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Posted by Jill E. (Member # 9121) on :
I started IM Bicillin injections a few weeks ago. Before starting them, I asked every Lyme patient I knew who had been on Bicillin to give me advice on how to minimize the pain as well as the lumps and bumps some people get from intramuscular antibiotics.

I've compiled a list of various tips from these patients as well as a few things I've learned on my own.

A couple of people asked me to post these, so here goes - please feel free to add what has worked or not worked for you.

Also, I would guess that some of the tips people gave me are not condoned by the pharmaceutical manufacturer or by some Lyme doctors, so please check with your practitioner first.

Here's what's been suggested - obviously not to do all, just whatever works for you and is OK with your Lyme doctor:

- Warm up the Bicillin first (I wasn't sure if this meant allowing it to come to room temperature, but I didn't do it given that the instructions are to keep Bicillin refrigerated, but another poster on this forum mentioned warming it up by rolling it in your hands)

- Ice the area before the injection (this worked pretty well for me)

- Use lidocaine cream or patches before the injection (I tried the lidocaine patch alone -it's pretty good, but now I put the lidocaine patch on about an hour or two before, then ice the area for about five or ten minutes before injection)

- If someone else is injecting you, rather than injecting yourself, lie down on your stomach, point your toes INWARD (this made a big difference for me) wiggle toes (haven't tried that yet) - position does help relax the muscles more

- Inject SLOWLY (I hate this but think it's one reason I've had no bumps)

- Take slow, deep breaths to stay relaxed

- Use a wet heating pad or warm damp washcloth or hot bath afterward

- Massage area afterward - this is both for pain and to minimize bumps (this has helped me)

- Walk afterward - for an hour if you can - this helps disperse the Bicillin to help prevent bumps (this has worked great for me)

- Rather than use the 21-gauge needle that comes with Bicillin, transfer the Bicillin to a syringe with a finer-gauge needle - 23-gauge was recommended (my nurse doesn't want to do this because she said there is a very tiny risk of contamination/losing sterility when transferring, but I know many people who do this with their doctor's complete approval)

- Mix Bicillin with equal parts lidocaine to both provide a numbing agent as it goes into the muscle and to thin out the Bicillin (a friend's Lyme practitioner gave her permission to do this. I asked my Lyme doctor, he had never heard of doing it and told me to call the pharmaceutical manufacturer. They said they had no clinical studies on that so couldn't say whether it would affect the Bicillin in any way)

I would love to hear your suggestions because I have many more injections to go!


[ 06. May 2006, 12:03 AM: Message edited by: Jill E. ]
Posted by DeniseS (Member # 7276) on :
I use most of the tips you mentioned however I'll have to try walking for an hour afterward - it would beat pacing around the room for 5 minutes!

I would not change needles and here's why. Please be aware that Bicillin LA is extremely dangerous if you inject it into a blood vessel. The syringe it comes in has little yellow patches painted on it that line up with the spot where you should look for blood when you draw back the needle. You can see a little metal outlet from the needle inside the syringe. This directs the blood over to the side of the vial where you can see it. If you change needles, you'll lose this. Over the past 80 injections, we just had one where there was blood at that spot. The instructions that come with the Bicillin has this info written more clearly than I can convey.

None of the nurses or doctors told us about this when they instructed us. They also told us to clear the needle of air, which the instructions clearly say not to do because, once again, it compromises the visualization spot which helps you see if you've hit a blood vessel.

Thanks for reading. I hope this helps.
Posted by Jill E. (Member # 9121) on :
Thanks, Denise, for your explanation why it's preferable not to change needles. The nurse who is injecting me does a fabulous job. She had never done Bicillin but had done IM Rocephin, and did not feel comfortable with the idea of transferring the Bicillin to a different syringe. So we're using the Bicillin just as it comes. But I will mention your post to my nurse because I'm sure she will appreciate any extra advice - this has been a learning experience for her, too, because I'm the only Lyme patient she has ever worked with.

Is the Bicillin helping you? I'm hoping for some improvements because I've been at a plateau for quite a while.

Posted by WildCondor (Member # 434) on :
Well, many of us get the Bicillin pre-filled so all we have to do is inject it. Warm it to room temp first, but not oo long, then inject over 10-20 seconds. It can help to put pressure on it after (so none drips out) and get in a warm shower. [Smile]
Posted by timaca (Member # 6911) on :
My husband does my injections, and he does a great job. Injecting it SLOWLY has made a great deal of differnce for me.

I'll try the laying on the bed approach. I've just been leaning over a counter, and I'm still a bit tense. Injecting the needle doesn't hurt, it's the meds that make me twinge some.

Anyone know how to inject yourself?? I just can't see how I'd do that, and see whether or not I hit a vessle....Suggestions?

Timaca much is everyone on? For now, I'm on 1.2MU once a week. I'm battling C. diff right now too [toilet] , so I can't go any higher....
Posted by Jill E. (Member # 9121) on :

I'm on 1.2 m.u. twice a week. Are you taking sacchormyces boulardii for C. Diff? I've been taking it since Lyme treatment to prevent it. A friend of mine had C. DIFF before she got Lyme and was told by a nutritionist that S. Boulardi was excellent to help prevent it, but I don't know if it works once you have it.

You're right - injecting slowly is very important.

I applaud those who inject themselves with Bicillin. I don't have the courage yet, plus my LLMD said to use the upper outer quadrant of the hips/buttocks- something very difficult to do with self-injections, so it would probably have to be the thigh.
Posted by timaca (Member # 6911) on :
HI Jill~

Yes, I'm taking the S. boulardii for the C. diff; along with Culturelle, which is supposed to be good. AND I'm taking Theralac, along with Primadolphilus....all to no avail. UGH.

I am going to try pulsing the oral vancomycin next, and my PCP wants me to try Cholestyramine to absorb the C. diff toxin. I hope it works!

Have you made good progress on the bicillin? It is helping me.

Posted by Jill E. (Member # 9121) on :
Hi again Timaca,

Gee, with all the probiotics and s. boulardii you take, you are certainly doing so much to protect yourself against C. DIFF. I'm so sorry you're going through this. I hope your new regimen will help.

I've only had six Bicillin injections so far, but I have noticed some mild improvements and some mild herxes. So I think there's hope but it's not quite the strong med I expected it to be. But I'm seeing my LLMD next week so I look forward to his assessment. I think I'm having major Bartonella problems right now so that could be complicating things. He will probably put me back on Levaquin.

You take good care of yourself!
Posted by timaca (Member # 6911) on :
Thanks, Jill. I hope you continue to see improvement with the bicillin, and are also able to address the bartonella issue.

I had a MAJOR herx with the bicillin. Ended up in the ER for 5 hours with tachycardia! My cardiologist, LLMD and PCP were quite surprised. They knew I had herxs on day 10-12 after starting an antibiotic, but this herx was most amazing.

What symptoms are you having that make you suspect Baronella?

Take care....Timaca
Posted by Jill E. (Member # 9121) on :

Wow, I'm so sorry your herx caused you to be rushed to the ER! Thanks for warning me, though, because Bicillin is obviously a strong medication, I just haven't had that strong a reaction - yet at least. I'm on 1.2 m.u., twice a week. When I see my Lyme doctor, perhaps he will want to increase frequency or dosage.

My Lyme doc and I have been suspecting Bartonella because my CNS symptoms are so bad - even though I've had improvement on antibiotics, and when I got put on Levaquin I got a huge rash that I thought was an allergic reaction so I stopped, but he is thinking it was a Bartonella rash. Now I'm dealing with very sore heels, and according to Dr. B's guidelines and DVD, sore soles are often a Bartonella-like Organism symptom. I don't know if you've ever seen photos of Bartonella rashes. If I had one, it was not the typical long red streaks, it was more like hives, but that can be Bartonella, too. But of course, it can also be an allergic reaction to medications - so again, everything is a judgment call on these decisions. But the sore heels are a new thing with me.

I'll let you know what he says.

Posted by timaca (Member # 6911) on :
Yes, please keep me posted. Good luck...Timaca
Posted by minimonkey (Member # 8693) on :
IM Bicillin has been a wonder drug for me! The herx has been really minimal compared to doxy (which nearly killed me) and the improvement has been great.

I inject myself. I don't find it difficult or painful at all -- My LLMD suggested putting my hand on my hip then moving it backward to find a good area -- just swab with alcohol and inject slowly. It helps to slide the needle in quickly, it barely pinches that way. It actually isn't hard to do on that hip area -- although I do better on the right side than the left (I'm right handed.) Definitely let it warm up first! I use a fair amount of pressure on the needle so it gets deep in the muscle -- that way there is no leakage. Only one time have I had any bleeding, and that was when I was on a lot of NSAIDs, so I think the blood thinning was the reason for that.
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