Injected MTX question

Starburst

Hello!

My apologies for not posting much. I started uni a couple of weeks ago and I've already been given a lot of reading to do and have a presentation next week. Who knew you have work hard at uni??!!

I had my first injected dose of MTX last week but did it with the rheumy nurse supervising. I did it myself last night and noticed that when I pulled the needle out, there was still a tiny bit of medicine still in the syringe. I didn't know if I should inject it into me and tried to squeeze it out to see if it would come out and it didn't. Did I do something wrong? I could phone rheumy nurse but thought I'd ask here first. I mind a lot less if I sound silly on here!

Thanks for reading!
Sophie x

valval

sorry can not help but sure some one else will be along soon who can val

Stu69

Hi Sophie,

I inject mtx too - I guess I could be a dab-hand at it now, I've done 32 of them... yay!

I found this happened sometimes despite whether vertically or horizontally injected, but the amount left was seriously seriously minuscule. As you probably know the air used to push the dose out is there to make sure it all does actually go, so you might sometimes hear a rather disconcerting squish of air, which in the past I assumed (wrongly) was a no-no, but with these injections, it is perfectly fine to inject the air into your body, but it should be behind the dose of mtx.

What I do is alternate stomach and leg jabs; I take the injection making sure the air bubble is at the top of the syringe, or behind the dose, next to the plunger if you like, so if you are sitting and injecting a leg, making sure the air is behind the plunger is easy because of the down angle you'd inject at, or behind the dose of mtx as I mentioned, then the air will push all of the dose in and then you'll get the faint hiss, or squish, which should prevent any remainder being left in the syringe.

When I have had a small amount left it has been because I injected at an angle, generally when I have injected into my stomach and in all probs, at the wrong angle slightly, so the bubble of air was in front of the dose thus the being first thing forced out of the needle, instead of it being the last thing forced out, thus then leaving a small amount in the bottom of the syringe.

Don't worry too much, it's just practice and really, it's a negligible amount left if and when it does happen in my experience.

Oh, and I don't mind saying, it's more the air going in that bugs me rather than the injections itself, but I'm still here! :oops:

Good luck! It's a bit of a faff but easily sorted!!

Stu.

traluvie

Sorry can't help..
I see Stu has given you some great advice,, so hope that helps..
Nice to see you are at uni, what are you studying?

dreamdaisy

hello starburst, it's nice to hear from you. Firstly congratulations on mastering the art of self-stabbing, it takes some courage at first but it does make life more convenient, yes?

I rang my rheumatology helpline once as I had a syringe with a substantial air bubble at the plunger end. I was told to hold it vertically, needle covered but pointing to the ceiling and do the whole flicking bit to shift the bubble to the needle end. I was also told again to do it at a 90 degree angle to the body part being used - they remind me of that every time I go! If there is a little amount left I just shrug and stuff the syringe in the sharps box.

I only ever use my stomach as a site as you have fewer nerves there. If you do use your thigh a useful tip is to do the jab sitting on a bed, legs out in front: this relaxes the muscles and might make the jab a little easier. Good luck with it all and I hope the meth kicks in sooner rather than later. DD

Stu69

Quote:

"Patients, who have switched to Metoject, the new sub-cutaneous methotrexate injection have been asking why this particular syringe contains an air bubble when previous injections did not. Advice from independent professionals, has confirmed that the inclusion of an air bubble is better for the patient and, the empty syringe is safer when a bubble is included.

Tony Johnson, Medac’s marketing manager, comments: “The air bubble is included to ensure that when injecting, all of the drug is expelled from the syringe. This guarantees that the patient receives an accurate dosage and that no drug is left in the syringe, making disposal much safer. It also helps prevent leakage from the injection site. The air bubble does not need to be aspirated from the syringe.”

The full link from where I quoted the above is here:

http://www.nras.org.uk/about_rheumatoid_arthritis/established_disease/drug_updates/drug_archive/why_is_there_is_bubble_in_my_metoject_methotrexate_injection.aspx

dreamdaisy

What I didn't make clear was I am on the old-fashioned steam-driven type of syringe, not one of the fancy new-fangled things! My apologies, starburst, if you are on the same as Stu then his advice is the one to read, not mine. DD

Stu69

DD, the tummy is actually far easier - you're right, because 50% of the time I do a thigh, it bleeds... can't miss those darn small veins, even when I eye it up and take aim, chances are I'll have a bleeder. The trade off is that sometimes, with the tummy jabs, there is a residual sting and ache which I don't seem to get with using the thigh. Oh, and if you do do a thigh, go off centre, either side of an imaginary 50mm strip down the length of the thigh where there should be more fatty tissue. If I go central, I can feel muscle, and that stings! :shock:

Curious stuff... I've never been able to decide which is the lesser of the two 'effects' of the site of the jab, but hey, 20 seconds is all it takes from packet to sharps bin and little to no side effects at all. Love them I do!

Starburst

Thank you for the helpful replies, Stu and DD. I definitley prefer injecting into my stomach. When I injected myself with anti-coag after my operation, I found my tummy much better....more flab! I'm not sure if I'm using metoject. I screw the needle on myself if that's any help! Sorry, I'm a bit clueless. Rheumy nurse did show me how to get rid of the air bubble which I tried to do. Maybe I do need to phone her. Memory like a sieve! :???:

Val, thanks for the reply. Hope you're ok.

Tracy, I'm doing social work. I'm enjoying the social aspect too. Just really blimmin' exhausted with it all!

dreamdaisy

Yup, I'm a screwer-onner too, so I reckon you are also on the old fashioned steam-driven-black-and-white syringes like me. I think that the best people to contact for clarification is your rheumatology nurse or helpline and see what they have to say. DD

Stu69

Yup, totally agreed, DD.

My assumption - wrongly - is that everyone has Metoject. I absolutely defer to you totally!

It seems a bit daft to me that we have two systems (maybe more?) on mtx injections. That's confusing here at ground level. I don't understand why people are on different methods either. Surely the safe and quick option of pre-loaded and ready to go is best??

Perhaps they think I'm a complete numpty and can't be trusted with screwing a needle cap on. Probably for the best, LOL!

dreamdaisy

My guess would be cost. My hospital brews their own meth every Monday, so we get the cheap and cheerful stuff. I have a month's supply in one go, mind you I have thrown three full ones away since being on the penicillin. What a waste of 30p!

(For reasons of clarification the 30p was a joke: I have no idea how much home-brew meth costs.)

Stu69

dreamdaisy wrote:

My guess would be cost. My hospital brews their own meth every Monday, so we get the cheap and cheerful stuff. I have a month's supply in one go, mind you I have thrown three full ones away since being on the penicillin. What a waste of 30p!

(For reasons of clarification the 30p was a joke: I have no idea how much home-brew meth costs.)

The pre-packs are about £70 or £80 online, which is obscene! I can have a far better night out on that cash than a box of mtx would give!!!

My good lady, between jobs a few years back, worked in the local hospital dpt that made chemo drugs and such like mtx for a couple of months and had to make stuff like that herself. How expensive it would be I don't know either, but it's one of those rare occasions when I'd refuse a double!! :???: