This is topic Any suggestions on IM Bicillin self-injection? in forum Medical Questions at LymeNet Flash.


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Posted by Melanie Reber (Member # 3707) on :
 
Good morning all,

Well, I am finally at the point where I am ready to tackle this myself. If others can, I can too, right?

So, if anyone has any last minute suggestions on making the self-injection process go a little easier, I am all ears.

Thanks so much in advance!
Melanie
 
Posted by dmc (Member # 5102) on :
 
You are so brave. Don't have any experience just think/sending positive thoughts & admiring your courage.

I am so impressed with those that do it, whether self injecting or have someone do it for them.
 
Posted by Dancer (Member # 11039) on :
 
I did some injections myself. I would sit on my heels and prop a large mirror so I could see better. The only tricky part was when drawing back to check for blood, need good lighting so you can see that. The good thing re: doing your own is you can go nice and slow with the injection. It was less painful than having nurses do it quickly. Also, I did the needle insertion very gently, pressed VERY lightly on skin and it just kind of floated in, could barely feel it.
Good luck!

Oh, I did the z-track thing - I found a nursing manual by googling, step by step instructions for the IM injection. That was helpful.
 
Posted by tick battler (Member # 21113) on :
 
My husband is starting injections and our LLMD asked that I get trained somewhere so I can do it for him. He mentioned you have to be careful about the sciatic nerve or something. I will look for the nursing manual. If anyone else has ideas on how to learn about this, please pass them on.

Thanks,

tickbattler
 
Posted by WildCondor (Member # 434) on :
 
Hey Melanie...

Take your time with it...go slow at first, make sure you aspirate the needle. It helped me when I did my own Bicillin to lie on one side and rotate your hip towards you. It may be easier for you to stand though. Make sure it is injected upper/outer quadrant of the buttocks.

Helps afterward to get in a hot shower and massage the spot, helps it absorb. Good luck!
 
Posted by Melanie Reber (Member # 3707) on :
 
Thanks so much to each of you for the input! I guess I did alright, since I am still around this morning! [Smile]

The only issue I experienced was that it was really difficult trying to push out the med through the syringe. I had to push really hard to get it to budge and then the needle wanted to keep coming back out of my hip, so I had to keep pushing that back in as well.

I might try sitting or lying down the next few times too as it became difficult to hold that twisted position for too long with my weight only on one leg.

Sooo, once you get past the initial gitters to sticking yourself, it really isn't too bad after all. (can you tell I am psyching myself up for the next one already?)

Thanks again!
Melanie
 
Posted by canbravelyme (Member # 9785) on :
 
Hi Melanie,

So glad to be of help to you!

I did Bicillin injections to myself for approx. eight months.

Two kinds of bicillin:

Premixed and powder.

If you're using the premix, I suggest you bring the syringe to room temperature before you inject.

The premixed is very thick, and will go in more easily at room temp.

The powder needs to be injected quite quickly after mixing it. It settles quite quickly and then becomes more painful to administer.

Another consideration re: the bicillin not injecting has something to do with the angle of the tip of the needle. I was taught that if the bicillin comes to a halt / won't inject further to pull the needle out a little bit, ASPIRATE AGAIN, and then continue the injection PROVIDED THERE WAS NO BLOOD IN THAT ASPIRATION.

Please ask your nurse about the latter before trying it yourself.

Best,
 
Posted by sammy (Member # 13952) on :
 
Melanie, I found it easier to sit on my bed twist around to administer the Bicillin.

It also helped me to find an appropriate spot by standing in the mirror. Easier to see landmarks this way. Once I found the spot I applied EMLA cream and a bandaid. You should wait an hour for the EMLA cream to fully numb the area.

Half hour before injection I applied ice to the site. When I removed the ice and the bandaid I had a nice white spot at the site. Made administering the shot easier.

I pulled the Bicillin syringe out of the fridge about 30min prior to injection to help warm it up. If you have the prefilled syringes do not prime the needle and push the air out of the syringe. The Bicillin is very thick and will block the needle if you do this. The syringes are made this way so that if you aspirate and have blood return you can see the blood. So don't worry about the small air bubble, it has a purpose.

So now you're ready to give the shot, sit on the bed, alcohol spot, twist to the right if giving in R side. I liked to brace the skin with Left hand and inject with R. Don't forget to aspirate to check for blood then administer the Bicillin slowly.

You will want to rotate sites regularly so run a search on google to locate ventrogluteal and dorsogluteal sites. I liked the ventrogluteal sites the best, easier and less pain.

After injection walk around, walk in place to relax the muscle. Massage the muscle gently and apply a warm compress/heating pad. Doing these things helped prevent stiffness and soreness that I would experience the day after injection. It also helps prevent the lumps.

I would also rub/gently massage the spot a couple times each day. This helped relieve the soreness and helped break up/prevent the lumps too.

Good luck!
 
Posted by micul (Member # 6314) on :
 
Yeah, don't to them...they're a pain in the ash! [Smile]

I did self injections for 6 months @ 2x's a week, but I would never do them again. I would go with Amoxy if I ever feel the need to get back on penicillin. These shots damage the muscle and surrounding tissue, and IMO were never meant to be taken on a long term basis

Yes Bicillin is long acting, but Amoxy is just as effective when used properly. I can understand that some people feel that they don't have a choice because of digestive tract issues, but I don't have that problem, and I know how to keep from ever getting it.
 
Posted by just don (Member # 1129) on :
 
Glad to hear your using these again!!!

Maybe you need a willing room mate!!

But others have done it themselves,,,you can TOO!!
 
Posted by Melanie Reber (Member # 3707) on :
 
Thank you, thank you, and thank you again! I just KNEW there were far more experienced members here with this sort of thing.

Yes, the EMLA creme helps tremendously, I have always let it sit for at least an hour or more if I can. Now that I am on my own time schedule instead of someone else's I can let that go as long as necessary.

I also found that icing really didn't do much good for me. I think the pain from the ice on my skin was just as uncomfortable as the shot itself. ")

BTW Micul, I am one of those who can't tolerate any oral 'cillins, so the IM works very well for me.

REALLY important point about aspirating AGAIN if the needle moves too much. I didn't even think of that as I was injecting at various depths yesterday! I will have to make sure that the needle stays put next time.

It seems like it will really be a stretch to try and shoot the left hip when I am right handed... but I suppose I will figure it out and get use to it eventually.

Once again, thanks to each of you!
M
 
Posted by MariaA (Member # 9128) on :
 
Could anyone make recommendations about injectible lidocaine- my LLMD's clinic sent me that instead of an Emla prescription, and I havne't had a chance to ask them how to use it ideally. I've heard that it's painful to inject lidocaine.
 
Posted by Carol in PA (Member # 5338) on :
 
Hi Melanie!

[hi]


When I was giving injections, I found that scrubbing the injection site with the alcohol swab helped to numb the nerves there.

I didn't have a numbing cream to use.
My patients assured me that the injection didn't hurt...some of them were needle phobic.

You can aspirate with one hand, by grasping the barrel in your palm and four fingers, and using the thumb to pull the plunger up a little.
(This is while the needle is embedded.)

Darting the needle into the skin is helpful.
You can practice by doing the motion with your fist, so that the muscles in your arm learn it.
You don't want to draw back as you strike the skin...you need to follow through, down into the muscle.

If the skin is really tough, the needle might bounce off.
This happened to me when I was learning.
I wasn't putting enough force into the darting motion, and the little boy who was getting the injection was diabetic...they have tougher skin.

Taking the cap off the needle is another skill.
When you remove it, you must pull it off in a smooth continuous motion, as if you were aiming at a spot about a foot away.

When I first started, I would pull the needle cap off but try to stop the motion after a couple inches.
This resulted in my hand "rebounding" towards the needle, and I would sometimes stick myself with it.
Ouch.

Carol
 
Posted by LymeDACnow (Member # 4649) on :
 
I had a RN friend do mine most of the time but a few times gave them to myself in my thighs...no more painful for me and didn't seem to get lumps there.
 
Posted by WildCondor (Member # 434) on :
 
Amoxicillin can't hold a candle to Bicillin LA. Bicillin is far superior and is an excellent choice.

Another tip, take it out of the fridge for about 20 minutes before injecting it so it's not as cold. Inject over 30-60 seconds if you need to go slow too.

Lying on a heating pad afterward helps too.
 
Posted by MariaA (Member # 9128) on :
 
Does anyone have leftover topical numbing cream they'd be willing to send? I have Extencillin (bicillin-like product from Europe) but accidentally got injectible lidocaine rather than the topical numbing cream, and can't afford to get the right product right now.
 
Posted by Glassgal (Member # 668) on :
 
My LLMD had me hold the the syringe in my hand for about 20 minutes so it would be warm before she injected it.
 
Posted by Got Lyme? (Member # 11109) on :
 
I always numbed the area with an ice pack for about 5-10 minutes before the injection. Never felt a thing only the pressure from the bicillin. Go slow while injecting and roll the syringe through your hands to warm it up before hand.
 
Posted by mcpny (Member # 24689) on :
 
I have taken Bicillin shots before and I got more info from the responses here than I ever expected. I never knew there was a numbing cream or that you could get lidocane. I was on shots for 3 years and was able to work now I am having all the symptoms again and my insurance won't pay for the shots. And I cannot take oral antiobiotics so am in a state. How did you get the biccilin paid for?+
Margaret
 
Posted by tick battler (Member # 21113) on :
 
I am wondering how some say that this doesn't hurt. My husband just had his second shot and the pain in his muscle is really bad. He needs to take advil to sleep! This time we massaged and used a heating pad, so hopefully the pain will not last for 3 days like last time. Has anyone had this experience?

Also - I think he really herxed on this. He felt his heart beating in his head at night and it was hard to sleep. Also had much more fatigue than usual. That seems to be the biggest herx symptom for him.

He's also on Doryx and pulsing Factive as part of his new protocol. Hopefully this will do something since he really hasn't improved much in over a year. I am encouraged that he is herxing on this.

tickbattler
 
Posted by Sammi (Member # 110) on :
 
Melanie, I tried to send you a message but your mailbox is full.
 
Posted by Sammi (Member # 110) on :
 
tick battler, I am sorry your husband is having pain. When he gets the shot is he standing or laying down? Does he use any numbing cream?

I don't think it should hurt for three days. How often does he get them? Is he giving them to himself?

The shots do get easier over time.
 
Posted by VB (Member # 16824) on :
 
It hurts much more (yes, can be for a few days) and creates more knots if you don't warm it up in your hands. Gave them to myself for 18 mths and did it cold until I learned how to do it warm. World of difference.

To avoid your sciatic nerve, I have heard to give it in upper outside quadrant, but below the start of your crack.

Also, I posted a while back about what I would make sure to do if I had it all to do over again... make sure to alternate hips, make sure to work the muscle out after injection and over the next few days to get the medicine out of the muscle and into your system, also consider massagng the site for a few days and putting heat on it.
 
Posted by Melanie Reber (Member # 3707) on :
 
Sammi! [Smile]

Please use my email instead if you don't mind. [email protected]
 
Posted by James H (Member # 6380) on :
 
Here... From Google Books "Fundamental Nursing Skills and Concepts"...

Page 804 - 815, Injection Sites

The problem with these nursing references is that they teach you how and where to give a SINGLE injection. They don't deal with the problems of managing multiple injections over an extended period of time. You have to think in terms of a 'safe area' for injections instead of a 'correct spot'.

The injection sites need to be varied as much as possible so that tissues can recover before they are injected into again. They don't teach that part!

[ 03-17-2010, 11:29 AM: Message edited by: James H ]
 
Posted by tick battler (Member # 21113) on :
 
James,
Thanks for the book - just good to see another diagram.

Thankfully my husband was not nearly as sore this past time. (Must be because I gave the shot this time rather than the doctor!) [Smile]

I massaged it and put a heating pad on, so that made a difference. Both times the shot had been out of the fridge for an hour before.

tickbattler
 
Posted by Melanie Reber (Member # 3707) on :
 
Just a quick follow-up...

Well, it hasn't been easy, even after a month now... but I am getting more use to the 'idea' of self injecting, at least. [Smile]

I have found that half-sitting on the edge of the restroom sink counter-top in front of a mirror, is the best way for me to tackle this.

It relieves the pressure off of the hip muscle being injected into and also makes it a little easier to twist AND keep my balance.

I'm still having issues with the actual injecting part. It seems as if the medicine itself just doesn't want to come out of the syringe without REALLY pushing it hard.

And if I do that, it tends to come out too fast, which isn't such a good thing either. This is after at least an hour of it coming out of the fridge to get to room temperature. The only good thing about waiting that long is that my hip is good and numb by then with the EMLA creme on it. [Smile]

BTW, I am about out of EMLA, and since it is a script, and I no longer have access to a doc, does anyone have any other ideas on a numbing creme that is not an Rx? (ice just doesn't work as well for me)

Anyway, just wanted to post a few words to let those who may have been thinking of self injecting too... that it really IS doable!
 
Posted by canbravelyme (Member # 9785) on :
 
I recollect Emla is available in Canada without a prescription. So, you should be able to access it through an online Canadian pharmacy.

XO
 
Posted by Melanie Reber (Member # 3707) on :
 
Thanks so much! Does anyone know of a reliable on-line Canadian Pharm to try?
 
Posted by Melanie Reber (Member # 3707) on :
 
Hmmm...
I just found this product and have ordered it. I'll update again once I try it. [Smile]

http://www.drnumb.com/
 
Posted by sammy (Member # 13952) on :
 
Melanie,

There is an OTC topical lidocaine product, it is called LMX4.

Here is a link with more information: http://www.cincinnatichildrens.org/health/info/medication/k-n/lmx4.htm

You might have to call around to find a pharmacy that carries it. Or ask your friendly pharmacist to order it for you.

If you can't find the LMX4 try the Neopsorin Pain relieving ointment (buy generic if available). It has a different kind of analgesic.

You also mentioned having difficulty injecting the medication, this is common. Bicillin LA is an extremely thick medication. It reminds me of wood glue. Imagine trying to push wood glue through a tiny straw, of course it would be difficult.

Be patient and just inject slowly. If you try to push it too fast your muscle will automatically tense and make it more difficult and painful for you to administer. If you push it slowly your muscle can relax and accommodate to accept the medication more readily.

When I administered my own Bicillin LA shots I did it over a 5-10mins, depending on how my body responded.

Take care [Smile]
 
Posted by canbravelyme (Member # 9785) on :
 
You can also mix lidocaine in with the Bicillin. Speak with you LLMD.
 
Posted by Melanie Reber (Member # 3707) on :
 
Thanks Sammy and Canb!
 


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