blood in the syringe

Does everyone check if there is blood in the syringe before push down the plunger, or after?

I am on my week 9 on tx and still not really comfortable doing the shots. I do injections in my stomach. I am pretty skinny so never sure if it goes under the skin or get into the muscle. Most instructions tell us to direct the needle straight but I use certain angle. Pegasus needle is about an inch long and how do you know how thick the subcutaneous  fat layer of a thin person?

Instruction tells me to check to see if there is blood in the syringe first (by pulling back a little) and stop the injection if it does. My doc has told me in some occasion, there is possibility that tip of the needle ended up in the blood vessel and we do not want that.
So I try to pull back the plunger a little in the early shots but with my shaky hands holding the syringe with needle in my stomach and blurry eyes over the tiny pegasys syringe never give me any confident whether I am doing it right,.. so at times, I just stick and push down the plunger.

But today I have noticed some blood in the syringe when I pulled it back. Does anyone have the same experience?

[Trinity4]

I was very diligent about that at first but as treatment progressed I just quit drawing back and shot in.  Several times I saw a little blood draw back in the syringe but I injected anyway.  The blood vessels in the tummy aren't that big to begin with.  I had black & blues regardless and even if I did see blood I didn't want to waste a shot.  It only happened a couple of times and I always pinched the skin angled the needle; didn't feel it as much that way.

Prefilled Pegasys syringes were sharp and not a lot of trouble but the Neupogen needles were a little bigger and didn't seem as sharp.

Trinity

[epiphiny]

Yes! After a while I also never bothered to draw back, just went straight in! Found it best to pinch up a bit of skin and go in on a 45 degree angle with the bevel facing upward. Barely felt a thing most times, always used my tummy and rotated the injection spots. There was always a tiny spot of blood after I removed the needle but it was never a bother for me. The blood vessels are so tiny I don't think you avoid hitting one but it didn't cause me any problems. I know I got enough medicine because I SVR'd. I think you will be ok!

Btw, a wee hint, if you don't already know it is to keep the needle in place for about 15 - 20 secs after you have fully depressed the plunger, this will help minimise any leakage that can occur when you withdraw the needle. I hated the idea of wasting even a micro-drop of the medicine!

Epi :)

[spectda]

I don't think you can pull back the redipen (prefilled syringe) back so I assume it can't be that serious if you do get a small vein.

The neupogen needles I have are not only longer but thicker gauge, they seem to need some force to get them through the skin. I think I hit blood with that when I injected the first and only time so far, but the pharmacist didn't tell me to check for blood so I injected regardless. Nothing serious happened.

I am not sure what the potential problem could be if you do hit a vein. Perhaps someone can answer
- Dave

[pcds]

Didn't want to be first confessing I don't do the pull up.  I am so shaky after my needle disengaged during my 3 week injection, I just go for it.  Easier for my in upper thigh where I am is sure and steady.  I look under the skin for a vein free area at the surface.

[Bill1954]

I don’t think it’s much of an issue myself. As spectda points out, the injecta-matic pen thingies don’t have a mechanism to allow that anyway; and with all us klutzes doing self-injections, there are bound to be errors made along the way.

I’m betting if it gets in under the skin and stays there, we’re in pretty good shape. It’d be worth asking our doctors about it, but that’s my two cents, for what it’s worth.

--Bill

[portann]

Mk, I definitely followed the instructions for about ten injections and then couldn't stand the hassle and fear of making things worse. So I just plunged without checking from then on.

I did confess to the nurse, who wasn't surprised one bit and told me not to worry, so my guess is that most of us plunge and give up on the drawing back.

I'm not saying it's not worthwhile to draw back but I was challenged enough without this extra step. After spilling a bit of my interferon one time, I didn't want to take any chances on losing a single droplet.

Some of us can get quite OCD about getting every bit of the med, as happened to me and as you can see from this thread that Epi started:

http://www.medhelp.org/posts/Hepatitis-C/Pegysus-Pre-Filled-Syringes/show/774853

Susan

P.S. I did something that may not have been that common around here but it was part of my ritual on shot night. I'd ice the injection area for about twenty minutes beforehand.

[mk_]

Thanks for the responses, so a little blood should be okay..
probably I won't bother the draw back next time since I will have to be shooting in anyway.

The instruction in the package said otherwise though,. but how the patient could throw away 'hundred-ed dollars-a-shot'  injection over the doubt seeing a little blood!! Again if it is a big deal than how could they make the it available as self-administered injection!

I am not sure about hitting the small vein/ blood vessel either; I would guess, it would have IV injection effect and IFN would not be time-released from the sub-q as intended..

[spectda]

I think the drug itself is time released. I would guess it's not just how long it takes to get from your fat to your capillaries to your blood stream. I am not absolutely sure though.

[Bill1954]

If you have any doubts as to whether the meds are good, or if you have troubles with the syringe, etc call the manufacturer and they will replace the product. You may be asked to return the faulty dose, so don't throw it away, but there shouldn't be any charges involved--

Bill

[Trinity4]

"The neupogen needles I have are not only longer but thicker gauge, they seem to need some force to get them through the skin."

You got that right Dave.  I hated Neupogen, right down to the needles but it saved my arse so grin and bear right?

Trin

[jusjames]

i just whack it in even if it hits a vessel it will just blow it away when you inject anyway and the vessel will detach,
once i had blood come back in the needle i just pumped it back in, i have lost 10 kilo and my stomach is looking a bit flat so no fat left just go at a slight angle and pinch some skin first, i had a few problems at first as i was trying to follow instructions , the time you just whack it in is the time you think " that was easy , and it becomes routine)

[pcds]

I use the whack technique myself.

[Diane12855]

I got a DVD from Pegasys that said to pinch up some skin and go in at an angle with the beveled side of the needle facing up. They said to draw back.

For my first shot my doctor wanted my nurse to help me, and she said just stick it straight in and push in the plunger.

I've tried to check a few times and actually gotten the plunger pulled back, but the needle moved around so much while I was doing it that I figured I wasn't even in the same spot where I was when I pulled it back, so I just do what the nurse said.

Diane

[nygirl7]

i just whack it in even if it hits a vessel it will just blow it away when you inject anyway and the vessel will detach, "

That is exactly what I did too...just put it in my thigh and closed my eyes and pressed down.  I never did any big deal about it at all. I didn't have any fat on my stomach really so had to sort of just pray it was getting into my leg - it seems to have worked because I've been cured for over three years.

[hcvJames]

I would think this is pretty standard, but maybe not.
The prefilled Peg needles are 27g x 1/2'.
The Neupogen, in my case, doesn't come with syringes. They have to be bought from a pharmacy. They ask for a prescription, but you can talk around that sometimes. The first time I got the 25g x 1' ... kinda a mistake ... 25g is dull feeling in comparison. Worse, even though I have 1 inch of skin to pinch, it left me with the irrational, mildly repulsive, freaky feeling of injecting straight into an organ.

Look at the gage and length on the packaging. If need to ask for 26g or 27g x 1/2'.

[banarep]

my study doc told me there was no need to pull back, just stick and push, that is what i did.