Basics of Interferon Injections

The following is a personal recourse from a fellow "hepper" on his experiences with Interferon (aka INF)

I've done a little checking and it seems there is a trend to not teaching how to use INF. Here are some of the things I've been taught and learned over the last 30 months.

Be clean, INF tends to reduce bacteria fighting, so you have to be extra careful. First, wash your hands before touching anything. I use iodine hand scrub, but anti-bacterial soft soaps are just as good. Scrub real good, your hands are big and bacteria is very small, but plentiful. After rinsing off the soap, don't touch anything until you get a paper towel(yes paper towels right off the roll). Dry from the fingers down. Throw that paper towel away, and get another. Use the next towel to get your INF out of the 'frig so you don't have to touch the door handle. The kitchen is a very 'dirty' place, especially the 'frig door handle. Take the box to where you inject, open up the box and take the vial out. Rip open a alcohol pad and place it over the top.

Cleaning the injection site.
I use the same pad that's sitting on the vial. I wipe the vial top. Now its time to find out where you are gonna make a hole. The nursing term is "clean to dirty". You put the pad at the spot where you are gonna inject and using a circular motion clean from that point out a few inches. Sometimes if I think the pad is too dry I open another and do this over again.

Filling the syringe.
Pull the top off the syringe. I push the plunger down to clear the air out. (I'm wearing my super reading glasses at this point) pull the cover off the needle. Holding the vial in one hand I then have the syringe in the other and brace both hands together. The reason is to not miss the center of the vial and nick or blunt the needle. Turn the vial upside down and draw in the IF. If its real cold, or the syringe is a 29g or smaller getting the stuff in can be a problem. Let it calm down and push out the air. (vial and syringe still upside down) Then draw to the full dose, occasionally pushing out air bubbles. I draw alittle more past the fill level, so if its a 3mil dose instead of the .5cc I go to a couple of small marks beyond .5. Flick the syringe near the vial with your finger, this makes air bubbles gather and go out the needle. Take the needle out of the vial, and with some contortions hold the syringe in one hand and drop the vial back in the box. (cleanliness)

Holding the syringe upside down, push the plunger to the correct level (ie .5cc) this gets rid of any air in the needle. You've probably seen this on tv or even your docs office where the stuff goes shooting off into space. Here I drop the syringe into my Inject-Ease. With one hand pinch the skin/fat layer at the injection site. As fast as possible push the needle into the layer with the syringe almost pararall to the skin. If you can learn how to do it, "flick" it in(a doc or nurse should be able to teach this). The faster the needle goes in the less pain there is. Push the plunger. Pull the syringe straight back. You get less bleeding if you don't play twister. Drop the syringe in the sharps container. Close the INF box, your hands are still clean so you keep the vial clean. Put the box back in the 'frig.

I've found that the .5cc 1/2 inch 29 (or 28) guage insulin syringe to be the best. Guages that are numbers like 24 or 22 are bigger and hurt more. Inject-Ease is a tool that litterally shoots the needle into the skin and practically eliminates the pain of injection. It is used by insulin users. Your doc or pharmacist can get it for you. If you have to pay they cost about $25. You may need to have them talk to a doc familiar with diabetics tho, since they may not understand why a hepper would know what it is.

Things that happen after injection.
A gusher. You can't hit anything vital when injecting (unless your eyes are closed). If you are really talented you might hit a small vein or arterary, which will bleed quit a bit. Cover it with a band-aid. A small drop of blood is normal, just let it clot.
The day after, a red area is quit normal. Mine range from dime size to silver dollar size. They may feel hot and tender, but not a problem. A problem is if it gets bigger and hotter, or you see something that looks infected. Thats bad, contact your doc. Most of the time my red areas take about 1 week to clear. If I hit a gusher, then a bruise is common.

I divide up my thighs by seeing a line from my knee to my hip, then another line across the middle of my thigh. That makes 4 sites on each thigh. So there are 8 sites on the legs. And for variety the tummy. I don't like using the tummy because my beltline. But there is very little injection pain there. On the thighs I rotate. Upper right leg outside, to upper left leg outside, lower right leg inside, lower left leg inside, lower right leg outside, lower left leg outside, upper right leg inside, upper left leg inside, then urlo. This rotates the injection sites and allows the areas to calm down before injection again. Keep the injection site recorded in your chart, since after a couple of weeks you probably won't be able to remember where you injected the last time.

Mental stuff.
From my very first shot, Dec '94, until my last shot, last Friday, each one has been as hard to do. Actually, easier since I got my Inject-Ease, but that was for the fear of pain. I keep telling myself that no matter how tough the IF is, its better then the alternative. And insulin users may have to inject several times each day, so 3 times each week is nothing to them.

Take care(a member of the "hole-in-the-thigh-gang") Bruce B.

OOPS - here are a few things I forgot to mention!

I keep everything in a kids lunch box. The plastic kind you buy every school year for the kids. I keep everything, execpt the INF, in it. Syringes, al packs, and Inject-Ease. Everything is kept clean and not subject to "oops the dog licked the syringes again".

Sharps containers.
You should be provided with one, either from where you get your INF or your docs office. If you have a problem getting one. There are some things that have been succesful in the past to get a sharps container. Keep the used syringes in a paper bag for a couple of weeks, then stop by the docs office and dump them on the receptionist/guard desk asking what to do with the things. Drop them in a pop bottle, then bring the bottle to the office and leave it, at least its hard to dump the things out. Eventually, someone might get the idea you need a real sharps container. If you have children and/or cats, keep your sharps container locked up. The hole is inviting to small hands and paws.

INF is pretty fragile, BUT it can be warmed to room temp for a day without problems. If you are using single use syringes, each one can be allowed to warm to room temp before injection. (reduces the sting at injection) Just keep all the rest in the 'frig tho. A bag of frozen peas layed on the injection site, prior to cleaning, helps "numb" the area before injection. This reduces the "sting". Don't use these for dinner tho. Just refreeze, and numb again.

The side effects hit about 8 to 12 hours after injecting. I find it oddly interesting that alot of first time INF users, post an hour or two after the first shot about "wow they are problems". Then about 12 hours later, they are going thru the chills, sweats, and headache. Hint: wait half a day before posting how you are feeling.

DRINK WATER!!!! alot of water, and more water. I found that my 3 pm shot, would have me pouring down water around midnight. A 'ole bunch of water, even more water. Dump it in. A half gallon is easy, a gallon is easy.

Most often something like tylenol is recommended. I guess it works. I've never taken it for the headaches tho. I don't like meds.

Since its summer here in the Northern Hemi, sunshine and warmth is prevalent. Before spending a day at the beach/desert.... do a few minutes outside at home. INF can make one photo-sensitive, ie you burn like a tadpole on a hot rock. Also, I think that HCV may have something to do with it either, since I haven't been able to go outside in the sun in 6 years. several more then on INF.

Mental stuff, every injection is an attack against an enemy. Sometimes you have to take some pain to win a battle. But, you do what you have to to defeat the enemy.

Note from the webmaster:
I thought this was a good place to put this info...

From the January 1997 Reader's Digest which took the story from HealthNews:
Here's a tip for easing the pain of an injection: press your thumb where the shot will be given until you feel resistance and hod it for ten seconds. Researchers found that 48 patients who got the pressure treatment before the shot felt less pain than 45 others who didn't.

In the study, nurses, who gave the shots also provided the pre-injection pressure. But researcher Roberta Erickson, associate professor of nursing at Oregon Health Sciences University School of Nursing, says that self administered pressure would likely do as well. The technique works for The same reason that rubbing you elbow helps if you've hit it: gently stimulating large sensory fibers helps inhibit smaller pain fibers in The same area triggered by a sharp stimulus.

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