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Pregnancy

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Original poster

Clexane and bruising

38 replies

Jossiejump · 18/04/2007 14:40

I'm self-injecting with Clexane. The consultant said to get rid of the air bubble first, but after I had a nasty bruise and lump, the midwife said not to do that.
She also said not to have any Clexane on the syringe, but I find that some sometimes comes out as I take off the lid. Doing the m/w's way I'm still bruising-does anyone else have advice please. (I don't rub it afterwards.

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Gumbo · 18/04/2007 14:50

I had to inject myself twice a day while pg, and also bruised a lot. I generally did it in the thigh, and found that by pinching the flesh slightly, then shoving the needle in, it hurt less - although sometimes still bruised. IME it seems a bit hit-and-miss whether you hit a capillary (sp?) or not, which is presumably what causes the bruising.

The only other thing that seemed to help was pressing on the site for a bit afterwards (not too hard). Also, I tried to use only one leg for a week, then when it was too battered and bruised I switched legs to give the other one a chance to recover!

Original poster
Jossiejump · 18/04/2007 14:52

Thanks Gumbo-I've been doing it into my (rather flabby) tummy, below the navel obviously, might try the leg.
Silly question, but the air bubble doesn't cause any problems if it goes in the wrong place does it?

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jenkel · 18/04/2007 14:53

Oh bring back memories for me. I had to inject for more or less the whole of my pregnancy. No advice to offer as I bruised all the time. I used to go swimming and had to wear cycling shorts over my costume as the top of my legs looked so bad. Perhaps somebody with more knowledge could offer advice but I thought it was down to actually doing the injection and slso because clexane thinned your blood and made you more likely to bruise.

Original poster
Jossiejump · 18/04/2007 14:54

I must be a bit slow Jenkel, I hadn't thought about the link between blood thinning and bruising ! (feel a bit silly)

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Gumbo · 18/04/2007 14:58

Before I ever had to inject myself I'd heard that the air bubble must be got rid of at all costs; but when the Consultant showed me how to do it she told me not to worry about the bubble at all - and I lived through it, so presumably she was right!

belgo · 18/04/2007 14:59

you should leave the bubble of air in, hold the syringe needle down, so the air bubble is at the top. Inject so that the clexane goes in first, then the air bubble.

You can rotate the injection sites between the tops of your arms and thighs.

Maybe you can ask your mw to show you the injection technique again to make sure you are doing it right?

belgo · 18/04/2007 15:00

jenkel - clexane is the only exception to the air bubble rule. It's because the needle goes into subcuntaneous fat.

In any other injection/infusion, there should be no air.

belgo · 18/04/2007 15:00

I mean Gumbo, not jenkel.

Original poster
Jossiejump · 18/04/2007 18:59

That explains why I was so worried that I might be doing myself harm with the air bubble!
Haven't been making sure it goes in last though, so will try that now.

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belgo · 18/04/2007 19:02

the air bubble acts as a kind of 'plug' to stop the clexane rising back up into the tissue above the sudcutaneous fat, therefore, hopefully preventing bruising.
I don't think all the air goes in.
The air shouldn't be injected first.

MrsBadger · 18/04/2007 19:04

second Gumbo's tip of pressing the site for a bit afterwards

treacletart is good on this as well - if I see her on the Due in Aug thread I'll send her over here.

belgo · 18/04/2007 19:05

at what angle are you injecing the needle?

Original poster
Jossiejump · 18/04/2007 20:21

They told me to inject straight in, and said not to rub it afterwards

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Original poster
Jossiejump · 18/04/2007 20:21

by straight in I mean at 90 degrees to the skin (I think)

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misdee · 18/04/2007 20:24

dh says to go straight in at a 90 degree angle and to inject into the stomache. he gets some bruising but not massive if he does it himself. if a nurse does it he gets bigger bruises.

Tiggly · 18/04/2007 20:52

What I do is inject it in to a site around the navel (preferably the flabbiest part of the patient!), pinch a wecge of skin, intorduce the needle slowly and not entirely up to the hilt (about 3/4 of the wat along), inject steadily in to the skin with the air bubble intact so it gets injected once all the clexane has been given. I wait for about 10-20 seconds before I let go of the pnch of skin, and then wait 10-20 seconds before withdrawing the needle. This I have found has helped some patients not to bruise (I work in haematology so clexane is used quite a lot!). Bruising is extreamly common due to the way the drug works, but some patients do end up looking like a dart board! I would advocate pressure afterward injecting just to make sure the site doesn't bleed or ooze. Good on you for doing it yourself, I couldn't!!

Original poster
Jossiejump · 18/04/2007 21:29

Thankyou for these ideas, I'll have a good try.
Tiggly I have to say that the thought of doing it was actually worse than doing it (doesn't mean to say I enjoy it!!) luckily I don't mind injections.
Have 2 x DS, but haven't needed this before, amazing what the "need" for another baby can make you do!

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belgo · 19/04/2007 07:03

I don't recommend she inject around the navel if she's pregnant.

90° is correct.

EdieMcredie · 19/04/2007 08:47

Actually in America they use the air bubble technique for most injections. I did a research critique when I was a student nurse, I had to compare research into the air bubble technique and the z track technique and found that there were no significant differences with regard to site complications (pain, bleeding, bruising).

But that is with intramuscular injecting. Just pointing out that you can inject air into muscle, it is not dangerous. Obv into a vein could be potentially life threatening!

Sorry not much help J, we had to use clexane on someone at work but I never did it. Def rotate the site though.

(Hello BTW xxxxxxxx)

Original poster
Jossiejump · 19/04/2007 18:38

Didn't expect to see you on this one Edie!
Thanks for all of the advice everyone -I don't feel so silly worrying about the air bubble now !
I've been told to do it on my stomach or legs, lower than my navel, so hope that's right.
Bruises are quite spectacular, but vary each time at the moment

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Taylormama · 19/04/2007 18:40

i was on clexane throughout my PG and had a lovely selection of bruises - found it was better to do after my morning shower (for some reason). I alternated my (chunky!) and then did my arms one or twice. Bruises faded pretty fast tbh and i never worried about air bubbles - didn't know i was meant to

Taylormama · 19/04/2007 18:42

should read chunky thighs LOL!!

belgo · 19/04/2007 18:42

yes lower then your navel is right, and two inches or more away from your navel. But I'm surprised you're injecting into your stomach if you're pregnant!

Original poster
Jossiejump · 19/04/2007 18:46

The consultant said to do that-but said that most women as their bump starts to get bigger can't bear to do that (even though it won't come anywhere near the baby), so then move onto their thighs.
I'm 8 weeks, so just fat attm. (Always have been well padded though).
He said I had to inject lower than my navel, and didn't mention arms Taylormama, did your doctor say to do that one? That would give me another alternative site then.

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Taylormama · 19/04/2007 18:48

jossie - my consultant recommended my upper arms - try it if you want to give your legs a rest.