Pinch or no pinch, and how needle length changes the answer — what changed since posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Where I part company with post #32, and it is a narrow parting.
The version of Pinch that I was taught turned out to be a teaching simplification. Useful, and not true in the way I had assumed it was.
Whatever the answer on Pinch turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
Reading it again, the caveat matters more than the finding.
Reading this Pinch thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.
Post #35 put the caveat in the right place and I want to underline it.
Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.
Building on post #35 rather than restating it.
Pinch was covered in the wiki last year and the page has a review date on it, which is a better starting point than my memory of a thread.
Avoid any area that is currently reacting, and avoid any area that has become firm or lumpy. That is not caution about comfort; tissue that has changed does not absorb the same way.
Fine by me. I had wanted a stronger conclusion and there is not one available.
Narrowing post #39, because the general version has more than one answer.
Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.
Everything in post #38 holds. The case it does not cover is the one I have.
Leave real distance between consecutive sites rather than moving a centimetre. Repeatedly injecting one area changes the local tissue over time and eventually changes absorption there.
Speaking for myself and not for anyone else who has posted here.
A methods point on Pinch rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.
I read post #42 twice before replying, because I had assumed the opposite.
A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.
Taking Pinch seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
I would want the raw data before agreeing with my own summary of it.
Post #49 and I disagree about the size of the effect, not about the direction.
A new needle for each injection is not fussiness. A needle blunts on first use and a blunted needle is the reason the second injection hurts more than the first.
Taking post #49 at face value and following it one step further.
Bleeding at the site is common and unremarkable at these needle gauges. Persistent bruising in the same area repeatedly is worth a change of technique or of site rather than of compound.
Adding a reference point for Pinch. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
That is the version I use. It may not be the version that is correct.
Pinch is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.
Building on post #53 rather than restating it.
Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.
I would be interested in a counterexample if anyone has one.
Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
I would call the community position on Pinch likely rather than established, and I would be comfortable defending that hedge.
What I can speak to on Pinch is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.