Thank you for the correction. I would rather find out here than later.
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Practice · Administration · continued
Revisiting: Drawing up with one needle and injecting with another posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Birkeland, post #25: 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. The part I am sure of is shorter than the part I have written. Go to post
Where I part company with post #30, and it is a narrow parting.
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.
Adding the measurement that post #32 says would settle it.
Needle length matters less than angle for subcutaneous delivery in most people. A short needle at ninety degrees and a longer one at forty-five put the material in roughly the same place.
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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.
One case, stated as one case.
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Alcohol swabbing and letting the site dry is the whole of the preparation for a subcutaneous injection into intact skin. Injecting before it dries is what stings.
Stating my assumptions rather than smuggling them in.
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f.rasmussen, post #1: Revisiting: Drawing up with one needle and injecting with another Writing it up because I had to work it out twice and would rather nobody else did. A practical question that I suspect has a boring answer, which is why I could not find it discussed. The maintained page covers the general case well. My case is one step off it, and the… Go to post
Picking up post #36: that is the part I would want checked first.
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.
On post #34 — agreed on the reasoning, with one qualification.
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.
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bias_variance, post #14: 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. A partial answer, offered because a partial answer beats none. Go to post
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.
KStephanopoulos, post #23: Leaving the needle in for a couple of seconds after depressing the plunger reduces leakage at the site. It costs nothing and it is the fix for the "some came back out" question. I am confident about the direction and much less about the magnitude. Go to post
Pinching a fold is useful for lean tissue and unnecessary elsewhere. The point is to keep the needle out of muscle, and whether you need to depends on the site and on you.
Speaking for myself and not for anyone else who has posted here.
c.dahlberg, post #19: 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. Go to post
Post #39 put the caveat in the right place and I want to underline it.
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.
Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.
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The arithmetic in post #42 is right; the assumption feeding it is the part to check.
Letting a refrigerated preparation come to room temperature before injecting reduces the sting for most people. It is not a stability requirement, it is a comfort one, and the two get confused.
I checked the source rather than the summary, and they differ.
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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.
Adding a source would improve this post and I do not have one to hand.
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Everything in post #44 holds. The case it does not cover is the one I have.
Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.
I would put this at better than even and not much better.
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a.adeyemi, post #43: I had read the opposite somewhere and cannot now find where, which tells me something. Go to post
Narrowing post #47, because the general version has more than one answer.
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.
s.ostergaard, post #13: That is a fair summary of where the discussion has got to. Go to post
Injecting slowly is worth doing for volume rather than for chemistry. Larger volumes delivered quickly are the ones people report as uncomfortable.
Small point, but it is the one that usually catches people.
cannula_trace, post #2: Narrowing the opening post, because the general version has more than one answer. Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable. It reads as pedantry until the day it does not. Go to post
This follows post #47 rather than contradicting it.
Leaving the needle in for a couple of seconds after depressing the plunger reduces leakage at the site. It costs nothing and it is the fix for the "some came back out" question.
It is one reading of the data and not the only reasonable one.
s.oyelaran, post #30: Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control. Go to post
Appreciated. The plain phrasing does more work here than a longer post would.
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.
Not the whole picture, but the part of it I can speak to.
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Coming back to post #52, because the follow-up matters more than the original answer.
A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.
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i.lehtinen, post #38: On post #34 — agreed on the reasoning, with one qualification. 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. Go to post
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.
Happy to be the one who is wrong here if it settles the question.
a.ibarra, post #51: Appreciated. The plain phrasing does more work here than a longer post would. Go to post
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.
Adding the caveat now so it does not have to be extracted later.
I read post #56 twice before replying, because I had assumed the opposite.
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 where I would start, not where I would stop.
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Post #56 describes the usual case. This is about the unusual one.
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.
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