been skittish about medical things, so I was very uneasy about the idea of injecting myself with Actemra. But I got through the initial few shots, and now I'm very calm about it. I have given myself 32 injections so far.

There are some videos on Youtube that are helpful. I watched them a few of those before trying it myself.

The first thing to realize is that the injecions are almost completely foolproof.

I follow this sequence for my weekly injections:

1. Take the Actemra out of the refrigerator and let it warm up at room temperature for at least 45 minutes.
2. Wash your hands good.
3. Use an alcohol swab to clean the area where you will take the injection. I always inject in my abdomen, because I'm very thin and that's where I have the most fat. If you have some fat on your thighs, you can also inject there.
4. After the alcohol dries in a minute or so, put the injector pen on your skin. I am right handed, so with my left hand I pinch the area around the pen for support. The pen won't inject the Actemra if it is not pressed firmly against the skin. I think of it as cocking a gun. The pen won't inject if it isn't cocked. Then press the plunger on the pen with your thumb. The Actemra will be automatically injected. It is very important to keep your hand steady while the pen is injecting and to maintain the pressure against your skin. You can watch the purple indicator of the plunger as it moves. It takes a few seconds. You will hear a click when the plunger completes injecting the Actemra. I wait a few seconds more to make sure it has completed. Then I take the injector pen away from my skin. You should see the purple indicator of the plunger inside the pen, and that shows it completed the injection. I check my skin where I injected for any small amount of Actemra or blood, and if necessary wipe it away with the alcohol wipe.
5. You can do this any way you like, but I send myself an email after every injection. I include where I injected and any issues. Since I inject in my abdomen, I use a clock notation for where the injection went in my abdomen (12 o'clock, 3 o'clock, etc). The benefits of the email are that I have a record to ensure I took the shot, and also it allows me to vary the position of the shot. I read that you shouldn't inject at the same location week after week.

That's it! Like I say it gets much easier after you've done it a few times.