help with bigger needles please

[Spearmint]

Hello, would like some more advice please!

My daughter had a check up at hospital clinic on Thursday
I had the dr check her injection sites as her legs are reacting to the Levemir
The 1st 2 weeks she had big red lumps appear after injecting which on her left thigh turned into 1 massive lump the size of a large pepper leaving that leg unusable
We then changed to her right thigh 2 weeks ago which is getting the red marks still but they have not joined up into a massive lump yet, her left thigh the lump is smaller so she is sometimes using that leg as well now but mostly the right

The dr decided that bigger needles would cause less of a reaction and would make the insulin absorb better
First of all she said she would change her from 5mm to 6mm needles which my daughter was not keen on but in the end she decided to change her to 8mm needles
Well my daughter has point blank refused to use them!!
She was at her dads this weekend so i sent her with the 5mm ones
She gets back before dinner today so at dinnertime i bribed her to try the 8mm needles just for her Levemir and still use the 5mm for the Novorapid, she will get a new wii game on friday if she uses the 8mm needles for Levemir every day

Well she used the bigger needles earlier for the Levemir but she hated it
She says it hurt a lot more then using the other ones
She also said it is harder to inject now she has to pinch her skin up as she does the 5mm needles into flat skin held taught

I am hoping that she will just get used to it but wondered if anyone had any tips on using this size needle and pinching the skin up?

Thanks

 

[HLW]

Most of this will have been covered by the consultant, but just in case anything was missed:

I get a lump with 5mm needles unless I hold them at exactly 90 degrees to the skin, have you made sure she is not holding them at an angle?

Do the 5mm needles cause a lump with the Novorapid on her stomach? Do the 5mm needles cause a lump if she injects Novorapid into her thigh? Do the 5mm needles cause a lump if she injects levemir into her stomach? Do the 5mm needles cause a lump if she pinches up the skin?

You need to work out if the needles are too short, or if it is a reaction to the levemir - it is possible to be allergic or react badly to specific types of insulin. There are other insulins that can be used instead of levemir, lantus is a common one.

If it is just that the needles are too short, and she isn't reacting to the levemir, can an alternative site be used for the injects eg buttocks?

 

[slimtony]

Hi Spearmint,

I switched to 6mm needles after using 8mm and hitting muscle a couple of times (which caused severe hypo), so this is something to be wary of if your daughter doesn't have a decent layer of fat covering her injection sites.

It's possible that the lubricant used on the needles is causing your daughter's injection site reaction.
It might be worth asking your doctor about an alternative brand of needle.

Good luck.

 

[Spearmint]

Most of this will have been covered by the consultant, but just in case anything was missed:

I get a lump with 5mm needles unless I hold them at exactly 90 degrees to the skin, have you made sure she is not holding them at an angle?

Do the 5mm needles cause a lump with the Novorapid on her stomach? Do the 5mm needles cause a lump if she injects Novorapid into her thigh? Do the 5mm needles cause a lump if she injects levemir into her stomach? Do the 5mm needles cause a lump if she pinches up the skin?

You need to work out if the needles are too short, or if it is a reaction to the levemir - it is possible to be allergic or react badly to specific types of insulin. There are other insulins that can be used instead of levemir, lantus is a common one.

If it is just that the needles are too short, and she isn't reacting to the levemir, can an alternative site be used for the injects eg buttocks?

No it was not covered by the consultant, nothing was explained about how to inject differently.

I supervise all her injections and the pen is held at the correct angle.
Her tummy is fine with Novorapid and 5mm needles.
Novorapid and 5mm needles are fine in her thigh as well.
She has never injected Levemir into her stomach as i was told it was best to do Novorapid there and Levemir in her thigh.
She has never pinched up skin with the 5mm needles as i was told it was not necessary.
We tried buttocks 2 weeks ago but she found it really awkward as her arms aren't long enough to reach properly, i made her try it for 3 days but she said it was really hurting there and it was taking ages for her to be able to actually reach round and get it done.

Thanks for your reply, think i have answered all your questions

 

[Spearmint]

Hi Spearmint,

I switched to 6mm needles after using 8mm and hitting muscle a couple of times (which caused severe hypo), so this is something to be wary of if your daughter doesn't have a decent layer of fat covering her injection sites.

It's possible that the lubricant used on the needles is causing your daughter's injection site reaction.
It might be worth asking your doctor about an alternative brand of needle.

Good luck.

Thanks tony

I don't know why she didn't give her the 6mm ones to try first as these needles are nearly twice as long and they are thicker too.

She has been using these needles for 2 years so hopefully it is not them themselves!

 

[iHs]

I don't blame your daughter at all for not liking the 8mm needles. I didn't either and quickly swopped to using the 5mm ones once they became available.

If the consultant wants your daughter to use the 8mm for the Levemir, she could use the side of her bum as that is fairly easy to use and works. No need to reach right behind. What helped me grip the insulin pen better was to put a rubber band around the body of it and then I could use my thumb to push the plunger down while gripping the pen with my fingers around the band.

 

[Spearmint]

I don't blame your daughter at all for not liking the 8mm needles. I didn't either and quickly swopped to using the 5mm ones once they became available.

If the consultant wants your daughter to use the 8mm for the Levemir, she could use the side of her bum as that is fairly easy to use and works. No need to reach right behind. What helped me grip the insulin pen better was to put a rubber band around the body of it and then I could use my thumb to push the plunger down while gripping the pen with my fingers around the band.

She is really struggling with all the extra injections as well, she has been feeling quite down about it all lately.

When we tried that, the only bit she could reach was the bottom bit just above her leg, she has quite short arms and really struggled to twist round and reach.
She also said that it really hurt alot.

She is supposed to be using the 8mm for all her injections
I thought if i could bribe her to use them for just the Levemir to start with that she would get used to them and then use them for everything.

 

[iHs]

Have a go with the 5mm needles again but use the side of the backside. I often injected through my knickers (but shhhhhh lol) and didn't have any problems. In fact, I very rarely even felt the jab.

 

[Spearmint]

Have a go with the 5mm needles again but use the side of the backside. I often injected through my knickers (but shhhhhh lol) and didn't have any problems. In fact, I very rarely even felt the jab.

I might end up giving her that choice!!!!

I have tried the position and can manage it easily but she just can't, i have tried helping her but i think it is just her proportions or body shape causing the problem.

 

[HLW]

In that case, you need to contact the Dr tomorrow and ask:

1) why is your daughter being asked to use 8mm needles for the Novorapid, as she is having no problems with novorapid and 5mm needles?
2) if the 5mm needles are not causing problems with the novorapid, why are they causing problems with the levemir? (I guess it is because the levemir doses are bigger, but the Dr should be explaining all this to you and your daughter)
3) Would pinching up when using the 5mm needles help?
4) is the Dr 100% sure it is not a reaction to the levemir itself? Even if your daughter has been using levemir for a while, she might have started having a reaction to it.

The doctors should be explaining all this to you and your daughter really.

 

[Spearmint]

In that case, you need to contact the Dr tomorrow and ask:

1) why is your daughter being asked to use 8mm needles for the Novorapid, as she is having no problems with novorapid and 5mm needles?
2) if the 5mm needles are not causing problems with the novorapid, why are they causing problems with the levemir? (I guess it is because the levemir doses are bigger, but the Dr should be explaining all this to you and your daughter)
3) Would pinching up when using the 5mm needles help?
4) is the Dr 100% sure it is not a reaction to the levemir itself? Even if your daughter has been using levemir for a while, she might have started having a reaction to it.

The doctors should be explaining all this to you and your daughter really.

I know it should have been explained, i will have no chance of speaking to the dr but i can try ringing her nurse and asking all of the above as she agreed the change of needles.

1 - i wondered this as well as it makes no sense to me!
2 - she currently has Levemir twice a day, 11 and 14 units, Novorapid is roughly 3, 3, 5 units
3 - i never thought of asking that!
4 - she has only been using Levemir and Novorapid for 4 weeks

Thank you for your help

 

[HLW]

The nurse should be able to help with all of that, it's usually the DSN not the consultants that do all the needle stuff anyway, so the DSN might be more help actually than the consultant!

Thanks for mentioning the amounts of insulin, it's reminded me I need to discuss my levemir dose when I see the nurse!

 

[Spearmint]

The nurse should be able to help with all of that, it's usually the DSN not the consultants that do all the needle stuff anyway, so the DSN might be more help actually than the consultant!

Thanks for mentioning the amounts of insulin, it's reminded me I need to discuss my levemir dose when I see the nurse!

I will ring her nurse tomorrow i think as i might want her help deciding which dose to adjust this week but i need todays and tomorrows readings first.

Oh i got told by the dr i need to change all her doses because she needs to be on a 50/50 split of the 2 insulins not the 65/35 she is currently having, like i don't have enough to think about with trying to work out what on earth doses will get her to the right level and keep her there!

This mornings Levemir with the 8mm needle went better than last nights, she said it hurt less so hopefully she will get used to them as the days go on.

 

[ebony321]

Hi,

I once was given a 12mm needle to use while i was in hospital :shock:

I used to use the 5mm and 6mm needles with ease.

although when i injected lantus into my legs as recommended (novorapid into the tummy) i also got little red lumps, itchiness, and little tiny blue bruises everywhere. I swapped to 5mm for the thighs, but still the same, i was so worried that i would damage my legs and sometime the lumps were so sore i couldnt lay down in bed on my side!

But when i injected lantus into my stomach there was no irriation or lumps or anything, the occasional sting if anything at all, but it was fine after i stopped using my legs, i now only use my stomach for cannula sites (i use an insulin pump now) and i have no problems.

Obviously doing this cuts down the amount of sites i use, but my consultant and DN are aware i only use my stomach and are fine with this and they check my stomach regularly for any changes to suggest i should expand my sites, but it's fine, i rotate extremely well and use the whole of my stomach. I've been using only my stomach for about 18 months now with no problems at all.

You could also try the 'love handle' area or the bum, i tried the bum a few times but found it tricky to see what i was doing!

When pinching with injections, it should be quite lightly as you should only lift the skin and fatty flesh to avoid hitting muscle. Pinching the skin should make it easier to use a bigger needle.

I would at least encourage her to use 6mm, i think going straight to 8mm from 5mm is quite a difference, in sight and in mind!

Also remember to change the needle every injection, rotate the sites your using, inject at a 90 degree angle and ensure you leave the needle in for around 10 seconds to makesure the insulin is absorbed, if the insulin leaks after an injection you need to leave it in longer, if the site still leaks after leaving it in longer then you need a bigger needle to ensure your getting it into the fatty layer and not leaving it under the skin.

You could also cool the area with some ice to numb the area while she gets used to bigger needles, or you can get numbing cream but these take a while to take effect.

 

[noblehead]

Certainly no experts but it could well be a reaction to the insulin which is causing the red lumps at the injection sites, is the consultant not willing to change her insulin to see if this resolves the problem?

Nigel

 

[dot]

My son has recently changed to 4mm needles. He is supposed to be avoiding using his tummy as has gone a bit lumpy - at least the DN says so but I think it is just podginess! Big advantage though - he has discovered they are short enough to inject into the arm with out pinching up so he is able to use these sites to give his tummy a rest.

 

[wigzaah]

i read this thread with some interest. i wasn't given a choice in the size needle i used and wasn't actually aware that there were different options!

i'm on novorapid and insulatard. i generally inject the novorapid into my tummy and insulatard into thigh / buttock area.

the interesting part (for me) were the comments about the red lumps. if inject into the right hand side of my tummy / buttocks it's fine but when i inject into the left side of my body i get the red lumps which generally swell and cause a fair bit of discomfort.

from reading the comments here i reckon it must be the angle the needle goes in at because it's only one side of my body that's affected - so can't be reaction to the insulin or lubricant etc.

if your daughter is fine injecting into her tummy it would seem that it won't be the needle or lubricant so by a process of elimination sounds to me like it must be the levemir, perhaps you could ask to try something different

good luck

Wig

 

[Spearmint]

Thanks to everyone who has replied

Well, this may just be co-incidence but since she's been using the 8mm needles her readings have been higher!!
Got her to do Novorapid before breakfast with an 8mm needle as well just to see if that makes any difference - i will find out shortly when i pop into school to help her at lunchtime.
I am tempted tonight to use a 5mm needle again for the Levemir to see if her night readings change.

They have said that if after 6-8 weeks the Levemir is still leaving lumps then they wil consider changing it for a different insulin, this is week 5 and the red marks seem to be less but the lump under the skin is still coming up even with bigger needles

 

[noblehead]

They have said that if after 6-8 weeks the Levemir is still leaving lumps then they wil consider changing it for a different insulin, this is week 5 and the red marks seem to be less but the lump under the skin is still coming up even with bigger needles

Just be sure to rotate the injection sites as much as possible, this will reduce the build up of fatty tissue/lumps under the skin.

Nigel

 

[Spearmint]

They have said that if after 6-8 weeks the Levemir is still leaving lumps then they wil consider changing it for a different insulin, this is week 5 and the red marks seem to be less but the lump under the skin is still coming up even with bigger needles

Just be sure to rotate the injection sites as much as possible, this will reduce the build up of fatty tissue/lumps under the skin.

Nigel

She uses one leg in the morning and the other at night, start of the week we start at the top and go down in a line then move across the next day

Well, could be a one off but at lunch today she was 4.7 instead of the usual 9-11, could just be the bigger needle with breakfast or could be one of those things, find out tomorrow!