Which needle?

Discussion specifically about the diagnosis and treatment of Pernicious Anaemia

Moderators: Missy, hampster, martyn, coryad, BeeNumber12, kimks mom, Vix, AndreaM, japatchett

Which needle?

Postby Haynes » Sun Apr 20, 2014 12:47 pm

I wonder if members that do their own injections could advise me on what colour needle to use? I have been using the green ones (which are bigger), but have recently lost weight and I am wondering if I should change to the blue ones? I inject Hydroxocobalamin once a week into alternate thighs.

The other thing I have been wondering about is the draw back technique to see if there is any blood in the syringe - to see if you have hit a blood vessel. I haven't been bothering to do this and it doesn't seem to have mattered? Why is it important to not inject into a blood vessel?

I also wondered how the hydroxocobalamin gets from the muscle into the areas where we need it?

A few years ago a nurse used to do my injections used to draw up with one needle and then change needles to inject - I can't fathom this out either - why did she do that? She used to draw up with a green and inject with a blue into my arm?

My GP practice don't monitor my injecting technique - I had one kind nurse who taught me and she has now left - the GP was very negative about it and tried to put me off, but I couldn't work if I didn't inject as I couldn't get the time off every week. It is so convenient and easy for me - just want to be sure I am doing it correctly?
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby Poacher » Sun Apr 20, 2014 3:40 pm

Poacher
 
Posts: 400
Joined: Thu Sep 09, 2010 3:00 pm
Location: United Kingdom

Re: Which needle?

Postby anotherwithpa » Sun Apr 20, 2014 4:50 pm

I use a green needle (21G) to suck up the B12 out of the ampoule, then change to blue (23G) for injecting, do expel air but do not pull the plunger up to check for blood. I was told that was not needed as modern needles are so fine that any damage will heal quickly. You will know if you hit a vein, it will hurt, I do everything very slowly and will stop immediately if it hurts and start again next to the initial pricked area. I have had several blunted needles from sucking up, the skin just dents and the needle does not go in, so I always change, and check the needle as some are blunt out of the package. Also making sure the eye of the needle faces your hart makes it go in better, why I do not know! Injecting after a hot bath helps to see veins. Warming up the ampoule to body temp also helps to have a painless experience.
I get my needles from:
http://www.medisave.co.uk/consumables-g ... inges.html

I hope this helps,

Kind regards, Marre.
anotherwithpa
 
Posts: 4795
Joined: Thu Jan 01, 1970 12:00 am
Location: Hants

Re: Which needle?

Postby Poacher » Sun Apr 20, 2014 7:17 pm

Poacher
 
Posts: 400
Joined: Thu Sep 09, 2010 3:00 pm
Location: United Kingdom

Re: Which needle?

Postby Haynes » Mon Apr 21, 2014 3:34 pm

Thanks everyone for your help.
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby Haynes » Sat May 10, 2014 11:08 am

I just wanted to give some more feedback. I have done my first injection using the green (rather large) needle to draw up and then swapping to the smaller blue needle (purchased from Medisave) to inject. It was much less painful and the tip stayed sharp. I wish I had realised before that hitting the end of the needle on the bottom of the vial may blunt the point and also that any bits and pieces that get drawn up can cause cellulitis if injected. I am not bothering with the drawback technique.

I also wondered if anyone has the same experience as me in that I inject on Sunday morning and the best time of the week for me is Monday afternoon. I get this feeling of well-being, calmness, anxiety lifts and fog-free and generally feeling good on Mondays. By Friday I am starting to get foggy again. I have good days and bad days. The main thing I notice is not being able to concentrate on what is being said to me when I am tired and my brain seems to be listening to itself rather than the person speaking to me or the television. I am the same with reading. I struggle to concentrate. I am managing to hold down a difficult job though, so it is not too bad, but I am not the same as I was prior to getting PA.
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby anotherwithpa » Sat May 10, 2014 3:46 pm

I also inject on Sunday am and usually feel well on Monday, give it 4-5 days and it can be sloping down, but other weeks 10 days is good, 4 brilliant 6 OK and 3-4 not so good until I inject again (every 2 weeks). It also depends on what type of B12 I use.
We all are different, we all seem to do very different things with the injected B12 it seems!

Kind regards,
marre.
anotherwithpa
 
Posts: 4795
Joined: Thu Jan 01, 1970 12:00 am
Location: Hants

Re: Which needle?

Postby hampster » Sat May 10, 2014 4:27 pm

I agree with Andrea, sounds to me like you would benefit from an extra jab a week.

Chris
hampster
 
Posts: 260
Joined: Tue Mar 05, 2013 1:49 pm
Location: England

Re: Which needle?

Postby Haynes » Sat May 10, 2014 5:54 pm

Thanks, that's interesting as I have gone from monthly to three weekly to two weekly and now to weekly and I am on my 3rd GP at the practice who wasn't terribly happy at my asking for a weekly prescription as she says the excess will just be excreted in the urine. So I am not confident they will give me any extra and I don't want to rock the boat. Do you all get yours on prescription from GP or does anyone manage to buy it from anywhere?
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby anotherwithpa » Sat May 10, 2014 6:48 pm

I get percribed hydroxocobalamin from my surgery for every 2 months (having been diagnosed with Sub acute degeneration of my spinal cord) and buy in Spain cyanocobalamin ampoules at the pharmacy. My father living in Spain was prescribed this so I trust what I buy. It cost me about 50 cents per ampoule. I also buy other medication in Spain at the pharmacy; those that are much cheaper than an NHS prescription (such as folic acid 5mg etc). Many here by on the internet, many from my care, for more info see this topic:
viewtopic.php?f=2&t=13746
Kind regards,
Marre.
anotherwithpa
 
Posts: 4795
Joined: Thu Jan 01, 1970 12:00 am
Location: Hants

Re: Which needle?

Postby hampster » Sat May 10, 2014 6:53 pm

Hi Haynes,

Sorry if you've been asked this before, but do you know your folate and ferritin levels? Perhaps they are low which is why you are needing more frequent injections. The other things to perhaps check are thyroid and vitamin D.

Ultimately, I found from my own experience that the better I felt, the more I did, and the more I did, the more B12 I needed. So I inject twice a week, and I buy my hydroxo from Goldpharma (my GP only gives me 3 monthly). Details are in the link Marre has given you.

Chris
hampster
 
Posts: 260
Joined: Tue Mar 05, 2013 1:49 pm
Location: England

Re: Which needle?

Postby Haynes » Sun May 11, 2014 9:57 am

Thanks for your replies. Yes I am hypothyroid and have been since my daughter was born 19 years ago. I have recently had a slight increase in my levothyroxine and take 125 mcg and 150 mcg on alternate days (first thing in the morning).

I take ferrous fumerate (as prescribed by GP), a multi-vitamin/mineral (Bionta), garlic and Jarrows oral methylcobalamin 1000 every evening. My ferritin and folate have been fine in the past but haven't been tested recently and I eat a healthy diet, don't drink much, don't smoke, try to exercise, and don't take antacids.

Can't see a link for Goldpharma on Marre's comment??

You may all be interested to hear that I went to a local meeting recently invited by my MP to see Norman Lamb, Lib Dem Health Minister and I handed them a list of all the problems. I have been bombarding my MP with emails for the last six years since my diagnosis. Whether we will get anywhere remains to be seen but at least I have tried!!

I think it is outrageous we can't get a vitamin!
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby hampster » Sun May 11, 2014 10:28 am

Marre's link is to a topic called "Where to Source Supplies"

viewtopic.php?f=2&t=13746

You will see options for buying B12 at the top.

If you are taking Multibionta, that only contains 200mcg of folic acid, I doubt this would be enough to support weekly injections. Maybe get folate retested so you can see where you're at (you need to fast for the test), or think about a higher dose, at least 800mcg. If you are deficient your GP should prescribe 5mg folic acid, or you can buy that strength on Amazon (brand name Bio-Tech).

Chris x
hampster
 
Posts: 260
Joined: Tue Mar 05, 2013 1:49 pm
Location: England

Re: Which needle?

Postby Haynes » Sun May 11, 2014 10:46 am

Once again many thanks brilliant feedback. Martyn has mentioned to me in the past that I may not have enough folic acid despite being in normal range, eating loads fruit and veg and the multibionta. So I will try taking more and see if it helps before increasing the injections as I don't enjoy doing them!! Can you overdose on folic acid?

Many thanks for the link Marre and Chris too, great help.

I did have my vitamin D tested and that was OK. I am beginning to wonder whether we can trust any of these tests anymore though.....

Clearly as I am someone with parietal cell antibodies the lack of stomach acid means that digestion is different to someone with high acidic stomach. It is an unknown really as to how much we are actually absorbing.

Also I think the possibility of bacterial/fungal overgrowth in a digestive system with no acid is high. I have had H.pylori antibiotics in the past and I do think it helped as my stomach used to bloat and it doesn't as much now. I do also get a lot of fungal skin infections since I have had PA and hence I take the garlic. I am wondering if fungal overgrowth in the gut also depletes the B12 quicker? I try to not eat too much sugar and white bread to try and starve the growth but it is hard! I have been wondering if I am slightly gluten sensitive too?
Haynes
 
Posts: 55
Joined: Fri Jan 30, 2009 7:04 pm
Location: England

Re: Which needle?

Postby hampster » Sun May 11, 2014 11:41 am

You're similar to me in some ways, I have TPOAbs and PCAbs but Graves rather than Hashi's. From the research I have done on autoimmune thyroid disease one of the first things I did was give up gluten, even though I tested negative for Coeliac Disease. I've never had issues with stomach pain, wind and bloating since. I have just recently given up dairy as this was contributing to silent reflux. It's worth experimenting with dietary changes, but one thing at a time. And get a proper Coeliac screen before you give up gluten, just in case.

On the folic acid front there is quite a lot of negative commentary about UMFA (unmetabolised folic acid). But for every negative paper on the dangers of too much folate, you will find another on the dangers of too little. Ultimately I think that you have to put in enough folic acid or methylfolate to complement the amount, or type, of B12 you take, at a level that keeps you well. You could by all means try methylfolate instead, it is a very individual thing as to what works and what doesn't. Personally I have hydroxo jabs twice a week and 5mg ordinary folic acid about 5x per week. I have 400mcg methyfolate daily in my B-Complex. If I reduce the folic acid any further (and I have tried) I become unwell.

Chris x
hampster
 
Posts: 260
Joined: Tue Mar 05, 2013 1:49 pm
Location: England

Next

Return to Diagnosis & Treatment

Who is online

Users browsing this forum: No registered users and 2 guests