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» LymeNet Flash » Questions and Discussion » Medical Questions » bicillin - scary thing happening - please help

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Author Topic: bicillin - scary thing happening - please help
VB
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Hello,

I am hoping someone can please help. I was on bicillin for about 18 mths. 2.4MU one time per week. I realized about 4 months ago that my hip muscles were getting abnormally large (other people noticed too), especially the hip that I inject the most. I am about a size 2, so it started getting obvious really fast, just like a very large muscle, not little patches of scar tissue (which I've experienced before).

I stopped injecting in the larger side for about a month. I then asked my LLMD about this and showed him my muscle and he said not to worry, but put me on a 2 week abx break, then started me on claforan IM instead.

I started claforan IM 2 weeks ago, and upon injecting the needle into my hip (the larger side), then pulling back the plunger to make sure I didn't hit a vein, I noticed that a creamy fluid (Bicillin, I'm pretty sure), started coming back into the syringe. This happened several times, so I called my LLMD. Note that I have been off of Bicillin for about 6 weeks or more at this point.

He told me that he had NEVER heard of this in his whole career (and he is very experienced and known in the Lyme community and I really do respect him--he has helped me a lot). So he told me to try and extract it tonight with a clean syringe. He then said he didn't know what else to tell me.

Well, SEVEN full syringes later (21 ml total), I still haven't gotten all of the bicillin fluid out of my hip muscle, but I stopped because I didn't think that poking at it more than 7 times would be good in case it was infected.

It does not hurt... feels itchy and weird sometimes, but does not feel infected or sore. Although now I'm slightly concerned that the fluid is pus? But, I'm pretty sure it's just bicillin that has built up.

Does anyone know what this is or if I did something wrong to get the bicillin to stay in me for that long? How do I get rid of it?

I am concerned about this... I don't want to have something wrong with my hip muscle now.

Thank you for any input you may have,
VB

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MADDOG
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WOW far out,I do the injections allso.i have not had this happen.

MADDOG

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tick battler
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That is scary, but if it doesn't hurt I think that's a good sign. Did you save any? I would see if you can get it analyzed...then you might know what it is.

tickbattler

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Haley
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Yes, absolutely save the syringe and have it analyzed.

It sounds like infection to me.

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Lymetoo
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Would definitely have it analyzed. Let us know what you find out!

--------------------
--Lymetutu--
Opinions, not medical advice!

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VB
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Thanks guys. I will try to save some next time I "drain" my hip.

Where can I take this to get it analyzed? Just take it to my LLMD for him to look at it?

What's interesting is that one of the 7 syringes appeared to be the clear yellow claforan fluid that I just recently started using too. It just seems like there was some sort of pocket that all of the medicine was getting trapped in. Can that happen?

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James H
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Google the term "sterile abscess".

Basically the Bicillin has just accumulated in a pocket and has not been absorbed yet. It is a depot injection that is supposed to absorb very slowly, but this is obviously more volume of the material than you were able to deal with.

A quick look with a microscope would verify that it was indeed penicillin and not pus from an infection.

That needs some medical follow up in my opinion.

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TF
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Yes, it sounds like a sterile abscess.

Here's what I found:

Sterile abscesses are usually a milder form which is not caused by bacteria or infection, but by irritants such as injected drugs or swallowed objects. These abscesses are 'sterile' because there is no infection and resultant immune response involved. If an injected drug like penicillin is not absorbed completely, it remains at the injection site and can cause irritation which may lead to a sterile abscess. Sterile abscesses are likely to be a hard, solid mass under the skin rather than a swollen pocket of pus.

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VB
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Okay. That makes me feel better. Thank you all very much for your help.

I'll try to get more out and save it. Wish my LLMD was closer. I don't think I could even attempt to explain all of this to some random doctor in my area and have him check out my syringe contents for pus!

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Hoosiers51
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Wow, that is pretty crazy.

Do you walk much? I could see maybe if you were not very mobile, what you described would have a greater likelihood of happening?

I almost always try to take a 15-20 minute walk after each injection. I read that on a "Bicillin tips" (from other patients, not anything official) handout that my LLMD's office gave me. It said that walking afterwards MAY help the medicine disperse better, so I made a habit of doing it (even though sometimes I dread it because of my fatigue).

Another tip I've heard is to apply heat to the area afterwards. This may help dispersion. I have heard some docs/nurses go so far as to say don't apply ice even beforehand, because having that area cold will make it not disperse as well.

Have you been applying heat? Have you been applying ice before or after?

Just kind of interested to hear what you have or have not been doing.

Of course this could all be out of your control, and it's just too much medicine for you. Who knows. I'm definitely not saying any of it is your fault, just bringing up things that might be helping or hurting your cause.

I would get it analyzed. You could even squirt some of the stuff onto a tissue, and smell it. If it stinks, it could be infected, though no smell wouldn't rule out infection.

You could perhaps do the 1.2's more often, to give it to yourself in smaller spurts. And include applying heat afterwards then walking for 15 min. I wonder if there is even a pediatric dose that is less than the 1.2? You could do 3 or 4 of those per week, though I'm sure getting poked that many times wouldn't be fun.

Otherwise, you could switch to high dose oral Amoxicillin.

Good luck, please keep us posted!

Oh last idea would be massaging the area after shots. I don't think any of these tips would get rid of what's accumulated, but they would be something to start doing if you resume the shots.

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Hoosiers51
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Also, keep in mind that it's winter. I know sometimes in winter that my butt will literally be cold to the touch. So I wonder if it's not a coincidence that this happened during a cold time of year. (going with the theory that heat helps it move around)
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VB
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Thanks Hoosiers! I move around during the day (at work and stuff... just normal movement though from cubicle to coffee pot) but was giving them to myself at night and then going right to bed. Not the best idea, I guess. I wasn't doing ice, but no heat either. And not really massaging it much. Ugh... if my foresight was as good as my hindsight I'd be a much happier girl.

Lately I have been trying to exercise, but I think it will take a while for it to go down. Tonight I have really been trying to exercise my glutes after the draining episode!

It's funny because previously when I'd exercise my legs and butt I'd herx really badly 48 hrs later. I thought it was just from the exercise, but now I think it's possible that I was just squeezing some of that bicillin into my system.

I actually did smell it (sorry,gross I know) and it didn't really have a smell so I guess that's good.

Well, thanks again. There's always something new and exciting with this illness, isn't there.

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Hoosiers51
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Yup, I have also herxed after moving around vigorously the next day. Mine was a little different because I seemed to herx right after the activity.

What happened was, I flew to my LLMD's, and got my first shot in his office. I think I did some light exercise about an hour or so after the shot, but it was very light walking.

Then the next day, I flew home. Walking to my gate and all that was fine. But then, I had a connecting flight, and it was REALLY far across the airport, and I basically had to speed walk/run to make the connection.

Once I got to the gate, after about 10 min, I was like, "wow, something's coming over me..." and I started crying. It was DEFINITLEY a herx. Then my knees started KILLING me, and I got a sharp headache.

I really believe that moving fast like that for 10 min straight really dispersed that first shot.

Of course it could have been chance, but to me, it really seemed like it was from hauling booty across the airport at warp speed, caused the med to be absorbed.

So when I walk afterwards, I try to power walk if i'm up for it, as opposed to strolling along.


Good luck!!!! I hope it gets straightened out and you can still take it.

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merrygirl
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wow!! I did 2.4 mu 3x a week and this never happened. I did hear of it on here once. I dont think you should be draining it on your own, I think you need medical intervention of some kind.the more you poke it with a needle more likely to infect it.

I would also soak in a nice hot bath!

good luck keep us posted.

melissa

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TF
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I hope you are not continuing injections.

My thought is that you would probably just be injecting more meds into the abscess, instead of getting it into a muscle.

In other words, the abscess is now in the way of the muscle, so I don't see how any more injections can be effective for you until the abscess is cleared up.

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WildCondor
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Get that examined by a doctor...sounds like an abscess to me indeed.
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James H
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VB, you need to give those injection sites a total rest until they can recover. If there aren't any suitable alternate injection sites for the claforan you may have to tough it out with something oral for awhile.

From my experience about 5 years ago, putting another injection into an area that had not recovered from the last one did not work out good. It becomes a real problem figuring out how to rotate injection sites before long. One ends up putting injections very carefully into areas of muscle that are not officially sanctioned or taking a break from IM meds that need to go in the gluteals for awhile.

Perhaps a good vibrating massager like a Hitachi Magic Wand would help with the healing? (but perhaps it would be a good idea to ask first.)

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sammy
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VB, I agree, please do not use those injection sites until you are certain that they are healed. It may take several months for your body to absorb what is left and heal itself.

I am also concerned that you may end up with an infection if you continue to attempt to drain the abscesses yourself. If you want the stuff removed, consider consulting with a general surgeon.

Please please don't continue to poke yourself repeatedly (causing more trauma to the tissue). Leave it alone or have the doctor open it and drain it with proper sterile procedure.

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Hoosiers51
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Just to clarify, I wasn't saying you should or shouldn't continue the shots. Just giving some ideas on how to *possibly* not have the same problem again if you do continue them.

Or, if your doctor says you can continue the shots on the opposite hip, maybe some of those techniques would help prevent the same problem from happening to the good hip.

But if you already have lumps on the good side, you might not wanna fan the fire anymore (aka add to the lumps).

I have noticed sometimes I get little hard lumps that go away on their own with time, so if you have little lumps on the good side, maybe they'll go away without draining.

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James H
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If it is just an excess of accumulated Bicillin it should take care of itself with a little time to recover.
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VB
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Thanks everyone for the responses. Don't worry, I'm doing the Claforan in my thighs now, so I'm not adding to the issue, and I've stopped poking around in my hip too [Smile]

I am going to see my LLMD on Monday, so will let you know how it all turns out!

Thanks again!

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VB
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I wanted to provide an update. Went to LLMD on Monday, and he extracted an additional 30 ml of bicillin from my hip, plus about 20 ml of mystery fluid, plus air bubbles that were trapped (weird). So in total, it was about 74ml of stuff in there, and my booty is much smaller now that it's gone.

It was not infected, fortunately. He said in his 25 years of medicine, he's never seen anything like it, and also said that there's no reason my body should not have absorbed it.

So anyway, I don't want this to scare anyone away from bicillin because I think it is a wonderful drug and helped me a lot. It's obviously not a common occurrence, so don't be scared.

I would recommend though, to have the pharmacy prescribe it in 1.2MU doses if you can so you can stick one in each hip (vs. all 2.4MU in one hip), although honestly people use the 2.4MU's all the time so even this shouldn't be a problem.

Also, be sure to alternate hips. And I would focus on rubbing the hip and moving around A LOT after injections.

At least, that's the advice I would give myself if I could go back and do it over!

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Haley
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thanks for the update. I was wondering what happened with this.

I'm glad you are ok.

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James H
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Thank you for reporting back to us about this. I think this is of interest since so many of us have either been on Bicillin in the past, are on it now, or may be put on it some day. I am happy for you that it turned out to just be something unusual and maybe a little amusing (when looking back), and not something life threatening.

I was using this stuff a few years ago and I could see where there could be problems with injection sites recovering before they had to be injected again, because all the other possible injection sites had also been used recently too. You end up with very sore, stiff and lumpy gluteal muscles.

If you look at an anatomy chart you will see that the gluteal muscles are not one big mass, but are in layers.

I think what may have happened is that the medication went in between two muscle layers instead of into the muscle tissue itself. It may be that the supplied needles were a length that when inserted into your backside ended up at just the wrong depth. They may have even gone clear through the muscle into loose connective tissue.

If it would have gone into muscle tissue like it should have the result would have been a hard, painful lump... not a relatively painless general swelling like you experienced. That is my theory at least. [Smile]

I agree with your Dr. that it was just a very unusual occurrence, and we are glad you are ok.

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