Copaxone injection technique

[doublevision1]

When I first started on Copaxone two months ago, I found the shots quite painful (stinging), and had some major site reactions (redness, huge welts, bruising, lumps).  I followed a regular routine of warming the site first, swabbing with alcohol, injecting the med at room temp using the autoinjector, and then using an ice pack for 15-30 mins afterwards.  After the first few weeks, the site reactions had improved quite a bit.  I continued to follow this same routine.

On my recent trip to the US, I didn't bother using the heat or ice pack as it was too inconvenient.  No microwave in the hotel room, and the mini-bar did not have a freezer.  I found that there was no difference in my site reactions.  I still had some stinging, but not nearly as bad as it was initially, and I could easily tolerate it without the ice pack.

So since returning home, I have not bothered with the heat or ice, and it makes my daily injection a much quicker task.  I also recently stopped using alcohol swabs, at the suggestion of Shared Solutions.  This also seems to help in reducing the reactions.  The nurse said not to worry about not using the swabs, as the risk of staph infection is very low when doing the shots in your own home.  I usually do my injection just after getting out of the shower.

My questions are:

- For those of you on Copaxone, what is working for you in terms of your injection technique?

- Does anyone know if there is a long term benefit for using heat and ice, ie: does this reduce the risk of lipoatrophy?  This is my only concern about discontinuing this practice, since my site reactions seem to be about the same, either way.

Thanks!

db

[Lulu54]

Hi Niki,
how about starting your question as a new post?  This is a really old thread and people may not look at it since it is from last year.

I'll watch for it.......

Lulu

[NikkiKMS]

The area I inject myself stays tender for a long time. Anyone have tips for that? I have 7 shot sites that I rotate, but I can tell you exactly where I injected last week because the area is tender. I've only been doing this for a week so I'm not sure if this will go away, but thought I'd throw it out there...

[Deb61]

Good advice!  I'm going to try it.

Deb

[Amyloo]

Something else to add:  I use a "clock" image for my hips and thighs for rotation.  For example, if I am on my right thigh I will document "right thigh 12oclock".  The next time "right thigh" comes up on the schedule for injection, I will use "right thigh 3oclock", then "right thigh 6oclock" and so on.

For arms, I use "right arm upper, mid or lower".  Stomach is just "tummy left, or tummy right".  

Very important (to me) to log where you inject everytime, so that you can just count backward and see what area is next.

Love, Amy

[Deb61]

I found that the heat works for me.  I've tried it without the heat and it hurts.  However, I don't use the gel packs, I use the hairdryer.  I learned pretty quickly that the ice pack never worked and stopped using this a long time ago.  

What works the best to prevent pain and pooling under the skin for me, was to stop using the Autoinject.  You can't control the rate of how fast the medicine enters your body and it goes in with such a force that it causes a big welt.  So, I manually inject (actually my husband does).

As far as the  lipatrophy goes, I don't have it, but have only been on Copaxone for 5 months now.  I also have had two big babies and have lots of stretch marks.  I do notice that it does sting more when I accidentally hit a stretch mark and stretch mark looks really red for a while.

I think I'm going to stop the alcohol swabs, too!  See the following site:

http://www.neura.net/channels/1.asp?id=341

It is recommended to not use alcohol, but to wash, cleanse and dry the area really well.  Also, icing is not recommended.  Tight fitting clothing on the injection site is not good (I have to watch that my underwear or pant's band is not on the injection site).  Rotation, of course, is key.  Plus, avoid sunscreens or lotions on the area.  

Thanks for db for the info!  I would have never have thought that there was another way!

Deb

[jensequitur]

I have to chill my injection area, otherwise I would never be able to push the button on the autoject!  It's hard enough even when I know it's numb.  I'm glad to hear the alcohol isn't absolutely necessary.  

As for injection sites, basically any place that has enough fat is fair game.  Stay away from the sides of your legs, as you can easily hit a vein and get a vagus reaction - quite scary.  I have a hard time injecting the backs of my arms, so I've started injecting my upper stomach area.  Both thighs have a big dent, and they're scarred on the inside - sometimes the medicine oozes right back out.

[cjacks]

db

I've been on Copaxone for five wks.  I started with warm packs but soon found that they were a pain , but that the ice packs wrapped in a small towel help with the stinging .. I continue to use them, mostly for my legs .  Shared Solutions said if I continued to have problems with my legs to ask my dr. for a suggestion for an alternative site ...  seems there are other places to inject but they weren't giving up the 'secret'.

My friend the nurse has been helping with my arms and I never feel a thing , nothing ... so I had her show me what she does .  You pinch up the skin and then looking  at the needle , put the beveled side up  (  hole facing up ) , inject at an angle ... between 90- 45degrees . Do not jab , gently press the needle in.

  She says alcohol wipes are not necessary.  I guess when its old hat I'll consider that.  I went over all of this with SS and they concur..  :)

I take my new syringe out the day before , keeping it in the auto injector case, meds are light sensitive. They are fine up to 86%.

I have everything nicely organized , When I start to get some energy back I'm going to make a nifty storage unit for all of my gear. Maybe covered with light sage glass tile . I'll do the back splash too.. Right now its all on the counter of the butlers pantry( I need it handy).  I feel this is all going to be in my life for a loonngg time so I might as well make it pretty and easy.. I'm looking for an attractive container to hold the syringes in the fridge ..    :)     really.. I'm ok  

I still haven't had the SS nurse here , she's on vacation.  I'll have her come later in the month to instruct me on the auto injector.

Tootles

Jo

[cz1970]

Yes lipatrophy is destruction (more like divets) left in tissue from repeated injections. If you clean the area really well w/ soap/water (Perfect after a shower) alcohol isn't necessary I imagine.Wwe dont teach diabetics to use alcohol w/ each finger ***** either because it drys out the skin too much.  I personally just started my Copaxone 8 days ago and am just learning about the "tender spots" YIKES!  But all in all it's going well.  I dont believe ice/heat makes a long term difference.

I know the best thing to prevent lipotrophy is to really rotate sites. Like try to avoid the last injection area for a few weeks. If you injected in your upper tricep area, do it in the mid area next week etc. then that gives you 2 weeks before you have to come back to the upper tricep area again.  I've found for me (just starting of course) that there are 8 areas to inject so that means really 16 cuz you can go above/below that area next time.  

I personally hate the auto injector. For me manual is best and I put the needle all the way in. Then the med is deep in the Sub Q so that helps.

Good luck!
cz

[Wobbly]

this is good information .. I might need to get more info from everyone on this...
is Lipatrophy tissue distruction?  and this is caused by?

is it alright not to use alcohol?  

sounds like db has found a way to make it easier too... I guess with practice it helps..

well, I'll see in a month or so if I'll be starting DMD?  

thanks for the info
andie

[Heather3418]

Lipatrophy is starting on my belly injection sites.  I do not ice or heat with any injections.  I have been on Copaxone almost 8 months.  The stinging only occurs occasionally now.  Thank God.  Some sites "spit" a few drops of medicine out and some bleed slightly.  I have only noticed  the fat tissue destruction on my belly.

I was an insulin dependent diabetic for many years (now off of all diabetes medications, thank the dear Lord) so I would imagine that my belly is a bit more sensitive to needles at this point.  Also hard not to hit a stretch mark, after carrying two big babies, so the skin is thin anyway.

I think you will find that the injections will start to go easier.  I barely think about them anymore and it's become second nature.  I try not to listen to Shared Solutions.  They are a pain in my kester.  I even asked them to STOP calling.  They get on my nerves.

Good luck with your continued shots.  We are in this together and can help each other through.  Craig now joins the Copaxone bunch....

Big Forum hugs,
Heather