What I learned from a medication injection mistake

I was having an incredible week! I’d pushed my body to the limit to meet my book deadline and had finished on time. I took part in a rare career opportunity and went to sleep on Tuesday night celebrating. Wednesday morning, I had to make a call about the opportunity, which I did while prepping an injection of my medication.

Thus began a chain reaction that would lead to a dosing error.

Yorvipath (palopegteriparatide), my hypoparathyroidism treatment, comes in a multidose vial pen injector. I screw a needle on the top, turn the pen’s dial to my prescribed dose, insert the needle into my thigh or stomach, and then press the dial down to give myself the injection. If I’m using a brand-new pen, the instructions say to leave the pen outside of the refrigerator for 20 minutes to bring it up to room temperature, test the pen flow (also known as priming the pen), and then take the first injection.

After seven years on Natpara (recombinant parathyroid hormone) and two on Yorvipath, injections are something I can do with my eyes closed. Or so I thought. My exhaustion from the night before, my distraction from the phone call that morning, and my “I’ve never messed this up before” attitude caused a perfect storm.

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I set the phone down, picked up my brand-new pen, screwed the needle on, and immediately tried to take my dose without priming. When I pushed down on the dial, it jumped through the numbers instead of clicking. Oh, no. I removed the pen from my leg, slapped on a bandage, and then panicked.

I attempted to call the nurse’s line at the Yorvipath developer and manufacturer, Ascendis Pharma, but didn’t get an answer. Thankfully, my endocrinologist’s medical assistant responded right away. I also reached out to my primary care physician and talked to her nurse.

My endocrinologist’s and primary care physician’s instructions were clear: Since we didn’t know how much of a dose I’d received, I couldn’t take any more medication. I had to wait until my next dose. But, they said, Yorvipath is known for having a 60-hour half-life, meaning that the medication level in my body decreases by half around hour 60. Since it would only be 48 hours between full doses, my calcium level was expected to stay stable throughout the entire day, even if I’d only received a partial dose.

The outcome

Ultimately, I was completely fine. I took an extra 200 mg of calcium to be on the safe side. I was able to test my calcium level two hours after my incorrect dose and again the next morning. My calcium was around 9.4 mg/dL both times, which is exactly in range for me. (The textbook ideal calcium range is 8.5-10.2 mg/dL, but my body prefers 9.2-9.8.)

I did have a few hypoparathyroidism symptoms that are usually absent after my full Yorvipath dose. Hypopara can affect mood, and for me specifically, cause anxiety. Before Yorvipath, I used to have a heavy boulder of dread that sat in the middle of my chest. No anti-anxiety medication took it away. After starting Yorvipath, that ball of doom went away. The day of my incorrect dose, the ball returned, slowly growing over the day and peaking about 5 a.m. Even with my emergency anti-anxiety medication — reserved for serious situations — I was unable to quell it.

My legs also felt unsteady, like they couldn’t support my weight. This symptom used to be common before I began injection therapy. I also had an increase in aches and pains. I spent the day in bed reading, resting, and trying to keep myself calm.

The next morning, I made sure to clear my head and set aside my phone before taking my medication. A few hours after my full, proper dose, the ball of doom disintegrated, the new aches and pains diminished, and my legs felt sturdy again. I was back to normal quickly, which was a relief.

This lesson was important for me in many ways. I need to remember that even with my experience, mistakes are easy to make. I need to prioritize taking my injection before doing anything else. I’m thankful for my medical team and my hypopara friends who supported me throughout the day, and they’re — lovingly — glad I was the guinea pig who did this so we all now have answers to what happens if anyone else does the same thing.

I’m grateful that I didn’t need a hospital visit, an office visit, or any follow-ups from making such a silly mistake. Outside of some discomfort, I’m relieved that my calcium levels stayed strong and steady. Learn from my mistakes: Prioritize paying attention to your medication to build good med habits! Take a deep breath and double-check before you inject.

Note: Hypoparathyroidism News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hypoparathyroidism News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to hypoparathyroidism.