[Godiva4me]

- Have RE draw ovals on hips to show you were to aim for. I had mine use a sharpie marker so it stayed on for days.

- Warm PIO when it is in syringe. I wrapped it in a heating pad for about 5 min. before injecting, although other tips I have heard are put syringe inside bra, under arm, etc. Guess I just felt like it was more sanitized in heating pad. Warming it helps liquify even more making it easier to go in.

- Either ice the oval area you are going to inject at for the night, or I have heard put heat on the area first. Apparently, heat helps the oil dissipate better, but I didn't know that and used ice for the first 8 days, which still seemed fine. Once you get the hang of it, you don't really need ice (more psych. I think)

- If you are standing up for injection. Put your weight on the leg of the side you are not using that time... it helps relax your other muscles on injections side.

- After injecting, rub oil in/massage area. Then I put the heating pad on it for about 10 minutes to help it.

THAT's it! The big needle is intimidating, but it honestly doesn't hurt. Act like your hip is a dart board and use that type motion to quickly insert the needle. Like I told you before, I did all of mine by myself.

Check out the You Tube videos if you want to see how some people did the PIO with husbands/partners, and some alone. (search PIO shots or PIO injections) I thought these videos were very helpful since I had my 'shot lessons' several weeks before I actually started doing the shots.

[~Twilight~]

Thanks so much! I sent a link to DH along with the comments from the other thread. It has helped quite a bit.

[lewlou]

Twighlight, I just started lupron ,should be moving on to estrace next week, so we are pretty much in the same boat. Is this your first cycle? Good luck to you

[Godiva4me]

Wanted to give this an updated hit, so those doing PIA/PIO shots would have some additional injection tips!

Don't let that BIG needle intimidate you, it really isn't so bad!

[Butterfly13]

Thanks for these tips!

[Leenalee]

Quick PIO question - do you rub the area as soon as you inject it? or do you wait a bit?

I think one clinic advised us to wait a while (30 minutes) before rubbing it. The other had no opinion. Since we have yet to do our first shot, I'm curious what other people think.

[Godiva4me]

Angela, I cleaned up the countertop, put pio away, etc, and then rubbed. Probably waited about 30 seconds-1minute. Thats it....I'll be curious what others say. Don't understand why you would wait, as you want it to disperse so you don't get lumpy/bumpy!

Good luck, your shot will go just fine! If I can do this by myself, anyone can, and when those find themselves needing to do it by themselves they do fabulous too!

[sunshine7482]

Wow, this is exactly the thread I was about to start!!!

I'm taking PIO shots twice daily, and I'm in constant pain.

By the way, what is the area you are using? We're doing shots in my behind, and I can't imagine reaching there with a needle on my own.

Is it possible that injecting somewhere else would hurt less?

[lisa_kev]

A helpful hint: Have your DH "dart" the needle in. The first administer of the PIO was pure torchure! DH put the 22 guage needle in slowly becuase he was so scared he'd hurt me. A friend of mine who's in the medical field did the shots a few times and she pulled the skin apart with her thumb and index finger then quickly jabbed in like a dart.

Some of you are using the smaller 25 guage needles. I however used what the pharmacy provided, which was the 22 guage. Much bigger and honestly, when done quickly you won't feel nothing but a quick poke and it's over with.

Also, rub the injection site with your fist, making sure you put pressure. You want that oil to spread!

[sunshine7482]

Godiva, I just read your post again, and I see you're using hips... Can you tell me where your RE drew ovals? A pic would be even better

Driving to my REs office and back would take me 3 hours. And, I can't go there before getting a shot tonight and a shot tomorrow morning.

The shots are not too bad, just a slight pinch - not much worse than lupron was. But the pain started 6 hours after the first shot, and hasn't stopped since.

The only thing that worked a little was massage with massage wand set on high and pressed hard on all the points that hurt (pretty much entire butt). Massage itself hurt, but not much more that the original pain. And when we were done, I was feeling only a little pain. Such a big improvement I was even in the mood for a party for two that night.

We tried massage the day before transfer. And since transfer I'm so worried about anything. My massage therapist once told me I always have to tell her if I was pregnant, because she'd need to be extra careful with first-trimester massage.

When you saw, "warm PIO when it's in the syringe" -- that is after getting rid of all the air bubbles?

[Godiva4me]

Sunshine- If you get the vial at the correct angle, you really shouldn't have too many air bubbles... (yes, warm it once it's in the syringe, with the cap back on the needle)Remember to inject air in the vial before turning it upside down to retrieve into your syringe. I came across a picture once online that showed you how to divide your butt/hips into quadrants and it showed right where to do IM injections. If I can locate it in the next few minutes, I'll PM you with the site.
(I might have it in my RE folder) I am glad to see you as we haven't heard from you and I was wondering if you did your ET yet, but see you did! Congrats!

Lisa- Thanks for your tips too! I unfortunately used the 22 gauge too and I agree... act like it's a dart!!!

[Godiva4me]

If you don't have circled drawn, follow the directions below for putting hands on hip. It seems like you are injecting up high and not really on the buttocks, but it is the correct location! Good luck!


IM injections must be done in the large muscle of the buttock. To locate the correct area, imagine the buttock is divided into four areas (like an x/y axis). The injection should be given in the upper, outer portions. Another easy way of locating the correct area was demonstrated by my nurse: place your hands on your hipbone, with your thumb pointing toward your butt crack and your other fingers on the front of your hip, with the area in between the thumb and forefinger flat against your hip bone (like you’re putting your hands on your hips).


The injection can be given below the thumb, but not past the tip of the thumb—that area gets close to your sciatica nerve and you want to avoid that area.

(Have someone draw ovals where your thumbs are on your hips!!)

[sunshine7482]

Thanks for responding. Now, what is the correct angle for drawing into syringe? I thought it should just be upside down.

Originally Posted by Godiva4me

Remember to inject air in the vial before turning it upside down to retrieve into your syringe. I came across a picture once online that showed you how to divide your butt/hips into quadrants and it showed right where to do IM injections.

If you can show me that pic, it would be wonderful.

Originally Posted by Godiva4me

I am glad to see you as we haven't heard from you and I was wondering if you did your ET yet, but see you did! Congrats!

Yes, things have been kind of crazy... I started taking a university course, which is taking insane amount of time.

I just can't believe it. You use the big needle and it doesn't hurt. The pharmacist told me smaller needles hurt less. By the way, after dart-ing the needle, do you inject fast or slow? I'm guessing slow is better because it allows for oil to spread around, right?

[Godiva4me]

http://www.drmalpani.com/images/inj6.jpgLying down-or standing with your weight off of the side to be injected-locate the upper outer quadrant (or quarter) of your buttock. The injection is given here. The other option is to give it in the outer aspect of your thigh, along the middle third.

Take a deep pinch between your thumb and forefinger and wipe with alcohol. Then let dry.
http://www.drmalpani.com/images/inj7.jpg
http://www.drmalpani.com/images/inj8.jpgTop

Place the needle into this pinch of tissue and muscle completely, leaving none of the needle exposed. This ensures you are taking the injection deep into the muscle.
Draw back on the plunger. If you are accidentally in a blood vessel ( incidentally, this is highly unlikely ! ) , blood will appear in the syringe. If so, pull the needle out, replace it with a new, sterile needle, and repeat the process.
http://www.drmalpani.com/images/inj9.jpg

Slowly push the plunger all the way to inject the medication, and pull the needle straight out. The key to a comfortable injection is swift needle entry followed by slow injection of fluid. Therefore, slowly push the plunger down then quickly withdraw the needle.

Alternate between your left and right sides, each time you give yourself an injection. This will prevent the muscles from becoming sore

http://www.drmalpani.com/images/inj10.jpg

Apply pressure and massage the injection site gently for thirty seconds after you administer the shot.

Using ice cubes can help to relieve some of the discomfort. Some patients find numbing the skin with ice cubes prior to taking the injection is also helpful.
Never reuse needles and syringes.

http://www.drmalpani.com/images/inj11.jpgTop

[sunshine7482]

Actually, my pharmacy has a video, too:
Freedom MedTEACH

We watched it before the first shot, and my husband said, "yeah, yeah, I got it".

Now I watched some you-tube videos, and your pictures, and the pharmacy video again, and then I took a sharpie and drew a potato (kind of hard to draw a circle...) on my hip. Told him to use this as his dart-board, and he was like "wow, that's much higher than I've been shooting you"

Hopefully, this will make things better, and by Friday, I'll be good enough to attend our wedding anniversary.