Pain and Swelling at Injection Site. Please Advise.

I am posting on behalf of a friend who is trying very hard to lower the ferritin, but has run into new obstacles. All advice is greatly appreciated.

"Since the last month, everytime I take desferal, the injection site gets swells like a round tennis ball and pains until 2 days non stop. It pains so much that I cant even tolerate my dress touching the skin. I put thrombophob and betadine incase it gets infected.
Then after about 3-5 days pain subsides, its like a hard spot and then disappears.

This has only happened to me in my very young years and have rarely occurred in the past 10 years or so..

I usually only clean using alcohol, but after this started I have started cleaning with both alcohol and betadine before injecting. Still doesnt help..

I am absolutely sure am not doing anything different than before and my dose (4 vials, 20ml water) i have been taking for 3 months or more, so I dont think its a case of the dose either..

Maybe my skin cannot take the long hours?? Am doing 18 hours now.. some nights 20 hours.. Or maybe I should just reduce the dose like before?? I rather take a low dose every night than 4 vials every 3 nights or so due to the pain
What should I do? This is seriously compromising my commitment."

This is quite common with desferal and can be a result of the desferal pooling under the skin.   It is helpful to keeping circulating the site where you are placing the needle. 

If you are using the butterfly needle it may be because the needle is going between layers of skin, and it is important to try to get a 45 degree angle been the layers of skin.

It may also be helpful to try a different type of needle for a little while - if you are using butterfly, maybe try thump back vice versa.

Try putting a warm compress on the affected area - using a wet warm cloth is best.  Let the area heal very well, do not use the affected area or area surrounding the affected area for quite some time - keep circulating the desferal.

Is it an option for you to use combination therapy?  Not only is it far more effective, it will also give your skin the much needed break that it needs.  If you also use exjade or ferriprox - you may be able to use desferal fewer times a week and for fewer hours - but this is a plan you need to discuss with your health care provider and adequate testing needs to be conducted to ensure that all of your levels remain good during such treatment.

I hope that this is helpful.  We have not used desferal for quite some time for my son - but I do remember the painful lumps beneath the skin..

Sharmin

i think I got it.

No.1 Change your Distilled water (this solved the same problem for my friend)

No.2 Make sure needles are not expired

No.3 Perhaps you are inserting the needle into the muscle, dont make it too deep.

No. 4 Reduce Desferal hours from 18-12


This happened to very close friend of mine, he changed water and he was O.K

P.S Swelling/Itching/Rashes happens at injection site nearly 99%. But the pain becomes unbearable when you have inserted needle into the muscle, needle has been on for too long or water for injection needs to be replaced

"Since the last month, everytime I take desferal, the injection site gets swells like a round tennis ball and pains until 2 days non stop. It pains so much that I cant even tolerate my dress touching the skin. I put thrombophob and betadine incase it gets infected.
Then after about 3-5 days pain subsides, its like a hard spot and then disappears.

This has only happened to me in my very young years and have rarely occurred in the past 10 years or so..

Been there, done that, suffered the pain .....

What worked for me (I was using butterfly needles - no thumb tacks) -

One, if you have a desferal pump with an adjustable rate, then adjust the rate for infusion time, and not the amount of water. When I was on desferal, taking 4-5 vials alternate days, I would limit the water to 10ml, and not more. Helps to reduce the amount of fluid being injected into your sub-cutaneous layer, which is not geared to absorb fluids.

Two, switching to saline, instead of distilled water helped a lot as well - maybe, that is because saline water is closer to the composition of one's sweat/glands in the sub-cutaneous layer or general fluid composition in the body or something else - it helped reduce my swelling and pain by over 75%.

What worked for Ashish (I never had the nerve to try this, I only injected in my abdomen area) - he used to take the desferal in the thighs - his view was that even walking would exercise the spot and ensure quicker dispersal of the fluid collected in the area and reduce the amount of pain. And, it worked quite well for him. He even tried the buttocks at times.


Hope that helps.


Poirot

I have faced once this kind of pain when i tried desferal at abdomen site due to unavailability of injecting sites at thighs.
Just want to ask that does that bleed when u insert or remove the needle from injecting site at the time starting or completing the desferal respectively ? If you can see the red line/some drops in the tube when u insert the needle, it means the needle touched or has made counter in the vein at that site. Then just remove the needle from there and try another site.
When u don't remove needle from such site it can cause this kind of intolerable pain.

And if your weight is low then it may also happen.