Booooo!!!! My clinic is switching to aranesp. :(

[mariannas]

Since I started PD I have been giving myself EPO injections and loving it.  They don't hurt and are no worse than my insulin injections...a far cry from when I used to have to have aranesp injections.  I don't know if it's because I don't really have any fat on my upper arms (where they administer the injections), but arenesp stung like a !$*/^#.  I hated it and dreaded going into my doctor's office every 3 weeks.  Well now the clinic is switching over to aranesp completely.     No way am I going to be able to give myself the shot.  I just cannot bring myself to do something that is going to hurt that bad.  Hopefully we'll be able to work something out since I've been on it before and I can at least have an every 3 week schedule like I was on before.  All I know for sure is that they are going to have to do it.  *grump*

[Aldente]

I'm sorry to hear about the pain. 

When you were giving yourself EPO what injection site were you using?  When I take EPO I use either the belly or the upper legs.  Are you saying that you have to change to the upper arm because of the new drug?  According to the Aranesp directions you should be able to administer the drug in the same locations as EPO.

http://www.fda.gov/medwAtch/safety/2005/Aranesp_PI_10-26-05.pdf

[stauffenberg]

The problem with Aranesp is that the bore of the syringe is ludicrously wide -- much wider than it has to be for the substance to pass through.  One way to deal with self-injection of Aranesp if the bore of the syringe hurts is simply to transfer the contents of the syringe to an insulin syringe, which has a much narrower bore.  I have done this several times with little loss of Aranesp during the transfer and only a little trouble getting rid of the air bubbles.  However, after a while you can get used to the Aranesp syringe bore as well, as I have.

Keep in mind that Aranesp and EPO, although similar, are different drugs, and with Aranesp you are getting a very different therapeutic effect by having a much smaller intensity of stimulus to the bone marrow to make red blood cells, but one which continues to act longer and more gradually.  So the change has more to do than with just switching from a comfortable to an uncomfortable syringe bore.

[mariannas]

It's not the needle stick that gets me, it's the incredible burning sensation that comes while the shot is being administered. 

Also, I give my EPO and most of my insulin in my butt.  I'm pretty flexible so I can reach back there really easily.  I have an extreme phobia about belly injections - especially after receiving heparin injections there this summer.  *shudder*

[paris]

Yes, it Aranesp does burn as it is injected. I can feel it from my upper arm to past my elbow.  But, as Staffenberg stated, it works different than Epo. They give me Aranesp when my numbers are low and can't keep a good level.  It is longer lasting and not needed as often.  So, I will be on one for months with good results, but then my numbers go wacky and they switch to the other. I don't care what they do as long as they can keep my hemoglobin above 11!  A few moments of pain is worth the trade off.  Hope you can make the adjustment with too little discomfort.

[mariannas]

Yeah...I know Aranesp and EPO work differently although my numbers have been higher (hematocrit and hemoglobin) since I started the EPO.  I know I have to do it, but I figured I could whine a little bit about it too.  I'm disappointed that I'll have to change from doing it myself to getting it done (since I'm too weenie) and making yet another extra trip to the clinic.  I know whine, whine, whine...

[Romona]

You can whine all you want. I ran away from a nurse that was going to give me my arensp shot in the stomach at the hospital. I have two neighbors that are nurses they gave me my shots when I came home. Because of a mix up I couldn't get my needles, so we used the insulin needles. Good Luck to you!

[jbeany]

mariannas, if you are going to be doing it at home, then demand insulin syringes, and also warm up the shot in the palms of your hands before you give it to yourself.  I also find that the slower the injection, the less it stings.  I'll actually stop pushing the syringe down for a couple of seconds when it starts to hurt.  Wait until the pain stops, and inject a tiny bit more each time.  One quick jab burns like crazy, but doing it a little bit at a time is only a bit prickly.

[goofynina]

and also ask for the 1ml 25g 5/8 syringes, they seem to be extremely small needles, 

[mariannas]

I actually already have insulin needles with veeeeeery small tips so I am all set there.  I will have to see if I can do it.  For some reason these shots just really get to me.  I mean geeze, I've had so many pokes and prods throughout my life, but for some reason IVs and aranesp shots send me into a panic. 

[Romona]

You are not alone. IV's hurt pretty bad sometimes. I also had a hard time with Arensp. I'm rooting for you!

[paddbear0000]

Don't even get me started on IVs--especially when they put them in the back of the hand! 

[mariannas]

YESSSSSS!!!  I WIN!!!  My doctor and the Kidney Center agreed that I could stay on EPO since I have private insurance.  I have to get it through a different pharmacy since the Kidney Center can no longer get it and my doctor will adjust the dose instead of the KC nurses. 

I am so relieved.  I was absolutely dreading having to start back with the aranesp.

[Black]

Don't even get me started on IVs--especially when they put them in the back of the hand! 

Yeah, the hand is often more painful, but it depends on the person doing it.  Just be glad you have someone doing it that way.     They are saving your arm veins from the scarring that IVs can cause, which can make a natural A/V fistula impossible.  Many techs and nurses are either ignorant, or don't care, and use the arm. 

[Lucinda]

I just saw this old thread on Aranesp because I was wondering if any of you were on it as you all talk about EPO.  The Aranesp does sting but we get it over here in a Sureclick syringe which you just press against your leg and click.  For those having problems, it is far worse when it is still cold.  I leave it out of the fridge for up to four hours before I use it and that usually reduces the sting.  Aranesp is stable for up to two days at room temperature so it is fine to leave it out of the fridge for a period before administering. Makes a huge difference!

[Zach]

Aranesp is stable for up to two days at room temperature ...

That's good to know, Lucinda.

EPO can't stay out of the refrigerator too long because it might lose some of its potency.

[Wallyz]

This was actually the reason my home clinic went to Aranesp- they had too much EPO go bad in transport.

[RichardMEL]

I'm on Aranesp and it seems to work fine for me no issues (and since they administer it through the machine that's one less prick I have to deal with!) though our unit also administer EPO. I think it depends on what particular doctors perscribe for their patients. My only real concern is watching that my hemoglobin doesn't go too high. Anything over 120 and I start to worry!

[jessup]

I'm on Aranesp and it seems to work fine for me no issues (and since they administer it through the machine that's one less prick I have to deal with!) though our unit also administer EPO. I think it depends on what particular doctors perscribe for their patients. My only real concern is watching that my hemoglobin doesn't go too high. Anything over 120 and I start to worry!

I don't understand this mate
What happens if hemoglobin goes too high?
I have not been aware of this issue
Just wondering about dear Dad and his hemoglobin

[jessup]

Oh I just read another thread
so now I know
Will now check what's happening with Dad

[monrein]

I've always been on Aranesp.  No issues I'm aware of.