Patient to Patient: Lovenox® Shot Tips

You have been handed these shots. I know you are scared. But, I know you can do it. And with these extra tips it should make things go a little smoother for you.

The extra things you will need:

• Flexible style blue ice pack - cold but not frozen
• A quart size zip lock bag to put the cold pack in
• An old pillow case to put the cold pack in to protect your skin from frostbite
• Rubbing alcohol swabs with benzocaine (available at Wal-Mart or Walgreens in the Diabetic Supply section) preferably or rubbing alcohol swabs
• Curad™ Sensitive Skin Spots band aids (And to be on the safe side regular bandaids and waterproof ones in case Murphy's Law likes you.)
• A sharps container.

The main thing I stress is numb your skin before the shot with a cold blue pack. You can also numb your skin after, but numbing your skin before is really key. It does two things. One, it reduces bruising and you won't find yourself running out of bruise free places to inject in a few days. Second, once numbed, it doesn't hurt as bad to give yourself the shot.

With enough time with the blue cold pack on your skin, you won't even feel it too much. It makes it a whole lot easier to do if you are nervous about the shots. When I can't feel my target zone anymore I know I'm ready.

While you are waiting for your skin to get cold, get your bandaid ready and all your other supplies ready to go.

Now for actual shot techniques on giving yourself the Lovenox® shot. As soon as you take off the cold pack, wipe a wide area with rubbing alcohol so it will be dry by the time you inject. You want it to dry because it will sting if the alcohol gets on the needle during the injection. (Note: If you are able to find the rubbing alcohol pads with the benzocaine in them, you want it to still be damp. The benzocaine will follow the needle in and reduce the sting even more.)

Then unpackaged the syringe and if you are giving yourself the full dose of the prepackaged syringe pull back just a little on the plunger before pulling off the cap. (Do not twist the cap, it will bend the needle.) This prevents the drip of Lovenox® from forming on the tip of the needle. Air bubbles are ok and preferable. They help distribute the Lovenox® into the fat, so don't get rid of the air bubble.

If you have to purge out some because your dose is less than the syringe contains, slowly purge the Lovenox® pointing the needle down. I point it into the garbage can that is lined with plastic. The goal is to keep the bubble in there.

Don't touch the needle. You want a dry needle. No Lovenox®, no alcohol. This is because as the needle goes through layers of skin any Lovenox® spilled will cause bruising, alcohol will make it sting. The goal is to get all the Lovenox® in the fat layer UNDER the skin, where there should be no bruising if all goes well. The little air bubble should be the last thing that goes in.

Now pick your target zone. I try to avoid place my blue jeans will rub, like my waist and zipper area. Now here comes the part that takes the courage. I promise you after a few shots you will be a pro at this.

Pinch your inch. Some people say to go in fast. I go in as fast as I'm comfortable. The needles are dull straight from the package so you'll have to jab quick initially to break through skin if you have thick skin. Try to get it in the first try because each try after that dulls the needle more, however, if it hurts real bad it's ok to pull out and stick it into another spot that has been numbed and wiped down with alcohol. That's why it's good to wipe down a large target zone. You probably hit a nerve in that spot and there's no sense in continuing if it's going to hurt. After a while you'll learn which spots are the best for your body and that won't happen as much. Do your best to avoid stretch marks, surgical scars, bruises and those little surface veins.

Don't push the Lovenox® in fast, go at a steady pace and if it starts to sting wait a few seconds before continuing. You want to go slow so your body can absorb the Lovenox® as you inject. If you go fast it tends to spill up the needle shaft opening...going into the layers of skin and causing bruises. Besides, it does us no good there. It needs to be in the fat to work, so take your time. At the end of the shot, count to ten and then quickly pull out. The counting to ten is to make sure the Lovenox® has had a chance to move away from the needle, preferably being pushed by that last air bubble.

Do not rub the spot. I am finding holding a little pressure with that damp rubber alcohol swab with benzocaine helps keep it from bleeding. If you are bleeding or wearing nice clothes that day, put a Curad Sensitive Skin Spot bandage over the injection site (or a bigger bandaid in case Murphy's Law is in effect). I put one over the injection spot so I don't lose track of where I injected. I call it a place marker. Even if you are not allergic to regular bandages, you want the sensitive skin ones because they come off without pulling. Removing a regular bandage will increase bruising, and if you do end up bruising in this spot will hurt real bad too. The sensitive skin ones just peel off no problem. You may also want to fold over a little part of the band aid for better grip for removal later.

If your injection site is sore or stinging, put the cold pack back on until it stops hurting and make a note to cold pack it longer next time. Otherwise put the cold pack back in the refrigerator and you are all done.

Push out the safety shield and dispose of the syringe in your sharps container.

Relax for a few minutes to let that Lovenox® move away from the injection site and have a great day.

Note: This is not intended to replace standard doctor-patient visits, physical examination, and medical testing. Information given is only an opinion. All information should be confirmed with your personal doctor. Always seek the advice of a trained physician in person before seeking any new treatment regarding your medical diagnosis or condition. Any information received from APS Foundation of America, Inc. is not intended to diagnose, treat, or cure. It is for informational purposes only.