Self injecting- tips to make it less painful?

[ClaraJ]

Hi all, after lots of discussions the GP has finally agreed that I can self inject with B12 monthly and the practice nurse has trained me. I did it for the first time tonight, but did find the injection very painful. I know that it usually is quite painful, even done in the practice, but wondered whether there are any tips? Should I be pushing the syringe down slowly or quickly?

[ellj]

Personally I inject into my thigh or tummy and do it fairly slowly.

Not had problems with it being painful.

Hope you find it better next time.

Ellie

[ClaraJ in reply to ellj]

Thanks! She insisted I inject into the top of my arm as they do into the practice but I suspect somewhere else might be less painful...

[Dopey-Grumpy-Sleepy in reply to ClaraJ]

Clara, my neighbor and friend is a retired accupuncturist and she gave me a great tip to make the insertion of the needle (in my belly, by my choice) painless. After I swipe the area with an alcohol prep pad and allow it to dry for a few seconds, I rapidly scratch the area - very lightly - with my fingernail. I've never had it fail to "numb" the area just long enough for the needle to go in with no sensation. If I forget to do it, sometimes the needle feels unpleasantly sharp as I try to push it in. Also, everything Cherylclaire said, plus positioning the needle just 1/2" above the skin, at a 45 degree angle, and then jabbing with a quick, gentle movement. Then push the needle all the way in after it has pierced the skin. Hope this helps!

Jayne

[ClaraJ in reply to Dopey-Grumpy-Sleepy]

Very useful tip- thanks!

[Cherylclaire Forum Support]

Like everything else about this condition and it's treatment, we are all different.

I was absolutely rubbish at injecting. No-one in the practice would show me how to do it. I watched videos -many made me cringe. Found a sensible one, someone genuinely wanting to help, not show off a new trick. Didn't have a computer then, so watched it in the library, tried to remember the essentials and jotted down some notes. Got some good advice from here too. Took a while to get better.

Memory and cognitive problems, anxiety, tension - being ill makes it more difficult.

Still, here I am, faring a lot better.

I self inject into the outer thigh muscle on either leg: outer edge, middle third of thigh ; if you flex your muscles first before relaxing, you can see where to go.

4 main reasons I can think of which can make it hurt:

1: Stinging on entry: If using alcohol wipes (and many now don't just ensure cleanliness), allow the alcohol time to dry. Can sting if you take some with you !

2: Stinging on entry: When getting rid of any bubbles, ensure that you don't leave a drop of B12 on the needle tip. Flick it off by tapping syringe (not needle) and wait a minute - or see the droplet form and very gently draw it back into the syringe. Just the droplet, no air.

3: Deep ache: If you store B12 in fridge and don't warm it up, it is still very thick and cold. It will feel heavy and resistant when it goes in. Some tuck it in their bra just while they sort out their sharps.

4: Deep ache: injecting the B12 in too fast. Very slowly and steadily when depressing the plunger will stop that. No rush.

What's the worst ? :

You can hit a small blood vessel: I once had blood spurt dramatically across the bedroom on removing needle - but only for a few seconds. I have also had a giant nerve/muscle -twitch push the needle back out of my leg !

Like I said: I was a bit rubbish at first.

Very rarely get more than a spot of blood now and no pain or bruising. Still sometimes have to have a couple of goes to get a good place though.

More tips:

If you feel it hurt as you are inserting the needle at any point, stop, withdraw and find a better place. It shouldn't hurt.

Stay relaxed. You can kid yourself that you have relaxed your muscles -only to find that 2/3 of the way in you feel like you're injecting into brickwork.

Best of luck !

[ClaraJ in reply to Cherylclaire]

Thanks very much- I think I forgot to relax the muscle so that’s probably the issue. Also, the practice nurse insisted I do it in the upper arm as they do there- I suspect the leg would’ve been better.

[lifegems in reply to ClaraJ]

I can’t understand why she would make you inject into your arm that’s ridiculously difficult and it’s going to be painful! I sometimes wonder how they manage to get qualified !! I know it’s tough for them etc but it’s common sense to inject in your thigh .. much easier and you simply need to inject into the muscle.

Practice helps .. I now find it much easier.. there’s some good reply’s so I won’t repeat but good luck 😉

[ClaraJ in reply to lifegems]

At that practice and my previous practice they’ve always injected the upper arm but that makes it particularly hard to do yourself... especially as they want me to switch between arms each month so I would need to use my left hand to inject my right arm!

[lifegems in reply to ClaraJ]

Yes same here.. but as you say very difficult doing it yourself.. but there is no reason why it has to be the arm as long as it goes into the muscle (at least as far as I’m aware)

I don’t have any faith in drs or nurses when it comes to PA .. in my experience they have very little knowledge.. I started SI 5 yrs ago so I would have control.. apart from anything else getting an appt was like getting an audience with god !

[deniseinmilden in reply to Cherylclaire]

What a superb reply!

Only thing I might be able to add is the slower you go the better, usually.

There are some spots that will be painful one day and not another so if you gently touch the needle tip to your skin and it feels sharp, move it a bit and try somewhere else or the other leg. I used to try to alternate legs each day but now I just use the most cooperative one!

Needles blunt very easily and the more perfect the needle the better so if you have touched anything with the tip, for the sake of a few pence, it's well worth swapping it for a new one. Always draw up with one needle and inject with a new one. Needles are easy to buy and less than 10pence each.

While it is always recommended that you use a 23G needle because it is safer because it is more robust, there are several of us renegades who take the risk of using finer needles. I use 26G ones and some people use ones as fine as 30G.

You have my sympathy as only injecting once a month doesn't afford you much practise: clouds having silver linings - there ARE advantages in needing lots of jabs!

Good on you and good luck!

[ClaraJ in reply to deniseinmilden]

Thank you very much! Injecting with a second needle- is that for hygiene? I do remember the nurse telling me to do that. She has supplied me with lots of needles. In the end they’ve actually been really helpful.

[ClaraJ in reply to ClaraJ]

PS yes you’re right, in between jabs it is easy to forget the routine with once a month!

[deniseinmilden in reply to ClaraJ]

The extra needles are just so you can use a perfectly sharp one for doing your jab because the sharper the better. Try not to touch the tip of your injection one against anything!!

[ClaraJ in reply to Cherylclaire]

PS do you think B12 needs to be stored in fridge? I haven’t been doing that but I see it says store below 25 •C...

[Cherylclaire Forum Support in reply to ClaraJ]

Not everyone does - it's just summer days like these, hard to find a cool enough place in my flat to keep it all. Like Denise, I inject quite often and so always have a lot of B12 to store.

She's absolutely right about the two needles.

I use green 21g 40mm for drawing up the B12, and blue 23g 30mm for injecting with. This was recommended to me at the start and I never really thought about changing.

I suppose a finer needle would give you less chance of hitting anything, less pain but probably being finer, more susceptible to blunting or breaking ?

Is that right, deniseinmilden ?

[Bellabab in reply to ClaraJ]

Individual 1 ml ampoules of hydroxocobalamin need to be kept at room temperature in their original cardboard packaging so they are not exposed to light. Below 25 degrees centigrade. They do not need to be refrigerated - indeed should not be. In the UK this means in a cupboard or drawer not next to a heater or other heat source and out of direct sunlight.

In the UK this would mean the temperature in such a storage space is very unlikely or at all to be above 25 degrees.

[cath_beal]

Hi ClaraJ, I agree with those saying the slower the better. If you are going to do it slowly it helps to find a technique to keep the syringe very still. I hold it a bit like a pencil (but upright) and rest my fist on the skin of my right thigh. I find being able to exert some pressure from my hand onto my thigh while pushing the needle in helps both to distract from the actual needle insertion and also to keep everything still while I use my left hand to push down the plunger (also slowly!)Good luck!

[ClaraJ in reply to cath_beal]

Thanks- very helpful tips!

[aksundell]

When I have a particularly painful injection, I remind myself how happy I am to have nerves that work well enough to feel pain. Bears the alternative

[ClaraJ in reply to aksundell]

Yes, that’s true!

[Ivo21]

You need to push the syringe slowly as this goes in the muscle. It is normal for this injections to feel pain afterwords, but still depends where you inject them.

[ClaraJ in reply to Ivo21]

Thanks very much! This is helpful.

[ClaraJ]

Thanks- I have moved mine out of the airing cupboard and in to a cool cupboard!