Help needed please: I just received my... - Pernicious Anaemi...

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Help needed please

totallyFrustrated profile image

I just received my B12 . Please can someone tell me how ot SI? For a start how do I open the glass ampoule without spilling what's in it? Please blow by blow instuctions, I am a SI virgin😀

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totallyFrustrated
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39 Replies

ok, managed it as per google video. Now is it more comfortable to SI into fat or muscle? Sadly I do own a hugh tire around my abdomen

EyesWideNow profile image
EyesWideNow in reply tototallyFrustrated

I do my upper outer thigh muscle or my ‘BCG’ injection site on the upper outer arm- it is totally up to you. Are you going IM to muscle or SD for shallower under skin? Once you are in then slowly inject to the count of 5. Not lying though you might get pain free or it may sting. Either way just remember that as it is safe to use IM, SD or IV then as long as you don’t go too deep and hit bone or artery then you are fine 👍🥰

totallyFrustrated profile image
totallyFrustrated in reply toEyesWideNow

Thank you for answering, I went 90degrees with 6mm needle into thigh muscle. find the stuff seems to burn there more than in arm when nurse does it. but then they use cyanocobalamin I think. I injected very slowly, but still quite burny. I got hydroxy, maybe that burns more, or maybe just because a bit nervous about the whole thing, struggled to het into the amoulle, just would not break, no matter how hard I tried. Then spotted the dot and tried it with dot in different place...

EyesWideNow profile image
EyesWideNow in reply tototallyFrustrated

Congratulations 🥳 I cut my thumb a couple of times and also used to use a steri-wipe on the top to protect me but I’m used to it now. I use a much longer needle though but my mum was a nurse and I was trained to give her meds and so you have done really well as I know it goes against the grain to SI 💪👍

Nackapan profile image
Nackapan in reply tototallyFrustrated

Get an ampoule opener .Snapit is a good one.

I use a 1/2" long needle 30 G for a subcutaneous injections.

Using my outer thighs or stomach 2" away from belly button

27-30G suitable

For IM you need a longer needle 1"

23-26G outer thighs or upper arm.

Make a roll

for sc

Skin flat for IM

I use hydroxcobalamin it can sting sometimes.

I count to 10 before removing the needle

wedgewood profile image
wedgewood in reply tototallyFrustrated

Don’t think that you can reach your thigh muscle with a 6mm needle . You will need a 25mm needle (1 inch) to reach the thigh muscle

. A 6 mm needle will give you a sub.cutaneous injection. Equally effective as an I. M .

Twaddletop profile image
Twaddletop in reply tototallyFrustrated

You can buy a wee gizmo to take the top off the ampoules. I think I got one from Amazon.

JanCymru profile image
JanCymru in reply toTwaddletop

I got my little gizmo from Ebay UK - about £2.95. Does the trick nicely and saves any cuts. Line up the dot so it is visible. Certainly one thing less to stress out about! Good luck and don't forget the forum is here with so much help and support at any time. 😍

totallyFrustrated profile image
totallyFrustrated in reply toEyesWideNow

and is it better to inject in the morning or at night? Or is it trial an error as we are all different?

EyesWideNow profile image
EyesWideNow in reply tototallyFrustrated

I keep my B12’s to earlier in the day as if they give you an energy burst it can keep you awake but it is a totally personal choice/see how you feel. How often do you plan on dosing etc ?

Nackapan profile image
Nackapan in reply tototallyFrustrated

I find a.m better .Could keep you awake at night

wedgewood profile image
wedgewood in reply toEyesWideNow

Only a heath professional shoujd use I V ( into the vein) We can use either I.M. ( Intra - Muscular) or Sub -Cut ( Sub-Cutaneous) I’ve used both and they are equally successful

.

EyesWideNow profile image
EyesWideNow in reply towedgewood

Oh sorry, my point was that if they accidentally hit a vein/venule-I wasn’t suggesting trying it-that the B12 itself wouldn’t cause a problem. 🥴

mauschen profile image
mauschen in reply toEyesWideNow

… or hit a nerve!

Bellabab profile image
Bellabab in reply toEyesWideNow

Please do not inject intravenously. Its too dangerous to do so.

Wheat profile image
Wheat in reply tototallyFrustrated

Hello, it s a matter of choice. Which you are more comfortable with. I.M (longer needle) or subcutaneous tissue (slower release into fat) are equally effective.

I find subcutaneous much more comfortable, and safer re. my physical conditions. I s.i. Into tummy or lap of thigh. Plastic Snap It Snapper from Ebay or Amazon £3 to £4, ampoule opener, means no cut fingers for me .

Also, congratulations on your first s.i. 🎈🎈🎈

EyesWideNow profile image
EyesWideNow in reply toWheat

Well said 👍

totallyFrustrated profile image
totallyFrustrated in reply toWheat

Hello Wheat, first time that wheat hasn't made me ill. am totally all grains intolerant ..lol thank you for your help. I never know where to reply to say thank you

Planning to go every other day as per NICE recommendations ( if only GPs were so adherent to their rules lol) and then see how I feel. Does if sting as much going into fat as it does going into lap thigh muscle? Have no fat on legs, so don't know where 6mm needle went

EyesWideNow profile image
EyesWideNow in reply tototallyFrustrated

I think it’s more a matter of how close to nerve endings you inject? Also if you try to inject too fast then you ‘inflate’ the tissue before it can dissipate into the body and sometimes when you take the needle out then you can lose some dose when it spurts back out x

ClareP5 profile image
ClareP5 in reply tototallyFrustrated

I find tummy roll least painful- left upper arm most painful- why? No idea. I think for a while I was quite nervous and that didn’t help! But you get used to it quickly. You can feel the pressure of the liquid going in on sub cutaneous- I press the area down afterwards - initially a strong sensation but it too passes🤣🤣🤣

Wwwdot profile image
Wwwdot

Hi totallyFrustrated

Sounds like you are doing well I am relatively new to self injection too.

I do sub- cut Hydroxocobalamin into my belly as slowly as possible so it doesn’t sting. Warm first in your hands before drawing into the syringe also reduces any sting.

I do mine in the morning and take folate to 400mg. I also take 1300ug methylcobalamin tablet and B Complex liquid daily and that has boosted me too.

Well done and congratulations for rowing your own boat!

🤗🤗🤗

totallyFrustrated profile image
totallyFrustrated in reply toWwwdot

thank you so much . all your encouragement really helps, and it sure helped me float my boat and keep it afloat when I felt not strong enough to row it myself. Thank you all of you

Carlosdoug profile image
Carlosdoug

well done, a couple of hints, as I keep my ampoules in the fridge, I pop it in my bra while I collect needle and two pieces of kitchen towel. First piece used to wrap round ampoule to break it. Second piece for emergency use when you nick a tiny vessel. It will look like murder , but just press firmly for a minute. We have all done it sometime.😉

Carlos ? Doug? wearing a bra?😍 a bit like M*A*S*H ? is my favorite TV show and I love every character in it. Thank you for the tip, I will put tomorrow morning's one in there and see if that helps. I don't know why I am so fussy about a bit of stinging, considering back injury gives nerve pain 24/7. I guess I feel I don't need ANY additional pain. Thank you so very much, such a useful bit of help, and I hope you took my joke as friendly banter as it was meant.🥰

Carlosdoug profile image
Carlosdoug in reply tototallyFrustrated

Morning, I didn’t see your reply till now. Carlos, Doug, two Maine coon cats. Me, female, bra wearer. Absolutely no offense taken.x

totallyFrustrated profile image
totallyFrustrated in reply toCarlosdoug

Glad to hear it, I like to personalize replies, as I am totally rubbish with IT so do not know where to go to thank everyone for their help altogether, or if I am relying to the individual and I worry if it only goes to the individual I will miss someone out and offend them

totallyFrustrated profile image
totallyFrustrated in reply tototallyFrustrated

but your tip about putting B12 in bra was spot on, did this this morning and injected into fat and it was totally painfree, thank you

Enuffisenuf profile image
Enuffisenuf in reply tototallyFrustrated

I also use the bra trick, and there is no stinging when I SI, so the advice to warm the fluid up a bit seems to work.

I pop the wrapper from the steri swab over the ampoule while I snap the top. So far I haven't cut myself, though I have have completely destroyed an ampoule. When I remember I'm buying a gizmo.

totallyFrustrated profile image
totallyFrustrated in reply toEnuffisenuf

Hello Debra-bill, thank you for your reply, yes I had wrapped the ampoule in a tissue before I broke it , so the 1000 pieces of glass remained mostly contained in the tissue,

makes me wonder how they can make the glass vial and contents in it without there appearing to be a seam....

🤔

mauschen profile image
mauschen

if you look on the neck of the ampule, you will see a small dot or mark. This is the breaking point for the ampule and you will get a clean break. If some liquid is in the top half, give it a few flicks and it will drain down to the bottom of the ampule ready for you to open.

Draw up the liquid into a syringe and be careful not to touch the sides of the glass with the needle.

Preferably, change the needle prior to injecting.

Also, check if the paperwork states IM or subcutaneous or both.

If you take blood thinners such as Warfarin or a NOAC for example Rivaroxiban, then speak with your doctor or nurse before self injecting

Bellabab profile image
Bellabab in reply tomauschen

You need to face the dot on the ampoule towards yourself and push the top of the ampoule away from you while holding its base firmly to snap it off.

Narwhal10 profile image
Narwhal10

Hi totallyFrustrated,

First things first grab your tools. Place them in order from right to left, if your right hand is your dominant hand. In a clean area, Carlosdog uses kitchen towel, as do I.

1) needle to draw up. (I use green)

2) syringe.

3) vial snapper if purchased.

4) B12.

5) needle to inject.

6) sterile swab (if you are using).

7) sharps box (in front of you not on kitchen towel).

Then again starting right to left. (You are working like a typewriter, very methodically).

Open tops of wrapping,

1) Assemble drawing up needle and 2ml syringe.

2) Pick up the vial of B12.

I) Look at it. There’s usually some fluid at the top. With forefinger and thumb, flick it a couple of times until there’s none or only a tiny bit.

II) To snap the bottle by hand. There is a white dot on the neck. You apply pressure there. The white dot is facing you, thumb and forefinger snaps it (directly) away from you. Glass top into sharps box.

3) Unsheathe drawing up needle with the syringe and draw up B12 into the syringe.

4) Once you have all the B12 in the syringe, discard glass vial in to sharps box.

5) Look at the 2ml syringe, note if the column has got any air at the top. If so, push the plunger so, B12 is up to the beginning needle.

6) Change the needle. A sharps box has been designed for this, if you look at its lid. If you wish to do it by hand then it is a twist pull mechanism to take it off. Needle (to inject) slots in. (Sharps bins are designed like this to reduce sharps injuries).

7) You now have your B12 to administer.

You can have a cuppa, a few minutes break. That B12 is going nowhere, it is pretty safe (from an infection control point of view and it is not going to go ‘off’.)

Health professionals are trained in this way. We do it very quickly because we have done it thousands of times. We work right to left for lots of reasons. Medications are in cupboards or under lock and key. We walk down corridors into rooms or bays with ‘ready to go’ medication in receptacles or in bags. It takes quite a few minutes to check, prepare, sign, counter sign etc.

I’ll write on injecting by midday. 😊

*sharps injuries are not appropriate because in this setting, if we accidentally catch ourselves with the needle, it’s our own blood.

totallyFrustrated profile image
totallyFrustrated in reply toNarwhal10

Oh thank you, you wonderful maritime unicorn you, that was excellent, and I could have done with this on Saturday, but I fumbled my way through, and this morning I almost did it like you suggested, even before I saw your mail. My sharps bin is at present a tupperware box. proper bin not arrived yet. And Carlosdog's tip about warming it in bra was excellent. Didn't hurt at all today going into fat. But the top of the ampoule broke into 1000 pieces when it came off. Yesterdays injection upped my strength so much already, that took me by surprise. One hopefully last question for a few weeks is this. following first S/I yesterday I got a dull headache that lasted till this morning, and this mornings S/I turned that headaches volume up a notch. Is that just me giving myself a headache because I am nervous and new at this? or something totally unrelated to B12, like maybe a cold wanting to come visit me, or is it that it's hydroxy when up to now I got GPs methyl? Any thoughts? And thank you again a million times. those instruction were so comprehensive, just what I had hoped for. Now I just need to figure out how to peel back the strip where the needles are, must have a bad batch, as there isn't an easy way to separate the paper from the plastic at the top. Thanks again.

Did you know that people thought unicorns were real because the Queen of England (cannot remember which one though) was given the "horn" of a narwhal and told it was a unicorn's.

Thank you for being on this site, your info is always so good and reassuring👍🥰

Narwhal10 profile image
Narwhal10 in reply tototallyFrustrated

Congratulations on achieving. Yay, it can be rather daunting. There’s a lot of steps but maybe if people think of things like cooking and recipes, it can become easier. It is my pleasure.

Great about the Tupperware box, I have used them too and glasses cases. It’s being resourceful. Yes, opening packaging can be tricky.

The headache. Hmm, previous symptoms of brain fog and fatigue ? Any tinnitus ? Balance problems ? Eye sight ? It is usually the brain which is a huge part of the ‘Nervous system’ saying, Thank you, you are healing me. Although, only you know you, so note, observe, if it worsens then ring GP. I do not put everything down to PA/B12 and my knowledge of folate is very basic and for thyroid problems, I have a dunce hat on my spike. 😞

We have accidents all the time, my sister was in work. She was a paed registrar and attempted to open a vial. Gloved up, it too shattered, exactly like you. It was a controlled drug, though. She just said, ‘Can someone clean that up, please.’ Not because she is a doctor but she was carrying out a sterile procedure.

I carry a RADAR key and so I can pull it out of my rucksack quickly, I have a little cuddly unicorn. He’s called Raphael because he’s an angel. Many a time, he’s saved me from the embarrassment of having an ‘accident’.

🥰

totallyFrustrated profile image
totallyFrustrated in reply toNarwhal10

Yes, to brain fog, ataxia, chronic fatigue, had something like tinnitus, but only a few times and only slight and short lasting, but all the time nausea, dizzyness, PB all over the shop recently, frightened me when it went to 185/127 , but upped my magnesium intake and now nice and sensible again. So are you saying that I may have swapped brain fog and tiredness for headache? Hello headache, welcome to my head, make yourself at home,🥰 Healing crises I can put up with anytime 😍

Narwhal10 profile image
Narwhal10 in reply tototallyFrustrated

The healing process is easily explained by comparison to a cut or graze. It’s a process.

They bleed and sting.

Then the goodies come along saying we will help. The bleeding stops.

Then they either starts knitting back together (think paper cut). If it is a graze, a scab begins to form.

In cases of scabs (skin granulation stage), it will get to a point where it is itchy and some people will scratch it off. Perfectly normal.

Unfortunately, we cannot scratch our brains. Nerves can be painful, they may throb, burn, give out strange sensations. It is the process.

Good to hear blood pressure has settled. Do keep an eye. Be gentle with yourself as PA/B12D has neurological symptoms which you clearly have recently had.

PA/B12D is a journey.

We all are different. For me, after my 11th injection, the following day, the only way I can describe it is, I thought that somebody had smashed a TV over my head. I had dreadful static. So, I just lay in bed as any movement triggered nausea. So, I closed my eyes and tuned myself into the film ‘When Harry met Sally.’

The theme from the film is ‘Can men and women ever just be friends ?

🥰

Oh thank you, you wonderful maritime unicorn you, that was excellent, and I could have done with this on Saturday, but I fumbled my way through, and this morning I almost did it like you suggested, even before I saw your mail. My sharps bin is at present a tupperware box. proper bin not arrived yet. And Carlosdog's tip about warming it in bra was excellent. Didn't hurt at all today going into fat. But the top of the ampoule broke into 1000 pieces when it came off. Yesterdays injection upped my strength so much already, that took me by surprise. One hopefully last question for a few weeks is this. following first S/I yesterday I got a dull headache that lasted till this morning, and this mornings S/I turned that headaches volume up a noth. Is that just me giving myself a headache because I am nervous and new at this? or something totally unrelated to B12, like maybe a cold wanting to come visit me, or is it that it's hydroxy when up to now I got GPs methyl? Any thoughts?

one last question ( hopefully)

I have finally managed to get an appointment with my GP where I hope to convince him to give me B12 injection more often that once every 8 weeks and I never had a loading dose. I hope I can get him to do some tests, like size shape and number of red blood cells, intrinsic factor, iron and folate levels etv. Question is this , have started to S/I with hydroxy, had 3 so far, will that slew all the test results or only the B12 levels? Should I stop with injections until I have seen him in 10 days time, or continue injecting every other day? I sure feel better when I s/i. Please will you tell me your thoughts on this?

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