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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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Id typed out a long question earlier but it was eaten by a

Resolved Question:

I'd typed out a long question earlier but it was eaten by a website glitch, so I'll be brief. Does it matter where I inject a sub-q medication? I've always done in my thigh or abdomen, but I have an anxiety problem when it comes to needles and it's getting worse over the years. Last year I had a knee replacement that resulted in an area of dead nerves on the outer sides of my knees, and it's been an incredible relief being able to inject without feeling a thing. I'd just like to know if there's any reason I shouldn't do it there. There's not much fatty tissue obviously, which results in a slight bump formed by the medication gathering under my skin after I inject it, but it absorbs into the surrounding tissue within a few minutes and seems normal enough. I used to get similar bumps as a kid when I was seriously underweight and didn't have much if any padding to my arms, which is where we usually did the injections.
Submitted: 2 years ago.
Category: Health
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I would like to try and help you but I need some more information please. What medication are you injecting SQ and how much of it (how many milliliters/ ccs/ how much do you draw up in the syringe). Additionally, how long is the needle that you use?

Thank you for clarifying,
Sincerely,
Susan
Customer: replied 2 years ago.
Hi Susan. The medication is Orencia, a drug for rheumatoid arthritis. It comes in pre-filled syringes of 125 mg/ml, although the instructional information sheet enclosed with the box of syringes states that there may be a small bit of liquid left in the syringe and not to worry about it.
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I am sorry to hear you have Rheumatoid arthritis, I imagine that is pretty painful. It may seem like a blessing to be able to inject where you cant feel...I know some injections hurt especially if the fluid is thick. But its not a good idea to give a subcutaneous (SQ) injection anywhere but the recommended sites (back of the arms, outer aspects of thighs, and abdomen) because the idea of the SQ injection is to inject in the subcutaneous or fatty layer of the skin. There are not as many blood vessels here as in other layers of the skin, so the medication injected SQ is able to be absorbed by the body at the proper slow rate that the makers of the medication desire.

Your knee doesn't likely have as much fatty tissue as the arms, thighs or abdomen, so there is no way to know where the injection is winding up...for all you know, it could be intramuscular, which can affect the rate of absorption. If there is scar tissue you inject in, that also changes the rate of absorption.

I know you likely wont appreciate this, but its best to stick with the recommended sites. Also, its a good idea to rotate the sites that you do use...one day a leg, one day an arm, etc. That is so scar tissue doesn't build up under your skin. Using the right place to inject is important, especially as the information on Orencia says that if its given intravenously, it has to be given VERY slowly. (Also says to avoid vaccinations with live virus preparations)

Here is a PDF file on subcutaneous injections for more information: http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf

Here is the information on Orencia I used: http://www.drugs.com/orencia.html

I hope I was able to help,
Sincerely,
Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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