Subcutaneous injection

[Nackapan]

Went for my b12 sc injection today as agreed by Gp to try.

Nurse said she'd had a meeting with Gp. Apparently told by pharmacy not licenced to be given sc?? I had it IM.

The nurse was busy so didnt discuss it as she said she was sorry but couldnt do it.

Ivr spoken to the pharmacy who is going to look into it. It may be the nurses aren't covered to give b12 sc? If it can be prescribed like wavylines perhaps it's only for self injection?. That's what i actually asked for but Gp wanted me to have with nurse . I know there was some problem with getting needles by people on here? but surely I can buy those. I'm still working with the surgery and having 2 weekly at present. The aim was to do sc inbetween IM injections done at the surgery which I was hoping to have less frequently. Say monthly if it worked sc.

Dies anyone know about it not being licensed?

I wi see what the pharmacist comes back with. Disappointed again. Especially after having to see a doctor last week who just scared me

[fbirder]

They are correct. It is only licensed for IM use.

That doesn't mean that they cannot give it SC. But they need to have a good reason to believe that going off label (as the practice of prescribing outwith the terms of the license is called) will be of benefit to the patient and will cause no harm.

[Nackapan in reply to fbirder]

Arrh okay thank you. So shouldn't really be a problem ad so many drugs are prescribed for ghingd they are not licensed for.

I expect the nurses unhappy to give it sc.

Maybe next time I see Gp I can discuss again doing it myself.

I do t want to lose the 2 weekly regime I have either with them.

[fbirder in reply to Nackapan]

I would imagine that the nurse should be used to showing diabetics how they should inject themselves SC.

[Nackapan in reply to fbirder]

Well yes. I will discuss again. See what pharmacist says. If nurse not actually doing it may be okay!

[Beatri in reply to fbirder]

It is often about surgeries being paid for giving the injection. It is also about finances

[wedgewood]

Well, on the Rotexmedica packet of B12 ampoules , it has printed on the front -for -

IM - Intramuscular

IV - Intravenous (slow)

SC - subcutaneous injection.

.I know that some members of this forum successfully inject subcutaneously

May be th are is some NHS regulation or other that prohibits sub-cut for a B12 injection in this country ?

[Nackapan in reply to wedgewood]

Interesting. Thank you.

If used off license in nhs for sc.I imagine the nurses unwilling to give it sc .I can understand that.

I actually asked to do it at home though between IM at surgery.

[fbirder in reply to wedgewood]

It's just the licencing for hydroxocobalamin is only for IM.

The latest NHS batch I've got, from Accord Healthcare, only says IM on the box and the PIL. That's despite them being made by - Rotexmedica!

[wedgewood in reply to fbirder]

Thanks . Can’t imagine what reasoning is behind that. I suppose some people might be put off self-injecting if they thought it had to be I.M.

And “they” want to discourage I.M .

[Nackapan]

Sorry I mean prescribed by the NHS. I have my injections at the surgery. I was just going to try sc but Gp wanted it done there .

Thdn perhaps move on to Diy

[buster_uk]

As it's only licensed in the uk for IM they are only covering there arse incase anything should go wrong. Best bet is order your own supplies and away you go. Just dont tell them. Or I should think they will stop your treatment altogether.

[Nackapan]

Yes you are right. If I did and told them they would stop the IM ones. My Gp initially agreed for me once taught to do them at home between the IM ones at the surgery. She then changed her mind and shè actually said she didnt want me to be tempted to do more Injections!!

Trying to do the right thing not working yet. I dont even know if Sc will work for me yet either!! I've tried extra injections before .

She is trying then comes out with things that are so wrong and i realise she dorsnt get how ill i still am.

She suggested duloxetine last time and another sodium....folate and the list goes on rather thdn trying to refer me to another specialist who might know what's going on..

Thanks for reply.

[Wagonwheel in reply to Nackapan]

It's such an awful roller coaster. Just when you feel supported by a gp they drop an ignoramus bomb on you, mine was I need to 'wean' myself off B12 as I've become dependant! Well done Sherlock yes I depend on it in order to live my life. At least she tried, saw me at my worst and then partly recovered so she understood it did something.

I was wondering, as sc is turning out to be such a faff, would it be easier to IM or SC yourself?

[Nackapan in reply to Wagonwheel]

Yrs I'm fully prepared tk do Sc .myself. that is what I asked the Gp for.

The pharmacist is being really helpful but as yet we cant found one he can order that has sc on the box

I'm getting closer to just buying the b12 for sc and continuing with my 2 weekly IM at the surgery.

I'm so slow with all of this as i really thought I'd have improved more by now. And Gps need educating . I'm also a bit scared as have worked with them so fat si transparent on my notes what's happening.

The Gp has tried but last time even reluctant to see me in 3 months she says to leave it 4-6 months. This is all very well if just for monitoring iron ect but I'm not functioning day to day to even get on a bus yet ir read or watch tv ect ect . I wrote and asked for last referral . Didnt come from her but she did do it!!

I think it's so so wrong to have to do diy.

But I think it's time I seriously thought about buying some so I have the flexibility to try more frequent again to see if it helps. My friend in Canada does and so many on here have had to take control as let down by doctors getting it.

Akso my Gp like yours said out of the blue my b12 deficiency is dietary. To take b12 tablets and have fewer injections

I was totally lost for words.

Has she not seen what's been happening to me over 16m . Has she not seen the only thing that has helped to date is IM b12 . I even started taking g b12 tablets I had in. 500mcg

The nurse suggested to stop them . If no difference she wi put it in my notes at next I jection appointment apt!!!

Thank you

[kittyflowers in reply to Nackapan]

I wonder what is holding you back from si?

Is it the cost? Are you struggling with the practicalities of si or squeamish? Or that you want to keep them onside as trying for a neurologist referral? Completely understand all these. However you are clearly not at all well and your experience is that the only thing that has helped is IM b12 so I just want to encourage you to take control. This forum is the expert. The medics are all rather behind. It feels good to be in control of ones doses actually...it makes me feel a little stronger. Less passive.

Hope you find a pathway to better times that suits you soon and sending a hug.

[Nackapan in reply to kittyflowers]

I was hoping for it all to be on my notes Also to work with Gp. I've seen 3 neurologists. Only one on the NHS. 2 mri scans

Its ingrained I think as a retired non medical but clinical NHS practitioner of 36 years.

I dont want to do IM at home. Was comfortable with trying Sc at home as well as keeping IM ones at the surgery. Gp clearly dirsnt want me to inject at home as it was her that said to have sc st the surgery. I'm also a useless liar. As if I do get supplies I feel I coulft tell them.

I'm not totally convinced even more injections the anawer but was going to try again. I've had every other day then weekly then 2 weekly. Tried 3 weekly a few times and back to 2 weekly. I've still no pattern to my symptoms.

I had a fall as undiagnosed with low b12. 2 out of 3 naurologists say not post concussion as well. No test for that!! So only diagnosis is b12 deficiency.

I'm better than I was a year ago.

Awaiting a neuro opthalomogist appointment.

I'm thinking about buying my own b12 for sc. As so weary trying to sort it. Gp has put the restriction of 2 weekly now . It was more flexible before. I realise I'm fortunate that she is at least trying. So many only get 2-3 monthly.

Thank you for reply

[Wagonwheel in reply to Nackapan]

It’s too much to have to fight for what you need, educate health professionals, explain away misinformation and battle with contradicting moral compasses and political views. Get better, focus and do everything to get better - get the stuff you need and diy!

[Nackapan in reply to Wagonwheel]

Yes thankyou. You are right

[Ms_J]

Oh Nackapan , I’m sorry to read you got all the way there for them to change things on you, I know how disappointing that is.

[Miss-guineapig]

I just feel, even if you do IM, there is no guarantee that it is deep enough always, and it will also be absorbed subcutaneously. Equally if you do subcutaneous it may go deeper than you think and be IM. I don't understand what the issue is to be honest, or am I just confused.

[Nackapan]

I understand what you are saying and that us true. i wanted to try sc as could then do it at home in my stomach or thigh.

I am not a nurse and do not want to do IM at home . The nurse does that deeply.

My arms are sore . So I wanted to have I'm at the surgery ad I do now and sc inbetween at home

The 'issue' is its not licenced ti do sc. So neither have to forget it or buy it and not tell Gp.

Go was happy for me to trial sc at the surgery first. Nurse was willow g to show me . Then of course it coukdnt happen. Pharmacist trying g to find a way round it. He rang today.

Hope that clarifies any confusion.

And hope you feeling brighter