Please explain what’s required for the golden/bonus dose…

[SkinnyJag]

… for someone who is needle phobic.

I have always been pretty needle phobic, fainted for holiday immunisations and jags during pregnancy. I nearly fainted when I took my first dose of mounjaro 4 months ago but have managed this since by doing the jab at bedtime and then just lying down straight away and going to sleep. I imagine repeated exposure to the process is helping a bit too.

I decided not to do the bonus dose as I didn’t want to be messing around over twisting pens to potentially break them and was nervous about using a regular needle and syringe. However, the price increase is not going to be sustainable for me long term, so I’m keen to get the bonus dose from my remaining pens.

Long story to get to my actual questions 😂 You can see I’m overthinking this!

Which syringes and needles should I buy? I do not really want to inject myself with the same needle I’m extracting with, that makes me feel weird. I would like to inject myself with a small/fine a needle as possible, the one on the pen is fine but I don’t really want to go bigger, I’m not sure I’ll manage it.

Would different needle sizes for extracting and injecting be beneficial?

Is there a chance of going too deep when injecting from a syringe? Or is that stupid?

A step by step guide would also be appreciated! I’m a capable person but this is well and truly out of my comfort zone due to my phobia, so I think an idiot’s guide would be useful. Thanks.

I can’t see why you would need separate needles for drawing up and injecting . Just buy some insulin needles from Amazon and draw up the bonus dose and inject it from the same needle/syringe . If you were having the dose administered by a nurse she wouldn’t change needles as it hasn’t been used before.

I can’t see why you would need separate needles for drawing up and injecting . Just buy some insulin needles from Amazon and draw up the bonus dose and inject it from the same needle/syringe . If you were having the dose administered by a nurse she wouldn’t change needles as it hasn’t been used before.

I can’t see why you would need separate needles for drawing up and injecting . Just buy some insulin needles from Amazon and draw up the bonus dose and inject it from the same needle/syringe . If you were having the dose administered by a nurse she wouldn’t change needles as it hasn’t been used before.

I can’t see why you would need separate needles for drawing up and injecting . Just buy some insulin needles from Amazon and draw up the bonus dose and inject it from the same needle/syringe . If you were having the dose administered by a nurse she wouldn’t change needles as it hasn’t been used before.

I can’t see why you would need separate needles for drawing up and injecting . Just buy some insulin needles from Amazon and draw up the bonus dose and inject it from the same needle/syringe . If you were having the dose administered by a nurse she wouldn’t change needles as it hasn’t been used before.

Oh heck @winnieanddaisy i think your internet connection is playing up! But I agree, there isn’t any need to change the needles. They never do that in healthcare.

If you’re needle phobic, or nervous, perhaps practice drawing up water and injecting into an orange or something until it feels easy?

@winnieanddaisyit’s not what I would do either but is it really hard to understand? The OP says it’s because she is needle phobic. The proper syringes are more needle like and twice the length of the teeny pen one. I get it.

however I have read from a HCP who posted here that it’s less of an infection risk to just use one syringe not two needles each time - it’s still small but you are doubling the opportunity for microbes to enter.

@winnieanddaisy OP said she is needle-phobic, so if this helps her then that is surely fine.

@winnieanddaisy

I would not recommend buying laboratory measuring tools from Amazon. Amazon cannot sell syringes as human grade so you have no idea what you are getting even if they look ok. Buy from a UK medical supplier.

Single use needles get dulled each time they are used to pierce something, whether that is a rubber seal or skin. The kwikpen rubber seal is not designed to minimise needle dulling, since it is not meant for syringe use. It is not a huge issue, some just feel more comfortable swapping to a fresh needle between extracting and injecting. It also reduces contamination risk. So while not strictly necessary it is not overly cautious either - just an individual, probably sensible, choice.

I read the opposite - that the needle swap increases contamination risk in comparison to using the same one to extract and inject. In any case with good hygiene and sterile needles from medical supplier the risks are tiny either way so best to go with what you are most comfortable with as both methods work.

How could it possibly reduce contamination risk? I’d think it would be more of a risk.

As soon as you uncap the needle it is exposed to containments.

Once you pierce the red seal, not designed for extraction, with the needle there is the risk of transfer of particles from the rubber seal or the surface of the seal to the needle (even if it has been wiped before)

The needle is no longer fresh sterile once it has been used to extract.

The needle is "damaged" during the first use, causing scraping of the metal, a damaged needle does not pierce the skin as cleanly and the risk of introducing bacteria is higher.

Using a fresh capped needle, capped until you inject is less risky. The difference in risk is not significant, but it is still there so for the sake of a couple of quid every 5 weeks or so why not choose to reduce it?

The thing is no one will actually know, because the red seal on a Mounjaro kwikpen is not intended for extraction with a syringe and hasn't been designed to minimise needle damage, there will have been no formal safety tests done on using a syringe as a delivery method.

Anything you read will be people guessing, same as I am guessing. For me I think eliminating a potential but unknown risk by replacing the needle will be safer. As you say the risks are probably small, unfortunately the consequences could be higher, which is why everyone needs to make their own risk assessment as to what they think minimises the risks the most.

It’s actually very common practice to use different needles to draw up and administer. You would generally use a wide bore needle to draw up as this makes extraction much easier, especially with viscous fluids, and you will note that Mounjaro is quite viscous.
You then change to a fine needle to inject. This needle hasn’t been in the septum of the fluid vial and so is still sterile.
So yes, you will see a nurse doing this, very often in fact.

Even my vet does this - draws up from a glass vial with one needle, changes needle, flicks out air, primes, pops needle into dog.
(yes, I was watching closely as my first ever fifth dose was looming)

Thanks for this. So useful.