More injection questions…

[RoundTheWorld]

Thank you for the previous tips. I tried them but still had an angry (larger!) reaction this week, but it went down much rapidly and hasn’t itched or bruised much. Progress!

Sorry for so many questions for a relatively trivial thing but please may I ask

- do you put the needle in part way or right up to the plastic tube (would a shallower injection would make any difference?)

- some of you (and the leaflet) say to inject at 45 degree angle, but the nurse has clearly told me 90 degrees more than once. Any advice re why one over the other?

Afterwards I spoke to the (general haematology) nurse and she suggested siting it lower (below belly button line) and use aloe Vera afterwards (which helped - I also used cooling (not frozen) pack following some of your comments, thank you). She confirmed to get rid of the wasted bit first as it helps to remove any air and to do this onto tissue discarded in the sharps bin.

I have a Consultant follow up call fairly soon so will ask (am hoping to see the mpn specialist soon as well) but your experiences are always educational! I’m starting to feel generally better I think so it’s worth a bit of localised reaction.

Thank you. Have a good rest of weekend.

[hunter5582]

The 90 vs 45 degree question is really just a personal preference. What matters is that it reaches the subcutaneous region. Likewise for how deep the needle should go. With the specific needle I use that would be about 3/4 needle deep.

Assuming you are letting the IFN coming up to room temperature, I think this may just be how your body reacts. Like you said, it is likely worth it if the IFN is working and otherwise tolerated. Best to review it with your MPN care team, which will hopefully soon contain a MPN specialist.

[RoundTheWorld in reply to hunter5582]

Thanks Hunter - wise words as usual.

As you say, perhaps just my personal reaction (it was room temp). Hope my skin reacts less over time but worth the discomfort if the interferon does its job; particularly now I know how to speed up calming it down somewhat with the cool pack and Aloe Vera.

[RoundTheWorld in reply to RoundTheWorld]

Hmm - have also just looked on the internet and I gather the angle of injection may depend on how much 'insulation' (and so cutaneous tissue) one has! Reminds me that I need to stay on track with healthy eating...

[DougyW]

I also found it helpful to move the injection site. Switch sides and I would do towards front middle than rearward so you only inject in an area every 6th injection. Not sure if this was just me but I didn't get a reaction.

[william-Indo]

If your fat belly thick enough, than you may shot with 90° and 45° for thin belly.

Just tries to find which is has a better result

Cheers

[monarch5000]

Consider following this person's injection technique into the belly. Notice he has no marks or scars on his belly despite years of injections. I don't have any either after almost 500 belly injections the past 9 years: youtu.be/ciYsCnK0TZs(Not working as expected?)

[RoundTheWorld in reply to monarch5000]

Thanks monarch.5000. Useful to see. And well done with your own injections! That’s how I’m doing it (other than the angle as I am not as lean as him) so, as Hunter said, maybe just the way my body reacts. It resolved more quickly this week so maybe I’m getting a tolerance.

Will definitely check with the haematologist or mon specialist when I get the chance. Hope you have a good day.

[Exeter21]

pinch the skin lower stomach always below belly button into pinched skin at an angle. Yes you must leave needle fully in & do not remove for a few seconds after completed.

You always get some slight mark as our blood disease causes inflammation. I get it from any insect bite. But your hospital should show you how to do injection if it is not satisfactory . It fades quickly but I alternate sides of stomach each time. Needle doesn’t go in like a flu injection into muscle . Just at angle into pinched skin 👌 Julia 👌

[RoundTheWorld in reply to Exeter21]

Thanks Exeter21. I was expecting a small mark but mine have been coming up a bit like an infected insect bite (swells above skin level, spread to maybe 8cm last time and was hot to the touch). I will definitely follow up with the team when a get the chance (next week) as it sounds as though mine is a bit more than typical but it’s currently manageable and the tips helped resolve it more quickly this time and without the itching from last time.

Much appreciated everyone.

[Exeter21 in reply to RoundTheWorld]

Hope they sort it . Mine was quite swollen first month but now 18 months on the body appears to be used to it. Make sure no drips from syringe stay on skin as you pull out. I always put small plaster or lint over it for 24 hrs 👌 Julia

[DougyW]

I noted he pulled back on the plunger. I wasn't shown to do that, do you guys do it?

[Spanelmad]

I inject into the thigh muscle alternating the leg with each injection.At 45 degrees so I can have the dosage

[RoundTheWorld in reply to Spanelmad]

Thanks Spanelmad - the nurse suggested that as an option later if other advice doesn't make a difference first.

[Spanelmad in reply to RoundTheWorld]

I've always done the thigh with MT X for rheumatoid arthritis so I immediately carried on with the intercom the same way. Make sure the area is really clean before injecting.

[KLCTJC]

I am so spoiled, I have my husband or one of my nurses give it to me in my arm. Do you have anyone who could give it to you? I am pretty tiny and don’t have much in the way of belly, so I get it in my “chicken wing” area!😆. Do you take an antihistamine? I have a particular medication I prescribe that does this and I recommend loading with antihistamine day before, day of and day after. This may help if you can take it.

[RoundTheWorld in reply to KLCTJC]

Hi KLCTJC. Re. your husband - that's devotion; well done both of you! Tbh I haven't minded the actual action of injecting too much as the needle is thin and it doesn't hurt - it's just the pesky reaction coming up later that's bothering me. The nurse did say I can try an antihistamine if itching is a big problem, but that didn't happen this week; maybe because I chose a site further from my waistband.

[Minify]

As others have stated, the angle depends on the length of the needle and the amount of subcutaneous fat. I do 90 degrees and aspirate prior to injecting. My needle is 27 gauge, 1/2 inch. I also wipe the needle with alcohol (and give it a moment to dry) prior to injecting — that removes the bit of drug on the needle which I think may be causing local reaction. I inject slowly and count to 10 after injection before I pull the needle out. The goal is to get the drug into the subcutaneous tissue and avoid the top layers of skin.

[WRLM]

I was getting red, angry, itchy reactions when i shot into my belly. I switched to my thighs and get absolutely no reaction or redness at all. Maybe try switching it up!

[RoundTheWorld]

Thanks WRLM - appreciate it. I'll try belly a bit lower (as the nurse suggested it) but it's good to know others have found a working alternative and will try that if no improvement.