METALLlC BLUE
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Member # 6628
posted
Do B INJ have to be given only in the rear, or can they be given in the large muscle of the front thigh? What is the exact preparation precedure for performing the injection?
When taking Zithromax/Azithromycin with Mepron, do you have to take the Zith exactly with the Mepron, or can you take say -- a 500mg tablet once per day, and take your morning Mepron and then Nighttime Mepron separately?
Example:
Post Breakfast 2tsp Mepron Lunch 500mg Zithromax Post Dinner 2tsp Mepron
If I have to take the Mepron with the Azithromycin exactly, can I divide a 500mg tablet?
I start B12 shots today later on. What is the exact procedure for doing this, and what preparations are needed before the actual injection, where is the injection given?
[ 02-24-2009, 05:02 PM: Message edited by: METALLlC BLUE ]
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
You're starting directly with 4 tsp of Mepron? Wow, you're a trooper! Good luck.
Yes, B-12 injections can be given directly into the large thigh muscle or the outer tricep area as well.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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Draw back syringe 1cc, or amount you plan to draw from bottle.
push needle into top of medication bottle
plunge air into bottle
draw out required amount into syringe
remove needle from bottle
I draw a small amount of air into the syringe, it helps prevent the medicine from leaking out of your skin after injection, like a lock
replace cap on needle
find spot you want to inject. I use large muscle upper frontal, half way between knee andgroin. I also use upper arm below shoulder, biceps?
rub area with alcohol swab
inject needle into skin/muscle. draw back plunger slightly,look for blood return. if bllod return you are in a vein and must start over. You dont want blood return.
push plunger, injecting meds into muscle. withdraw needle, and discard into sharps container.
You can buy sharps container at CVS. I was also told to keep the bottle in the frige. If you do, them draw the B-12 and let it come to room temp before injecting. I always feel a brusing like feeling at the site for a couple hours after the injection. It goes away.
I hope this helps. I believe there are videos on you tube, if you are a visual learner. I also hope the B-12 makes you feel lots better.
Posts: 261 | From Piedmont | Registered: May 2008
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treepatrol
Honored Contributor (10K+ posts)
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posted
I inject under skin and above fat layer so its absorbed slower more steady I do this on my belly. If injected into the muscle (say thigh or butt) its absorbed faster.(Thats not what you want unless your really low? at first) and what isnt used is either saved in liver or passed in urine.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
very good info given by ticked-offinNC--the air bubble "lock" you want is only to just below the "hub" (part of needle where needle twists into syringe)
also, you will want to draw it up with one needle, then throw that one away and use new 1in IM needle to inject. drawing up the B-12 dulls the needele. Can give in quad, in hip--divide one butt cheek into 4th. stay away from upper/inner 4th due to siactic nerve. if using arm--go 1-2 finger width from where you feel the shoulder/coller bone area and will get the right muscle. when you feel that area you will feel the boney part, then place one finger and fell then two fingers and will feel the difference (almost a drop..kinda..) and that is the area
if no sharps use coffee can and duct tape the lid all over once full.
i takek mepron/zith too and dont always take together, doc said just to take each twice/daily. have to take mepron with food for better absorption
my b-12 is daily...correct compound HAS to be refidgerated.
-------------------- i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **
dx in 08:lyme, rmsf, bart, babs, and m.pneumonia. Posts: 422 | From TX | Registered: Oct 2008
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posted
Are you asking about Bicillin injections, B-12 injections....or both?
Bicillin needs to be given in the upper, outer quadrant of the buttock.
B-12 can be given in the thigh muscle
Anne
Posts: 250 | From canada | Registered: Oct 2007
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
quote: You're starting directly with 4 tsp of Mepron? Wow, you're a trooper! [Smile] Good luck.
Yes, B-12 injections can be given directly into the large thigh muscle or the outer tricep area as well.
I didn't start overnight on 4 tsp. It took about 1 month to get up to that dose by going up 1/2 tsp every 4-5 days.
Ok, so Bicillin must be given in the rear outer quadrant. (Upper, Lower or Middle?)
My B12 levels are very good, but my physician said it was a must. All my levels were very strong. I attribute that to my Multivitamin I've been using for quite awhile, and a reasonably strong diet.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
Bicillin should be taken in the upper outer quandrant and rotate each cheek. And my LLMD says you can take zith or biaxin away from mepron. I take abx away from food because that's when I take most minerals.
posted
All the ppl injecting B12 IM surprised me - it is not a depot, it is just a water solution. Subcutaneous should work as well as IM and has less risk of hitting a blood vessel or nerve. Needles are much smaller and less expensive also.
Posts: 263 | From Capital Region, NY, USA | Registered: Jun 2008
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
I'm getting conflicting reports on the B12. My prescription from my specialist said intramuscular shots on the front of the pharmacy slip. Fallon Wellness was the pharmacy. I'm calling them right now.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
METALLlC BLUE
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posted
Ok, I called Fallon Wellness and here is what they did:
Here was the phone record:
1:04 PM 2/23/2009 - Fallon Wellness Pharmacy 518-220-2053: Told the girl I had a prescription with them and I had a question. I was prescriped B12 injections and I wanted to know whether to inject these beneath the skin subcutaneous or do they have to be directly into the muscle. The girl told me my shots were intramuscular and to inject them into the shoulder, thigh, or buttocks if I chose. I asked her if she's absolutely certain about the injection method, and she asked for my name both first and last, then looked up my account, and then she asked me to hold on while she confirmed the injection method with another tech. It did end up being Intramuscular.
It's intramuscular Methylcobalamin. I left a message with my physician who prescribed them, and asked them the same question. Dr. H's office in New York.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
posted
I've always done mine in the the lower part of my butt, the droopy area :-)
When I had them done at a dr office they did it in my shoulder and also the front muscle of my leg.
Posts: 348 | From maryland | Registered: Jul 2008
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posted
My LLMD had me pulsing zithromax because I couldn't tolerate the full dose, so I am guessing based on that that it's not necessary to be taken exactly at the same time as the Mepron.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
These Bicillin shots, are they painful?
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
posted
Metallic Blue, odd - my son sees the same LLMD as you and the B12 shot he got in the office was sub-q. That was methylcobalamin, which is a daily injection. I think there is also a depot formulation of B12 - can not remember if it is methyl or cyanocobalamin - that is a 1-2/wk injection which would probably be IM. Sorry for any confusion.
Fallon Pharmacy is not too far from me, since they compound rx there maybe the LLMD had them compound something other than the off the shelf methylcobalamin.
Posts: 263 | From Capital Region, NY, USA | Registered: Jun 2008
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METALLlC BLUE
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Member # 6628
posted
Hey TCW, yeah I have to take it twice per week. Here is what it says on the actual package with the pre-filled syringes.
Methylocobalamin (stock) 25mg/ml Injec,
16ML - NDC 51927296300
Inject 0.2 milliliters intra-muscularly twice a week (1 cc 25g 5/8" syringes)
She probably did have them compound it differently as a result of my numbers for B12. My blood tests showed very healthy levels of B vitamins, especially B6 and B12. I wasn't even on any supplements at the time. I hadn't taken any for a month or so.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
13 years Lyme & Co.; Small Fiber Neuropathy; Myasthenia Gravis, Adrenal Insufficiency. On chemo for 2 1/2 years as experimental treatment for MG. Posts: 4480 | From Northeastern Connecticut | Registered: Jun 2005
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METALLlC BLUE
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posted
Really, injection takes five minutes? ****.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
posted
Did he give you a script for lidocaine or emula? This helps numb the area so at least you don't feel the needle go in. The drawback is you have to leave it on for 45 min to get numb. I just put plastic wrap over the area where the cream is.
We do it pretty quick, I'd say 30 seconds. I'd rather get it over quick. It hurts pretty bad, especially if you hit a nerve. Supposed to be the most painful shot. I don't dread them though. Sit on a heating pad for 5-10 minutes and then it's tolerable. Also, I wobble around around a bit while sitting to help disperse it.
Posts: 348 | From maryland | Registered: Jul 2008
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METALLlC BLUE
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posted
So Mandy, I should use the heating pad afterwards? Which one is more useful, Lidocaine, or Emula? When you say plastic wrap, you mean after putting the cream on, while waiting for it to work?
I shouldn't hit a nerve if I do it on the outside upper quadrant though, right? Also, does the pain last for a long time afterwards? What size needle are we talking here? 1 inch, 2 inches? I'm such a wuss before I do something new like this.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
posted
Yes, use heating pad AFTER shot. Lidocain/Prilocaine/Emula are I believe, all the same thing. I use saran wrap over the pea size drop of cream while waiting for it to numb.
Sometimes it feels as if I hit something but maybe it isn't a nerve. The needle is 2 inches long. It's long, I don't watch. You should call and get a script for the cream. The size of my needle is 19 1/2 gauge. The smaller the needle gauge, the thicker the opening of the needle.
I get mine from overseas where you have the saline and suspension powder and mix it up. You probably are getting yours pre-filled. My friend says her pre-filled ones are the same size.
I think these have helped the most with my neuro symptoms. It's good stuff. Expect a herx, mine lasted 6-8 weeks of bad fatigue but now after 4 months I take it with no noticeable sides. It'll help, go for it!
Posts: 348 | From maryland | Registered: Jul 2008
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METALLlC BLUE
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Mandy, you rock. Thanks for the advice.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
METALLlC BLUE
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Member # 6628
posted
Good to know also. So do you use ice before, or after Amanda? When you say standing on a foot rest, do you mean like Captain Morgan style or are you laying down? I can't picture it.
-- Mike
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
djf2005
Frequent Contributor (1K+ posts)
Member # 11449
posted
mike-
be sure to be completely free of mercury before doing so.
dr b mentioned to me that if one is using methyl b 12 and has mercury the b12 will mobilize the mercury and your mercury will become more proliferated as it is now METHYL MERCURY.
derek
-------------------- "Experience is not what happens to you; it is what you do with what happens to you."
My recent heavy metals test was very elevated for mercury. Reference range 4- mine was 21! I do B12 injections daily! I have heard b12 mobilizes mercury, but it's one of those things I didn't pay attention to.
Should one stop the b12 if mercury is an issue? What is the best way to chelate? DMSA?
METALLlC BLUE
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posted
I got a call back from the doctors office regarding "my" B12 shots. My specific shots are in-fact intramuscular only.
Mandy, the best thing I can think of is working with someone who is very skilled in heavy metal chelation. It can be a serious thing if not done correctly from what I've been told.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
You have to be _really_ lean to use a 5/8 needle for an IM shot. 25g 5/8 are usually for sub-q injections. 0.2cc is a really small amount - I can not imagine that much fluid causing much pain - especially B12 in water. Usually IM injections are 1.5 inch needles - I am not sure if you will have to get 1.5 needles and 1cc syringes separately.
Bicillin LA is a different thing altogether - that is 2cc of penicillin in suspension (not solution) through a 18g 1.5 inch needle. That is definitely going to produce some pain.
Posts: 263 | From Capital Region, NY, USA | Registered: Jun 2008
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David95928
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posted
Bicillin 1.2 MU comes with a 1.5 inch needle and mine are definitely not 18 gauge or even 20 gauge. I'd say they are 22 gauge. It does sting sometimes at the time of injection and does ach afterwards sometimes. I've learned to ignore both phenomena. Dave
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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METALLlC BLUE
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Dave, if I'm half as badass as you, this will be easy. Thanks man, that's encouraging.
How fast do you inject it Dave? Any "routine" you follow before or after - icing, heat, etc?
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
David95928
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posted
Mike, I just make sure to aspirate and stay in the upper, outer quadrant. It probably takes me about thirty seconds to get it injected, I just follow my own pain trajectory. That is, if it hurts more, slow down. Simple. Dave
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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METALLlC BLUE
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Could you explain that further, about aspirating. Here is my understanding.
Wash hands, put on gloves, use alcohol swaps at night of entry.
Take the cap off the needle, and if it's prefilled, just make sure no air is present, or a fractional minimum.
Inject the needle firmly and directly, and then begin injecting the substance itself.
Am I missing something? Do I have to pull back before I press the plunger, drawing a little blood into the syringe?
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
David95928
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posted
Mike, it's of critical importance to avoid getting Bicillin into a blood vessel. Therefore you need to pull back on the plunger once you have the needle in to see if you draw any blood. Assuming no blood become s visible, it si similarly critical to maintain the needle location/depth while injecting. Most important is to avoid hitting the gluteal artery but if you stay up high and to the outer side that should be no problem. However, even getting some of it into a smaller blood vessel is not good. That's why the pre-filled syringes have an air pocket in them. The stuff is so darned thick that the blood can be invisible. I suggest storing the Bicillin in a position that will allow the medicine to fall away from the needle hub. Then when you aspirate, any blood will appear in the air pocket. The isntruction are to dicard the meidcine if blood appears but it's so expensive I am reluctant to do that. Instead, I pull out about half way and put it back in at a different angle and try again. The small amount of air is not harmful as the body will get it out. What is dangerous is a large amount of air injected directly into the blood stream. Feel free to PM if I have not been clear. Dave Oh, I'm ot a doctor or nurse. I've just used Bicillin three times a week for about six years.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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Ocean
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posted
Dave is absolutely correct, because you are injecting into the muscle, you need to aspirate (pull back) on the syringe to check for a blood return. If there is a blood return, you must pull out, get a new needle and start over.
And yup, since after becoming a nurse I have seen PLENTY of nurses NOT aspirate, it drives me crazy! Same thing with a blood pressure cuff. We were taught (OK, this was DRILLED into our brains) to NEVER place a cuff over clothing, it must be done on bare skin.
I don't think (rarely anyhow) I've had a nurse ask me to pull my shirt sleeve up. Usually I will or offer and they will just wave their hand, "no, that's not necessary."
UGH!!!!
Good luck with your new protocol. I hope you get somewhere quickly!
METALLlC BLUE
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posted
quote: Mike, it's of critical importance to avoid getting Bicillin into a blood vessel. Therefore you need to pull back on the plunger once you have the needle in to see if you draw any blood. Assuming no blood become s visible, it si similarly critical to maintain the needle location/depth while injecting. Most important is to avoid hitting the gluteal artery but if you stay up high and to the outer side that should be no problem. However, even getting some of it into a smaller blood vessel is not good. That's why the pre-filled syringes have an air pocket in them. The stuff is so darned thick that the blood can be invisible. I suggest storing the Bicillin in a position that will allow the medicine to fall away from the needle hub. Then when you aspirate, any blood will appear in the air pocket. The isntruction are to dicard the meidcine if blood appears but it's so expensive I am reluctant to do that. Instead, I pull out about half way and put it back in at a different angle and try again. The small amount of air is not harmful as the body will get it out. What is dangerous is a large amount of air injected directly into the blood stream. Feel free to PM if I have not been clear. Dave Oh, I'm ot a doctor or nurse. I've just used Bicillin three times a week for about six years.
Ok, I think I understand. How far do you aspirate? Additionally, when you say the blood can be invisible, what do you mean regarding the air pocket? When you aspirate, aren't you going to see blood regardless if you pull back far?
And when you say storing, do you mean the should be upside down, with the needle facing upward?
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
David95928
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posted
Mike, I think having a nurse perform this task a time or two, for instructional purposes, is a good idea. YOu don't have to pull back real far when you aspirate. A bit of vacuum will drawblood if the tip is in a blood vessel. Are you injecting B12, if so, that's good stuff to practice with because it's so benign. You could get comfortable with that before trying Bicillin. Reaching and seeing the butt can be a bit difficult. Doing it in front of a mirror can help. Alternately, is there a friend or family member who can help you out? Dave
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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METALLlC BLUE
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posted
Dave, Thanks for your further suggestions. I contacted my primary after our last message and asked her for a brief lesson on the injection. I'll have my mother and her present and allow her to show my mother how to do it. Hopefully I can set this up quickly.
I can do the B12 without a problem, but it's also very fast and not painful. I've done shots like those before, but not things like Bicillin which appears to be a more significant process.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
David95928
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posted
Mike, it sounds like a plan. You can learn it but having help at the beginning makes sense. BTW, if you don't mind, where are you located? I was in Northampton for a couple of years. Dave
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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METALLlC BLUE
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posted
I live in Springfield Dave, just south about 20 miles. I did contact my PCP and she said she felt it was a good idea also that I did a lesson with her.
The appt is for next Thursday. I'm not in a hurry.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
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