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Pernicious Anaemia Society
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Self-injecting question

I'm well into SI (just did my second!) and using the same needle to draw the liquid out of the ampoule as to inject, which doesn't seem to be a problem except that I can't get it all out of the ampoule no matter how I try. Tonight I ended up injecting just over 1/2ml. I've tried pushing air into the ampoule, tipping it upside down, on its side, repeatedly trying to draw more up. Help! What am I doing wrong?

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Hi Pingo,I've just started self injecting too.Are you making sure there is no liquid in the top of the ampule?I noticed that I wasn't quite getting 1ml into the syringe and then noticed some of the B12 was in the top that had been snapped off.

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Nope, I'm really careful about that -- I know some people use a separate drawing needle to get it out (the nurse at my surgery) but I'm just using the same needle. I'm so over-excited at the idea of being in control though! Great, isn't it margareta12321!

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What length needle and what gauge are you using - 23G, 21G? Should be labelled on the packaging. Also what sizes barrel? So is there 0.5 3ml left inside the ampule after you've drawn up the 0.5ml into the syringe?

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At the moment I'm using 26 but am switching to 23. There doesn't seem to be 0.5 left in the ampoule but there's definitely some that I can't get out. I'm thinking I might need a special needle to draw it up?

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There shouldn't be a need for a special needle as such. I use a 21g (green) to draw up (wider gauge) then a 23g (light blue) to inject. Never a problem getting pretty much all of it out. I also use 2.5ml barrels. I get my needles etc at local needle exchange. I've never used a 26g but am guessing it's too fine a needle for drawing maybe??

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I've done it 6times now and feel improvement.I use thicker needle to withdraw and thin one to inject.I always manage to get all out the ampule.I hope you feel the benefit soon.

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When I was a nurse I was taught that the reason a separate needle was used for drawing up ampoules was to minimise the risk of injecting glass shards. Makes sense and needles are cheap!

Breaking ampoules was my least favourite thing to do, always ended up with glass in my fingers I was so inept! 😁

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the ampoules are designed so you can invert them without the liquid dropping out and this is something you will need to do - or tip them on to their side and slightly inverted - in order to get the liquid out.

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I was taught to use the 21g (green) needle to draw up and the 23g (blue) to inject. Tilt the ampoule with the top snapped off slightly, put the tip of the needle right down into the lowest part of the ampoule and draw up the serum.

Change to the thinner needle and expel the air. Then inject.

The reason for using the two needles, and they could both be the fine ones if you were so ammind, is to make sure the tip is a sharp as it can be, without a turning over of the tip which can happen when you push it down to the bottom of the ampoule. You would know about it if you were withdrawing a hooked needle point.

Needles are £2.37/100 plus VAT and p&p so not worth taking the risk.

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I draw out liquid with a green needle - but I was shown how to first pull the plunger back a little way on the syringe before removing the liquid, so there's a gap at the top between the drawn out liquid and the flat part of the plunger. Then I change needles to a tiny yellow one for subcutaneous injection. Plunge syringe gently to get liquid to end of needle. Because there's a small gap between plunger and liquid, you'll find all of the liquid goes into the needle when you start to inject. Obviously stop when it's all gone, so you're not injecting the tiny bit of air. It's this little bit of air that pushes all the liquid out, meaning you'll get the full benefit of the entire 1ml instead of it being short. This technique should work too if you're only using one needle, I imagine. Good luck!

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Hi what is the difference between im and subcutaneous please as i have been injecting in my stomach to scared to do it in thigh or arm.

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kyanah

Hi, As far as I understand, IM injections are absorbed a bit more quickly than S/C.

I started by IM injections but now I do S/c with an orange (25G) needle, and inject into my abdomen. I find it easier, to be honest, than in leg. Self-injecting into arm is quite hard although, I suppose it's possible - I wouldn't be able to do it into arm.

Good luck

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I've read various peoples' opinions about which is best, but common consensus seems to be that it really doesn't matter which you do - whatever you feel most comfortable with. Some people say IM gets into your system quicker, but then you'll only use however much B12 you need anyway, and the rest will be passed out of your body, so it doesn't really matter. I can't do IM either - feel much happier injecting into the flesh of my stomach and it works well for me!

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Hi - the best way to get all the liquid into the syringe is to have the bevel of the needle facing down and slightly tilting the ampoule, this allows all the liquid to be sucked up - this has always worked for me. I also only use one needle to draw up and inject.

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Thank you Tmbg - total success this time. Don't know why I didn't think of the bevel. Also did it very slowly and that worked better too.

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