Giving the aranesp shot

[natnnnat]

Gregory has been put on weekly aranesp since his bout of pneumonia in November, when they noticed his haemoglobin was down.  He did the first one himself, but I noticed that his hands shake too much to hold the needle steady, and it made me nervous.  Plus, I wanted to learn what it was like to give the needle.  So now I do it.  First couple of times I went fine, then one day I couldn't get it to go in (it actually bounced out!) and that freaked me out.  I think I have it alright again now, but I find it hard to squeeze the needle so slowly that it doesn't sting.  The first few moments, the needle seems to resist, and then it goes all of a sudden.  Any tips?  Also wanted to remark:  when I stuff it up (e.g. the day it wouldn't go in) it really DOES MY HEAD IN.  I can see that if that was a fistula and a dialysis needle rather than a teeny tiny aranesp injection things could get really really whacky.

Just thinkin' aloud really.  Love to all out there.
xn
http://godbold.name/experiencingdialysis/

[Pam]

natnnnat.....I had to inject Procrit every week for about 4 mos before I started "D" they told me to inject just like I do for insulin. I never had a problem with the needle bouncing out. They say to pinch an inch but I don't do that either. I can.t stand to have a shot in my thigh I give my shots in the abdomen. Maybe changing the site will help. Another thing that might help the stinging is to roll the bottle between your hands to warm it up a little before filling the syringe.
Pam

[billybags]

Nat are yours the same as ours, they come pre loaded. We were fine with this one, hubby just grabs an inch around his waist and jabs away. They changed us to Mercia this is a monthly one, also preloaded and this one is a bugger, it is spring loaded or seems to be and that took some getting use too.

[jbeany]

Yes, warm it, warm it, warm it.  Cold makes it burn 10 times worse.  Also, if you are having trouble with the slow and steady motion staying that way, you can also just inch it along.  Give a smidge, wait a second, give a smidge, etc.  It's easier on your hand, and when the pressure finally gives way, you are less likely to push the plunger all the way down.

[Poppylicious]

I never had to do it when Blokey was on aranesp.  Despite being completely needle phobic he did it himself, thankfully.  I just couldn't bear it (indeed, things may get really really whacky,) which might go some way to explain why he won't even consider home-dialysis. I think you're very brave to do it, especially after stuffing it up!

 

[natnnnat]

Today is Tuesday, so it was Aranesp injection day.  I acted on three suggestions:  I did this...

Another thing that might help the stinging is to roll the bottle between your hands to warm it up a little before filling the syringe.
Pam

and this...

...if you are having trouble with the slow and steady motion staying that way, you can also just inch it along.  Give a smidge, wait a second, give a smidge, etc.  It's easier on your hand, and when the pressure finally gives way, you are less likely to push the plunger all the way down.

and this, which I got from another board:

I had this problem and I found drawing in a little air and the expelling it from the syringe seems to help it a little. I think it's because it been sitting in the fridge for a while that causes it to stick.

These three tricks made for a much easier injection.  Hooray for renal discussion groups who share their tricks and help each other out!
xxn

[M3Riddler]

Gregory has been put on weekly aranesp since his bout of pneumonia in November, when they noticed his haemoglobin was down.  He did the first one himself, but I noticed that his hands shake too much to hold the needle steady, and it made me nervous.  Plus, I wanted to learn what it was like to give the needle.  So now I do it.  First couple of times I went fine, then one day I couldn't get it to go in (it actually bounced out!) and that freaked me out.  I think I have it alright again now, but I find it hard to squeeze the needle so slowly that it doesn't sting.  The first few moments, the needle seems to resist, and then it goes all of a sudden.  Any tips?  Also wanted to remark:  when I stuff it up (e.g. the day it wouldn't go in) it really DOES MY HEAD IN.  I can see that if that was a fistula and a dialysis needle rather than a teeny tiny aranesp injection things could get really really whacky.

Just thinkin' aloud really.  Love to all out there.
xn
http://godbold.name/experiencingdialysis/

Not sure why more people dont give araneps/epo through the filter or med port on hemo. There is no evidence to show/ or show against/ the aranesp/epo being dialyzed out. 
I have been giving araneps through the filter ever since starting home hemo. Works great and does nto affect the hemoglobin any more or less than getting it when I was shooting it in my arm.

///M3R

[greg10]

..
These three tricks made for a much easier injection.  Hooray for renal discussion groups who share their tricks and help each other out!
xxn

The soreness is probably due to the citrate stabilizer which may also act as an anticoagulant.  Try using a more concentrated formula if possible (therefore less total citrate stabilizer injected).

Not sure why more people dont give araneps/epo through the filter or med port on hemo. There is no evidence to show/ or show against/ the aranesp/epo being dialyzed out...
///M3R

There are many benefits from injection subcutaneously, one of them is less hypertension and possibly less clotting.  The dosage required is also lowered, which is always good for cost benefit and also possibly less side effects.

http://www.uptodate.com/patients/content/topic.do?topicKey=~GBBcyvkvnb9klI
Although erythropoietin (EPO) is commonly given intravenously to patients on maintenance hemodialysis, there are a number of advantages of subcutaneous administration in hemodialysis, peritoneal dialysis, and predialysis patients. The adverse effects of subcutaneous EPO are generally similar to those for intravenous EPO, except that the subcutaneous route is less likely to cause hypertension. (See "Hypertension following erythropoietin in chronic kidney disease".)

However, some patients complain of pain at the site of injection, possibly induced by the citrate used as a stabilizer. This problem can be minimized by using a concentrated formulation.

The average weekly dose of EPO was 32 percent less for those randomly assigned to the subcutaneous regimen (94 versus 150 U/kg).

[Henry P Snicklesnorter]

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[natnnnat]

I've been using my new techniques for the aranesp shot.   Tonight (yes, a day late) we opened a new packet of aranesp and found the needle was different.  Instead of looking like the one in Harry's photo, this one has like, a spring around it, near the pointy end.  I've adopted Harry's suggestion to warm the needle first by sticking it in my shirt, then drew in a bit of air and let it out again to unstick it, stuck it in with quick motion, pushed in bit by bit using jbeany's method (tried your holding position Harry, it wasn't for me). 

The surprise came at the end.  We both decided it was all in down to the end, and I took the needle out.  Gave it a bit more of a shove to see.. some more aranesp came shooting out, and then the spring sprung, and the needle had sucked itself back up into the casing.  Amazing.  Some kind of design to stop needlestick injuries I guess, or to make them hard to reuse.  Well I'll be darned.

[Henry P Snicklesnorter]

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[natnnnat]

 
Stinkin' Harry!  I'm obsessed with him aren't I!!!?