Injection sites

[BronxRican007]

All,

Seems like I'm runnning out of places to stick myself. I've used my thighs and abdomen (still freaks me out). On every single injection I have a reaction that lasts a few weeks. I get a red circle, tender to the touch, about an 1.5 inches in diameter, which then turns dark.

Anyway I was wondering if anyone injects the Peg in areas other than thighs and abdomen.

Thanks
br007

[spiritwalkin]

Those are the areas where meds. are best to be injected for most effectiveness. It's been a total drag on my wife whose completed 2 now to start 3rd. round post-transplant. You'll get used to it hopefully. Gotta do what ya gotta do. Bye

[mare52]

I also have the round red spot after every injection. I *think* I had read that site redness was common. I am only using thigh area. My husband is diabetic and he does my injection for me. Sometimes it hurts during & after the injection. I do use a loofa sponge & mild vegetarian bar soap (Dr. Bronners) to massage the previous weeks site. I do not know if this practice would disturd the most recent shot site so I do not rub that leg after injection. But this method of rubbing has greatly dimished my red circles faster than before.
I might imagine that any spot a diabetic might use would be a decent site idea for our medication also..? only my opinion of course
Mare

[stc1993]

When I was on tx i found if I injected at an angle I would get those red marks, if I injected straight in it would go deeper & wouldn't turn red & leave a mark.

Monte

[NYgirl]

I just jam the shots in anyways - honestly between the interferon and the epogen there just isn't much room left.  As long as I am not wearing shorts nobody can see it so I just deal.

I can relate - as we all can.  Yuck.

[fishdoc]

doc said fleshy (hate that word) part of the upper arm is also OK, but said I would need assistance if I went there.  You described my site rxn to a t, but I am not concerned, as we're all in the wierd red zone together........

[Dale_Ray]

Same here. Mine are maybe two inch purple areas and it happens everytime. I'm thin build so legs aren't an option. Tried it and it just wasn't for me. My stomach is getting harder and harder to find spots but like NYgirl said I just stick it and deal. I do know that if you hit at least a 45 degree angle and let the meds sit out for a few minutes to warm in the room that the sting and redness hasn't been as bad. I hope it gets better for you. I know it will and hang in there we can relate. DR

[anise]

I have had 2 shots so far and both are a big red circle and itch.  The first shot was given in my upper arm (sure hope that was effective??).  The second shot was in my abdomen.  I go for my 3rd shot thursday.  the NP is going to make sure I do this myself.  Lilmoma, were are you to give me my shot :)

Thanks everyone for the tips on doing the shot.

[mimi3535]

Hi to all!  I am new to this site.  My husband has Hep c 1b with cirrhosis. I'm a registered nurse and give subcutaneous injection all the time. I am licensed in Hawaii & Nevada as a Registered Nurse and administer this and other medications to people in the hosptial setting all the time.

There are several areas that you can use other than the abdomen and thigh.  I believe that one of the reason the manufacturer suggests the thigh and abdomen is that they are assuming that YOU will be giving the injections to yourself.  The injections that you are giving yourself are call subcutaneous injections. This means that the injections must be in an area that has a layer of fat between the skin and the muscle. The following parts of your body have subcutaneous layers:

-outer surface of the upper arm
-top of thighs
-buttocks
-abdomen, except the navel or waistline

If you have someone to help you, then you can use the outer surface of the upper arm, AKA for all us women, the grandma flab area of the arm.  But it must be the other side of the arm, not the inside closes to your body.  Another area that can be used is the buttocks area.  I discribe it as more like the hip area. (If you place your hand on your waist, with your fingers facing your abdomen and the thumb facing your back, and then rotate your fingers down and then to the back.) This entire area can be used for injecting yourself; (The area from where your fingers are facing down to where they are facing towards your back.) You may or may not need someone else to inject you.  

I hope this has helped.  I look forward to reading more of what every one has to say because it has been a great help for us!!!

[mare52]

Hiya & thanks for the alternate sites. I am right now crying with laughter at trying to make sense of the hand on the waist, finger placement (I think I might be developmentally challenged). I did finally figure out how to "place myself", now who is up for a snappy game of twister?
thanks,
mare

[NYgirl]

Jez talk about being confused? I'll just keep closing my eyes and smashing the thing into my leg no matter how bruised and red it looks - I just can't picture pulling that off no matter what!

ARGH!  ;-)

[mare52]

I am gratefull that my husband (the diabetic) gives me my shot (ok I am taking a free ride here on the once weekly shot) If I was diabetic I would try to learn myself as that would be a daily issue. I am an immature baby 'bout the needle AND him grabbing my flesh ( ahemmm fat ) is so soul baring.
BTW~ I totally enjoyed my DVD last week. Flight Plan (Jodie Foster) suspensefull until the very end.
Mare
Hey a fudgesicle idea for you maybe... I used my plastic reusable popscicle molds (internet purchase, after a long search)to make non fat milk with chocolate syrup for an almost healthier frozen fudgepop

[goldyn]

I hope someone can help me ..everytime i do a shot will do 12 on friday  i always worry that im going to hit a vien ..what would happened if you hit a vien i always give my shot in my tummy. I also have a 1 inch needle..does everyone shoot with a one incher im such a nut on shot day i get so nervouse,because i keep thinking what if i accidently hit a stray vien, would it fry my brain even more...otherwise tx is going along ok, i just freak out about this part.

[roxxiroo]

I'll never know for sure about this I suppose. But the night of my 14th or 15th shot I bled some when the needle was pulled back out of my injection site. That night I felt achy within just a couple of hours and had the worst flu symptoms as the night progressed. I suspected that maybe some directly entered my blood stream. Could just be a fluke though. I do pay close attention now for any blood vessels showing in my skin. I'm twenty shots down now, and not long before I can claim to be half way done. Happy days will be here again....one day. Just sing the first part of that. Feels good!

[GoofyDad]

Thankfully, I don't get site reactions - I've had a few minor bruises, but not much to talk about. In fact, I can never tell where I've already shot before.

I put the last peg shot in my belly - around the waist line, I guess. Upon withdrawing the syringe, I saw blood in the little nipple at the end of the barrel. I guess it must have been pulled in by the vacuum created as I withdrew the needle. The site bled a little bit and required a bandaid.

Any speculation on whether the meds ended up where they needed to go? I do think I felt more fluey than usual the next day.

BTW, I use the prefilled peg syringes, with about a 1/2 inch needle.

[NYgirl]

OOOOOOOOOOOoooh I could make them in the kids pops maker that you use in the summer time!  I cn find some at the store soon!  That would be so AWESOME to make my own!  What a great idea you just gave to me thank you! And I could even make them like mocha or cinnamon in there and stuff if I wanted LOL. Oh I'm already going nuts huh!

You are lucky you have a needle giver.  Boy let me tell you in the beginning I was sure i could NEVER do it. But being a New York Italian girl....I was like oh i am NOT such a pansy my family will laugh at me and I just jammed the sucker in and you know it wasn't bad at all.

My mom came with me to the lesson cause she figured in all truth I'd punk out...and she'd come up and get me in the butt while i was sleeping. As she said you are MY child...no matter how big you get and if this medicine is going to help you I CAN DO IT.

I cried. She is so phobic she doesn't even take Tylenol but she'd do it for me.

Family MATTERS doesn't it?  :)

PS you are lucky to have a husband to do it for you - i'm glad my mom is doing it for me if it was my xhusband...I dont think he'd be putting in the "right" medicine and I'd be nodding out all night long and not getting any better.  He is a jerk who thinks I might as well quit tx cause it's hard.  LOL.

Idiot - you don't quit things because they are HARD that is the most important time to continue!

[strator]

I've been pretty lucky there too as far as hardly any marks from injections. I do the peg prefilled(sure looks bigger than a 1/2 inch Goof. I have done all my shots in the right or left of and 1-2in down from the belly button. I imagine a 3x3 square on either side and shoot in there. Have noticed a difference if I don't make sure that little flat or spoon side is facing up.

Goldyn- I put the instructions in front of me and read em each time as I'm going.With my instructions after I go in with the needle I pull back 'slightly' w/plunger, if no blood comes in the needle I go. One time I noticed as I went through the skin it stung a little,then I noticed just a little blood around the entry point. So I took the needle out and moved over an inch before continuing.

BTW NY Girl, I did #24 Saturday(I believe Goof and I started 9/17, a wk ahead of you). I'll go for my 24wk pcr Thurs of Friday hopefully.
goldyn

Happy darts,
Don

[azgrl]

I thought if you pulled back on the syringe and there was blood in it you had to throw it away?  

deb in az

[goldyn]

roxxiroo im glad to know im not the only one that looks for those blood vessels..,i wish i could say 20 but that would mean i woulndnt have to sweat out this 12th week pcr and that would be to easy we all have to go through the right of passage.                                                                                                                                                                                         srrator; my shot last week did the same thing i swear i went dizzy..thought i was going to faint because i just knew it went straight to my brain and was frying it but then i was ok but did have stronger sides and fell asleep within  an hour and hat was wierd for me..  


goofydad; i get so nervouse that i dont know if i could pull out and check to see if there is any blood...but i think i will try fri that would give a little piece of mind...your on 24 yawzzzzza!!!!!

[goldyn]

sorry guys got you mixed up in my response ive been doing stuff like that alot....ah the smell of brain fog in the morning.

[NYgirl]

I don't pull back on the syringe so I don't know about that.

I don't know if you would have to throw the syringe away or not but I do know we can't use them twice.

I just take that needle and plung it in. Since it's going in to fat I pray I dont hit any veins - I dont' think I could if I tried.

[NYgirl]

I don't pull back on the syringe so I don't know about that.

I don't know if you would have to throw the syringe away or not but I do know we can't use them twice.

I just take that needle and plung it in. Since it's going in to fat I pray I dont hit any veins - I dont' think I could if I tried.

[can-do-man]

Whats with you, is it just double the fun? Its either double dosing, double the ice cream or double the post. Is there any thing else you like to do twice? :)

[NYgirl]

Double vision is the problem.  It's on your end....

hahahahahahahahah

Something about this server at work every once in a while it causes it to double post I don't know why even if I'm NOT hitting it again before it goes.  It is a major pain.

[friole]

goldyn -- what the heck are they doing to you giving you 1" needles?  March right back to that pharmacy and get 1/2 inch needles - 27ga or smaller.  I was prescribed the prefilled syringes but my first rx was filled with vials instead.  They gave me 1", 22 ga needles -- just huge!  I really struggled through that first shot, then posted here and found out what I should have.  You get too deep with a 1" needle.  You need the 1/2" to stay in the fat layer, plus you can just jab it in all the way and not worry about it moving in and out.

azgirl - When you read all the literature, they tell you to pull back to make sure you are not in a vein.  In practicality I never mastered that art - I think I would need a third hand so I don't do that anymore.  I do make sure there is no obvious vein by my shot area.  I don't think it will hurt you if you do get it in a vein, except that the side effects would probably be very severe.  I believe interferon is injectable (by professionals) in the vein or subcutaneous.

bronx - sorry you are having such site reaction problems.  Could your platelets be really low?  Perhaps vitamin E would help.. both orally and to break open the capsules and put it one the site -- vitamin E is known to stop scar tissue from forming.

goof -- you know I tried to vary things up but the peg still works better in my thigh.  When I do the belly shot with the peg, it itches like heck for weeks.  So back to the thighs with the peg, saving the belly for the Procrit and Neupo.

[NYgirl]

don't feel bad my stupid NP called me in 3s.  Yup not even 1s. They are freaking HUGE.

I've been using them for a few months for the Epogen and let me tell you it's a nightmare. but I paid for them and have to find out if I can exchange at the pharmacy. Hey another $20 is another $20.

NY is a pain with needles. I could just drive over the boarder into CT where I work and buy them for like a buck and get what I want.

[FlGuy]

As a point of reference, Redi-pens don't even allow the pull-back function to see if a vein was hit.  I think that's the premise behind short needles and pinching skin is to avoid that.
NY: In NY can't you exhange needles wherever lottery tickets are sold?

[NYgirl]

I use the regular syringe for the Epo - no redipens for that! ;-)

I have NO IDEA where they have needle exchanges and I would be just too nervous if I did - it'd probably be in one of the "bad" parts of town that would freak me out. Now I had no problem going to them at 2am looking for drugs in the olden days...why would I be scared now? Makes no sense but it's the way it is.

So I just pay for them. I have to admit I HATE those 3s though. I have to actually use a PULLOUT method with them and hit the needle in and then pull it half way out - there just is NO fat for that sucker to hit otherwise!

I guess the pullout method might not be so common but...some of us do use it ;-)

PS Shoot I am afraid to even touch an old needle let alone reinject it. My luck...I'd run out and have just cleared and then stuck it back into my body again LOL. That's just what would happen to me.

[jmjm530]

It wasn't until about the sixth shot I had the dexerity/confidence to "pull back" on the plunger before the shot. So far, haven't hit a vein, but if I did, I'd simply move the needle to a slightly different site before injecting, per instructions from my NP. BTW blood drops on the skin appearing after the shot does not mean you injected into a vein, just passed through one. That's what the bandaids are for :) Not sure how important the "pull back" is but it's in all the instructions, and once mastered, it does give you the pride of excellence :) not to mention no anxiety or questions whether you hit a vein. The waistline (and esp belly button) is to be avoided because that's where you'll find more veins and arteries.

NY,

I'm not sure exactly what you're doing/buying with the Procrit, but after tried just about every needle/barrel combination, I'll tell you what works for me.

I use a BD 3Ml syringe (barrel)  with the "Luer-Lok" tip system. The barrel comes without the needles. I then order TWO needles for each barrel. The needles are the B-D 27 G 1/2 gauge "PrecisionGlide" needle. These are about if not exactly the same size needles you get with the Pegasys syringes and probably slighly longer than with the Peg Intron Redipen device. If your pharmacy doesn't supply the syringes, your  doc or NP can simply write you a script for both.

First, I let the Procrit (don't shake, don't stir) warm up to room temp which seems to take 20-30 minutes. Then I pop the cap and wipe the rubber stopper with an alcohol wipe to keep the field sterile per instructions. Now I screw on the syringe needle to the barrel and back it up 1ML. I then inject 1ML of air into the Procrit vile, making sure the air goes into the space above the Procrit and not into the Procrit itself. Then I turn the Procrit vile upside down and slowly draw back on the barrel letting the Procrit flow into the syringe. Sometimes you may have to do a little back and forth (inject some back into the vial) in order to suck all the Procrit out.

Now...and here's the important part...once you've sucked up all the Procrit, with the barrel pointed upward (duh) unscrew the needle and insert a second needle. Now go ahead with your injection. Briefly, I use the abdomen, above or below the navel, somewhat off center or at the love handles. I do the pinch thing, then let go, draw back, and inject at about 45 degrees.

Before I started switching needles mid shot, I had a rough time getting the needle through the skin. The culprit turns out to be a dulled needle because it passes through the rubber stopper. By switching needles in the middle, the needles sails right on through. Good luck.

-- Jim

[NYgirl]

Oh so you switch needles so the needle is still "poppin' fresh" and breaks the skin easier? I simply cannot inject into my stomach - even if I had some fat there I mentally can't. GOT to use the leg it's the only thing that I can do (and I sort of close my eyes still)

I too warm up my Epogen (usually about 15 minutes or so).  The needles that are attached to the 3ml barrel are just HUGE in comparison to the smaller 1s....

I have to call to set up my PCR (make sure that paper work is waiting there when it's TIME) and I will ask her to call them in as you said to the pharmacy. Then I will make them take back the unopened ones I have.

It's amazing I remember when I first asked you how to inject the meds...it all sounded like gobbledeegook but just reading it now it's like oh yeah that's what i do...uh huh yup LOL

Amazing how much "knowledge" you get on this board that you really didn't ever think you would have!  :)

[jmjm530]

NY said: "Oh so you switch needles so the needle is still "poppin' fresh" and breaks the skin easier?
------------------------------------
That's exactly it. Same princple if you inject into your thigh. Absolutely no reason why you need more than a 1/2" long needle for a SQ injection. If I remember correctly, the needles and barrels are quite cheap, so you might just pay out-of-pocket instead of waiting for the insurance process. Just remember that when you change needles, you're holding the syringe UPRIGHT (needle to ceiling) or you're going to be sucking EPO off the floor. LOL.

-- Jim

[friole]

Your method of injection is exactly how the NP told me to do it. But then the pharmacy gave me those syringes with the undetachable needles so I use them.  I am aware that the needle is dulled from the rubber but still don't seem to have a problem or injection reactions.  However, the prefilled Peg needles definitely does go in smoother.  THe one time I tried to change out the needle on a procrit dose, I ended up with a bunch of bubbles, and by the time I got those out, I had less than 1cc to inject.  Thus I went back to the others.

[jmjm530]

Hear you on the bubbles, but the trick is to get rid of them before you switch needles.

In any event, if you use a 3ml barrel, any leftover bubbles seem to settle by themselves with a little tapping and patience. After the needle switch, the Procrit needle has the same exact smoothness as the Pegasys needle, which makes sense since they're the same needle :) I noticed more of a difference when I injected into my thigh, probably because the skin was thicker there. But with hardly no fat left in the thighs, a few months ago I switched over to the abdomen exclusively.

You don't seem to have the same problem, but if you want, the pharmacy should swap out your needles if the "Luer-Lok" were specfied. All said, the two-needle approach definitely has a richer ritual to it. LOL.

-- Jim

[goldyn]

thanks yall for all your wonderful sage advice....im sure going to try to get  some smaller needles thanks friole for the tip!!!

[GoofyDad]

I tried the pull out method, but well it just never quite did it for me. AZgirl, my nurse said not to bother. I never understood the throw it away and use a new one approach - neither for injectables or condoms, but I digress.  

Anyway, in my post above, I was trying to say that after I had completed injecting, upon withdrawing the syringe I discovered the blood in the barrel.

Anybody know why they say to avoid the waistline? I assumed it was just for clothing irritation, no?

Friole, now that you mention it, I do have some belly itching as of late. Hmmmmm....

[strator]

Jim,
You know what through me for a loop the first week. I push the needle through the skin, then I do the pullback, wow great, no blood coming back in, but wait... are those air bubbles coming back in, didn't I just get rid of them...aw screw it..PLUNGE!

Goof-Yes the pullback method does take dexterity, more than I sometimes have.....my 30yro and 14yro children unknowingly provide excellent attestment to that fact.
:)

[fishdoc]

OK, my 2 bits worth.  Pull out don't work.  He's 23 now.  onward.. We are very lucky that fat is poorly vascularized.  I don't think checking for veins is necessary, hence the one way on our redipens.  I am counting on poor vascularization.  This house has had two rattlesnakes ON THE TOILET in two years.  I have been here since november.  Did I mention I am counting on poor vascularization in fatty regions..   May find out just how much the ole hubby luvs me....

[can-do-man]

You say.....You know what through me for a loop the first week.

You can fool some of the people all of the time, but you can't fool all of the people all of the time. And me and goof knows all about them wild nights you have. Do i need to say more?

[jmjm530]

I think a couple of clear bubbles on the pull-back is normal. As long as they're not red, plunge away. What I found in the very beginning was that the plunger on the pre-filled Pegasys syringes felt "stuck" when I tried to pull it back, so I chickened out and injected without pulling back. Now what I do is rotate the plunger in the barrel a few times before the injection to loosen it up a bit. Also, unless you're *very* dexterious, you have to let go of the pinched skin since the pull-back requires both hands.

-- Jim