Where do i get needles?

[nastynigel]

Hi,

My wife has PA & has an injection every 8 weeks but the doctor can't increase due to Nice guidelines. I've looked into getting a supply of b12 from Germany but am clueless on where to get a supply of needles & which size, I'm going to inject my wife intramuscular (hoping to get training from somewhere!!) as this is what her gp practice nurse does.

Any advice would be greatly received. Thanks Nigel x

[Narwhal10]

Hi Nigel,Welcome, sorry I’m exhausted so, short and sweet.

Here’s a link to buying stuff to start

healthunlocked.com/pasoc/po....

X

[nastynigel in reply to Narwhal10]

Many thanks, hope ya feeling better sooner rather than later x

[Narwhal10 in reply to nastynigel]

Thanks Nigel,X

[Nackapan]

I do subcutaneous b12 inbetween my NHS IM ones. May be worth considering as easy. And just as effective .

Meanwhile push for more injections . Tour doctor can prescribe more if it's in the best interest of patient!!

I'm prescribed 2 weekly.

Have been trying a higher frequency after a year of 2 weekly.

Write in. Often more effective.

State symptoms and when they return.

Bullet points.

Meanwhile get your own supplies

Good luck

I use 30G 1/2 " needles for subcutaneous injections .

Medisave

[helvella]

Currently there are no formal NICE guidelines for B12/Pernicious anaemia. What does exist are Clinical Knowledge Summaries which are not produced by NICE but are on their website. (They used to be on the NHS website.)

NICE is developing guidelines:

nice.org.uk/guidance/indeve...

Those NICE guidelines which do exist all state the following:

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

That is, doctors are absolutely NOT supposed to slavishly obey them.

[Gambit62 Administrator]

Sorry to hear about your wife's GP's attitude. As Helvella says, the guidelines are guidelines. They are not a straight jacket and GPs etc are expected to use clinical judgement, though many don't for whatever reasons.

Does the GP know that you intend to self inject because of the rigidity of his application of the guidelines. Its a difficult one as you don't want to open yourself up to accusations of 'blackmailing' but it could soften their attitude.

[Tuscansun]

medisupplies.co.uk/Syringes...

[nastynigel]

Thanks all for your replies, only speaking to Sue's doctor over the phone at moment, so will hopefully be better when allowed to meet in person.Best get pen to paper 👍

[Cherylclaire Forum Support in reply to nastynigel]

If guidelines are being followed, those who have neurological symptoms are supposed initially to get injections every other day until no more improvement can be gained. (NOT the same thing as "until patient deteriorates again" or "until nurses start to complain" or "until GP decides to call it a day"! )

Only then would it be appropriate to start a maintenance frequency - every 2 months.

So if Sue hasn't had that yet and does have neurological symptoms, there is something perhaps worth pushing for.

My GP realised that I wasn't doing well on 1 injection every 3 months, had my MMA tested -it was raised, so I was given 2 injections a week for 6 months. Nurses not able to do every other day, and not all were keen to follow this regime anyway - but at least it stopped my deterioration.

[brainchild in reply to Cherylclaire]

Hi Cherylclaire Thank you. Please can you provide the source of your quote: If guidelines are being followed, those who have neurological symptoms are supposed initially to get injections every other day until no more improvement can be gained. It would be handy to go armed with it!!

[Cherylclaire Forum Support in reply to brainchild]

bnf.nice.org.uk/drug/hydroxocobalamin should get you there (although you might have to put hydroxocobalamin in their search strip)

you will find this under treatment for those with neurological symptoms:

"Initially I mg once daily on alternate days until no further improvement, then 1 mg every 2 months."

Print it out (one for you), copy it (one for GP, one for Practice Manager), highlight relevant section and send them by post with a brief accompanying letter about why you think this treatment is relevant to you. Expect a reply.

I hope it is a positive one !