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Clexane injection advice please
Injecting a child

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20 replies to this topic

#1 lishermide

Posted 11 January 2013 - 09:03 AM

I hope this is OK here, I though it might be a good place to catch the experience of EB'ers original.gif

DD13 is having to have daily Clexane injections for the next 6 weeks due to being immobilized in broomstick casts. She has Factor V Leiden, so docs are worried about the potential for blood clots.

She's become a bit of an expert at needles lately, but had the first Clexane shot in hospital yesterday and cried at the pain. She's terrified at the thought of the next one, let alone 6 weeks of them. I know there would be lots of experienced clexane users here on EB, so thought I might tap into that.

I've thought of EMLA cream, though have been told by some that it really only helps where the needle goes in, not with the deeper pain/burning. Ay experience there?

Injection site tips? She is very slim, so hard to find anywhere with fat lol.

Has anyone else had to deal with this for a child?

#2 Bluestocking

Posted 11 January 2013 - 09:10 AM

Might have been a one of thing that it hurt so much? I've given quite a few, most patients don't even wince despite the fact I'm a student biggrin.gif

Don't rub the injection site. It will bruise and be a lot more painful. Rotate where you give the needle each day. If she is skinny, you will need to pinch the skin to give it, or give it at an angle. I prefer to pinch the skin.

See how she goes with the next one.

#3 Bluemakede

Posted 11 January 2013 - 09:13 AM

I have no advice for the pain, but injections should be abdomen, lower, stay away from the belly button though. I've also given them many times in the outer thigh (it was policy on a ward I was on), though I'd check with the dr if you decided to inject there.

Pinch the skin up to give more fatty tissue and slowly release. And don't alco swab before hand (not sure if you are or not, but clexane becomes more painful if you wipe as it removes the oil from the needle).

Hopefully someone will have better tips for you to deal with the pain.

#4 lishermide

Posted 11 January 2013 - 09:16 AM

She'd already had 4 needles without a whimper earlier in the day. I don't doubt it hurt. From what I've read and been told she's absolutely not alone in finding it very painful.

Her skin was pinched. It went in slowly.

Pinched skin at an angle?

#5 lishermide

Posted 11 January 2013 - 09:17 AM

Bluemakede, they did alcohol swab first. So that could have been part of the problem. Thanks.

#6 kwiggle

Posted 11 January 2013 - 09:18 AM

I agree with your daughter - they always hurt me!  Both DH and I have had to have it at various times and he calls me Dr Dracula when I give it to him too slowly, so a medium pace for the injection is my tip.  EMLA might help a little, but probably won't take away the sting.  She might feel better using it though, sometimes the placebo effect is very valuable!

#7 Therese

Posted 11 January 2013 - 09:18 AM

A few years ago my youngest had to have clexane after getting a DVT.  She has some other big medical issues so the Dr's and nurses were intent on making this as painfree as possible as she needs lot of other interventions.

We were told that it does hurt.

We ended up using a different needle than the one on the clexane. A thinner needle which meant we needed to draw it up differently every day but it was supposed to make it less painful.

And no alcohol swabs either as that makes it sting.

EMLA is a tricky one. It takes an hour to numb the site which can just add to the fear as she is waiting for the needle if that makes sense.

Good luck, I hope it all goes well.

#8 Satay Chicken

Posted 11 January 2013 - 09:25 AM

I've done about 70 Clexane injections during my time TTC so a bit of experience  wink.gif

I personally found having a hot shower, then straight after sitting on the loo so I could see what I was doing and be able to grab some fat (although I would have alot more than your daughter), insert the syringe on a 45 degree angle with the sharpest point going into the skin first.  Doing it this way I never really had any pain and no bruzing. I think the skin is softer and more subtle after being damp and warm.

All the very best, I know its pretty tough...

#9 elmo_mum

Posted 11 January 2013 - 09:26 AM

i had clexane daily for 7weeks, most times it didnt hurt

the nurses "pinched" the skin - and just quickly did it!

hugs to your daughter

#10 lishermide

Posted 11 January 2013 - 09:30 AM

Just a bit of experience Satay Chicken wink.gif I just knew EB would be the right place to ask.

We're not up to trying showers yet. Double casts with bar across, plaster can't get wet. Sponge baths only here until we get a bit better at maneuvering. These casts are so heavy!

Thanks Therese, sorry you've been through this with your child too.

#11 Nepheline

Posted 11 January 2013 - 09:34 AM

I've got nothing helpful to add but just wanted to express my sympathies for your family! I had to google what a broomstick cast is..... your poor daughter! Does she have to have it on for long?

#12 NFT

Posted 11 January 2013 - 09:55 AM

I've been on clexane for months at a time, and also injected it hundreds of times. The needle does seem to be a little harder to insert than others. I found it hurt less if you "darted" it into taut skin quite quickly, then use your index finger to tap the medication in at a medium pace. Emla did help (it may have been psychological).

#13 Wishing2011

Posted 11 January 2013 - 09:59 AM

I have to take Clexane daily. I pinch my skin and push the needle in (that doesnt hurt much). it is the medication that stings afterwards. I inject it slowly while slowly releasing the skin. Some days it stings some days it doesnt. I don't rub it. I usually just get up and walk around afterwards.

#14 kez71

Posted 11 January 2013 - 10:05 AM

i have taken clexane daily for the last 28 weeks and will continue until 6 weeks after baby is born, also due to factor V Leiden. I use a cube of ice to numb the spot before injecting straight down 90 degrees. Mine are done around my belly. sometimes they sting a bit, sometimes i feel nothing. sometimes they bleed and bruise, but mostly its nothing at all.

A friend did one for me the other night and put it in at an angle and it was the most painful one ive ever had, so i recommend straight in, no angle.

#15 Wishing2011

Posted 11 January 2013 - 10:08 AM

yeh me too. I tried once on an angle and it was the most painful one I injected too

#16 megalula

Posted 11 January 2013 - 10:09 AM

I've done a lot of these too. My advice is really different. I watched a youtube video that advised icing afterwards and that really helped. Also I would go in really slowly and come out really slowly as at the same time as releasing the pinch on the skin. Never a bruise!

But maybe try my approach as a last resort? It seems I am going quite against the grain!

#17 lishermide

Posted 11 January 2013 - 10:16 AM

Minimae, she's in it for 6 weeks for now. Casts come off late February.

For anyone interested in the story....she has Avascular Necrosis of the Hip, meaning the hip lost blood supply at some point, and the bone in the ball of her hip has died and is breaking down. Possibly because of her all-consuming gymnastics, but also possible it just happened for no good reason at all. We are working madly at stopping the breakdown and rebuilding the bone before she finishes growing. It's very similar to Perthes Disease in children.

She has been non weight bearing on crutches for over 8 months. She had surgery in July called a Core Decompression where they drilled holes up through the femur into the middle of her femoral heap (ball) and injected Stem Cells, aimed at stopping the breakdown and re-establishing growth. She also goes for regular treatment by infusion to help her lay down new bone.

The last MRI showed lots of fluid and inflammation around the joint, causing the ball to be pushed out of the socket somewhat. Cue steroid injection and casts yesterday to help reduce the fluid and re-contain the hip in the socket.

The good news is that the arthrogram yesterday showed no further breakdown from the previous MRI at this stage, so we are really cheering to have some good news original.gif

I just whipped down to the chemist and have EMLA on hand. Fingers crossed. At almost $20 for a 5g tube this stuff had better be miracle cream!

Edited by lishermide, 11 January 2013 - 10:17 AM.

#18 Wishing2011

Posted 11 January 2013 - 10:18 AM

But for me its not the needle that stings.. its the medication itself that stings afterwards. Hopefully EMLA can help that?

poor girl sounds like she has been through alot

Edited by Wishing2011, 11 January 2013 - 10:19 AM.

#19 Bluemakede

Posted 11 January 2013 - 11:20 AM

QUOTE (lishermide @ 11/01/2013, 09:17 AM) <{POST_SNAPBACK}>
Bluemakede, they did alcohol swab first. So that could have been part of the problem. Thanks.

That may have been the problem. Clexane needles are coated the alco wipes remove the coating effectively blunting the needles. I find they are already quite a hard needle to administer they seem to need a harder push to get in the skin compared to heparin etc.

Also don't angle it, they're meant to be 90 degrees they have a shorter needle than other subcut needles. Also ensure the air bubble is at the top of the syringe (injected last) it seals the injection site.

#20 lishermide

Posted 11 January 2013 - 12:22 PM

If I don't angle it won't I hit muscle though? Or not because I've pinched it up.

#21 nik_klinger

Posted 11 January 2013 - 12:27 PM

QUOTE (Satay chicken @ 11/01/2013, 10:25 AM) <{POST_SNAPBACK}>
I've done about 70 Clexane injections during my time TTC so a bit of experience  wink.gif

I personally found having a hot shower, then straight after sitting on the loo so I could see what I was doing and be able to grab some fat (although I would have alot more than your daughter), insert the syringe on a 45 degree angle with the sharpest point going into the skin first.  Doing it this way I never really had any pain and no bruzing. I think the skin is softer and more subtle after being damp and warm.

All the very best, I know its pretty tough...

Same, definitely at an angle but I actually do it before going into the shower (must try after).

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