Shots in the stomach for the shot impaired

November 6, 2006 5:23 PM

Follow up to this question. I had the knee surgery today, and my doc when explaining my post-op care to my friend said that I'm going to have to have shots of Lovenox in my friggin' stomach for a while. Anyone have the experience of giving themselves injections, especially if you're a little phobic?

I guess they're concerned about DVT. The doc never explained that this would be a part of the deal, so I'm a little tweaked. Additionally, are there any alternatives to this type of treatment? Thanks in advance...

posted by moonbird to health (15 comments total)

Subcutaneous injection? Piece of cake.
posted by caddis at 5:39 PM on November 6, 2006

I gave myself subq Lovenox injections during my last pregnancy. You know what helped me? Hypnosis. Sorry, I'm a flake, but it really did--I had one session with a therapist I'd worked with before. I said, "I want doing my injections to be like brushing my teeth--something I do automatically, don't fret about beforehand, don't hesitate to do, don't worry about it later." And that's how it was. I did them for months and I barely remember it. It was not difficult or traumatic at all. Hypnosis worked great for me, but I'm very susceptible to hypnosis, so YMMV.

The other thing is that when it comes time to do that first shot, do not hesitate. When the nurse taught me how to do it, she offered to do the first one for me, and I said no. I took the needle, counted to three, and bammo, did it. Hesitating, getting a friend to do it, stuff like that just jacks up your anxiety and makes it harder the next time.

Also, caddis is flip but correct. A subcutaneous injection is not like trying to hit a vein, or giving an injection deep in a muscle. You just have to pop the skin, and it really is no big deal. Once in awhile, the Lovenox itself stung a bit going in, but mostly not. Mostly it didn't hurt at all. Mostly it really was just part of the morning routine--get up, pee, inject Lovenox into pudgy part of stomach, brush teeth, shower.

Good luck.
posted by not that girl at 5:47 PM on November 6, 2006

One more thing--my Lovenox came in these cute little pre-loaded syringes. If you're needle-phobic, perhaps that will help a bit. You don't have to mess around with the needle or load the syringe from a bottle or anything like that. You don't have to spend very much time with that needle at all: just pop the cap off, do the shot, a spring-loaded safety cover automatically snaps up to cover the needle, you drop it in the sharps container, and you're good to go.
posted by not that girl at 5:50 PM on November 6, 2006

I have to do an injection every week. They gave me the choice of thighs or stomach, and I was pretty freaked about the stomach option. But, I've found it to be pretty easy. Pushing through the skin hurts a bit, but the rest is (relatively) easy.
posted by saffry at 5:55 PM on November 6, 2006

I have to say, the idea of giving myself a subcutaneous injection is far less icky than the alternative of giving myself a thrombus in a deep vein.
posted by trevyn at 5:56 PM on November 6, 2006

I had to do this following a cruciate ligament 'issue' when skiing. Saffry is almost right but for me it was the thought of it much more than the actual procedure. The hard one is the first one, it really is more uncomfortable than painful.

After a while I was quite into the whole thing, playing doctor and all...
posted by itsjustanalias at 5:59 PM on November 6, 2006

Having diabetes, I give myself injections all the time.

The trick, until you get used to it (and you do get used to it) is just what not that girl said. Just be deliberate. Steady, reasonably quick, and committed. The needle will hurt a lot less than you imagine - most of the time not at all, in fact. Beginners get fearful and chicken out at the time to stab. Don't worry about going too deep;the syringe will stop it.

Good luck.
posted by Benny Andajetz at 6:10 PM on November 6, 2006

I've done a daily subcutaneous injection for about five years. It's a piece of cake unless you are very thin. If you are very thin, then it can be hard to get the needle to land in the fatty tissue between the skin and the muscle, which is where you want it. If the needle lands in the muscle, it will hurt a lot. If the needle lands between the layers of skin, then you get a scary looking bubbly effect and it also hurts, though not as much as going into the muscle.

The trick is to go in at a shallow angle, and also to pinch up some skin. Good luck!
posted by alms at 6:26 PM on November 6, 2006

As a student nurse (not your nurse), I can tell you (only from my experiences with patients receiving them) that the most painful part about these shots is removing the needle too soon after you've injected the Lovenox. Inject slowly, and after it's all in, wait a good few seconds, then remove it as fast as possible. As far as actually injecting -- mind over matter.

Additionally, don't let any of the comments scare you. Your doctor and your nurse will help you with what is right for you in your care. All the best
posted by viachicago at 7:08 PM on November 6, 2006

I give myself an intramuscular injection once a week, and I can tell you that it rarely hurts. The secret is to insert the whole needle all at once. Subcutaneous injections are similar; don't try to ease the needle in or it will only hurt more. Put the needle at a 45 degree angle from your skin and put the whole needle in with one smooth dart-like motion. I think you'll be shocked at how little you feel.

Then go slowly as you push the medication in, and like viachicago says, wait a few seconds before withdrawing the needle. Just think 'needle fast, med slow' and you'll be all set.

(Also, I'm a nurse and I give injections all the time using the same technique, and rarely do any of my patients complain of pain with the injection.)
posted by jesourie at 7:26 PM on November 6, 2006

Have you asked your doctor about getting an Autoject? You load up the syringe, hit a button and it's done. Still not fun, but you don't have to look at the needle when it's going in.
posted by tomble at 8:49 PM on November 6, 2006

My wife had to take lovenox for almost her entire second pregnancy. She would do it lying down on the bed to make sure she was relatively relaxed, and she always flicked the bubble of air to the top of the syringe and then pushed it out before doing the injection. She said it was painful much less often that way.
posted by ulotrichous at 10:05 PM on November 6, 2006

There are oral equivalents to lovinox - namely coumadin/warfarin sodium. They're twitchy in terms of getting to the right therapeutic levels especially when you've had a mix of the IV versions and are taking certain classes of antibiotics. From a maintenance/safety point of view, the IV is more predictable, but you can always ask.
posted by plinth at 4:50 AM on November 7, 2006

I am thin and I found that these injections hurt. However, once the nurse told me to relax my stomach muscles as much as possible, it was a piece of cake. No pain at all.
posted by pollystark at 6:43 AM on November 7, 2006

Okay, while coumadin isn't an option, I'm now in aspirin therapy, so asking fir an oral alternative did the trick. Thanks for the support and ideas, everybody!
posted by moonbird at 2:39 PM on November 7, 2006