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1225178 tn?1318980604

Trying to figure this out.

After being on tx for almost 12 weeks, I am seeing a huge variation of sx from week to week and wondering if it has anything to do with where I give myself the shot. I take my shot of Friday evening at about 6:00, and usually feel OK till Sat. evening, then things get worse till Monday and level out for Tuesday and maybe Wednesday. Some weeks I feel pretty good on Thursday and Friday, but some weeks I feel horrible those days. I notice the fat in the center of my stomach seems to be a different consistency than the fat more to the side, and I'm wondering if that causes it to take longer to get into my blood stream.

Anybody else notice a difference?
27 Responses
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Avatar universal
I had good days and bad days, on all of my treatments.  It didn't seem to have any rhyme nor reason to it.  Also, you need to consider that the Riba is a factor as well, not just the shots.  Remember the Riba is a daily thing and even if you don't get hit one week with bad shot sides, your Riba could potentially, bring you down more on one day if your anemia kicks in more on that day.  Just a thought.  Just that one day at a time and realize that with each day, you have one less day left to treat!  

Blessings...

Susan400
Helpful - 0
412873 tn?1329174455
I was always told the abdomen was the best place to inject because it had the best absorption.  Not because of fat- I have a pretty consistant layer all over- but because it is more vascular than the thighs or arms.

I was all about getting the most bang for the buck interferon-wise.

And, yeah....it always stinks.  Right about the time you feel (almost) human, it's shot day again.  Peaks and valleys.

Hang in there!!

Isobella
Helpful - 0
Avatar universal
I inject into my upper thigh toward the outside. I do it on my bed I find I have great control there, especially after my syringe disengaged while doing a side of abdomen shot.  I don't notice any difference in the area I inject as far as consistency of fat at my thigh. Being into all the details is just how we are.  For you and I Diane, things will be different after our 12 wk viral load, I hope.
Helpful - 0
1225178 tn?1318980604
I am not obsessing, just curious. Besides how could you know the answer to this question? You don't have any abdominal fat ... lucky lady... so you don't know how different the consistency is.
Helpful - 0
179856 tn?1333547362
I'd imagine if it did the doctor would say 'inject yourself exactly 2 and 6/8ths inches away from your belly button on the left hand side at exactly 90 degrees'......or something like that.

I just set up the shot and then jammed it where it went - worked just fine. I would not obsess about this as we obsess about so many things arleady.
Helpful - 0
Avatar universal
The idea that injection site determines the extent of side effects is dubious - at best.

The insulin article was addressing Humalog and Regular insulin both of which are fast acting insulins. They peak within 1 to 3 hours. That can be very important when trying to offset the carbohydrates ingested at meal and snack times. Pegylated interferons don't act quite that rapidly and the site of the injection has no bearing on the time of the onset or the degree/magnitude of side effects - with the obvious exception of injection site skin issues.

Mike

Helpful - 0
1225178 tn?1318980604
I know about his blunder with the hep c info. I think it was unwise of him to speak about something he doesn't deal with on a regular basis.

He does deal with dietary health issues regularly though. As well as doing cardiac surgery, so I think it is safe to listen to him about those issues. I did my research last November when I first started having chest pains and TIAs. Thank goodness I don't have them any more... based on his recommendations.
Helpful - 0
475300 tn?1312423126
I like Dr Oz but I saw the show where stated hep c was sexually transmitted and I lost a good bit of faith.

Diane, I am done with TX so don't worry about finding the links, I don't need them.  But thank you

Denise
Helpful - 0
179856 tn?1333547362
I got a lot of this info from Dr. Oz's "

Be careful of Dr. Oz - a lot of what he says is completely and totally bogus and we've had plenty of comments in here about him and HepC and all the falsehoods he has promoted recently.  Unless of course anyone believes hepc sexborne disease and not a blood borne disease - then he was on the $$$.

Helpful - 0
1225178 tn?1318980604
I think I'll try the thigh next... I'll let you know how that goes.

(:-)
Helpful - 0
1225178 tn?1318980604
I got the idea about belly fat from reading about the different ways abdominal fat effected overall health compared to regular body fat. It is more dense and harder to get rid of, and I believe it also has less blood supply. I got a lot of this info from Dr. Oz's web site and links that I followed from there. I didn't save them, so if you want specifics, you'll have to wait until I finish tx and get my brain back. Sorry about that.

Diane
Helpful - 0
Avatar universal
Hey Diane,

I was wondering why you thought to ask that question in your OP, so I just had a quick look-see in google.  I can almost see how your thinking and educational background led you to ask the question!

Given your background in laboratory work, it might tweak your interest to read the following, although this concerns insulin and presumably IM shots, not SC ones.  

The info for the IM ones may be applicable or not but of course I have no idea. It's just interesting that you're the only one I've seen ask this and the only one I know who also trained in this.

The sentence that stands out is:

"Does skinfold thickness affect absorption?
The fatter the area, the slower the absorption. Absorption may also be delayed in areas affected by lipohypertrophy."


"How does the injection site affect absorption?
The abdomen is the fastest. Then comes arms, finally the thighs. Buttocks are up for grabs (sorry!). There are no scientific data on the rate of absorption in the buttocks. These differences may be used to prolong or speed up the effect of the injected insulin for special circumstances, but it's better to keep injecting within the same anatomical area all the time."

"Do absorption rates vary from one person to another?
Yes. Some people with diabetes get 16-20 hours out of an NPH/Lente shot, while others get 8-10 hours. Day to day variation up to 50 percent may occur in the same person, with the same dose, in the same area of injection and the same insulin. The same person, using the same technique, may see a 25-50 percent difference in the time of peak action of any insulin on a day to day basis..."

http://cgibin.rcn.com/johncm/cgi-bin/index.pl?Site=Insulin#7

Now would it impact in a significant or even measurable way where you do your injections? How the heck would I know but I see where you're coming from and want to let you know about the above, even though it concerns IM insulin.

So good night and hope tomorrow is OK, wherever you do your injection.

Susan (who hated to do it in her tummy, unlike many others who preferred it.)
Helpful - 0
475300 tn?1312423126
I hated making plans for about a year post.  I had some wierd stuff going on and never knew when I would be sick.  Thankfully 2 years post that seems resolved.
Helpful - 0
427265 tn?1444076436
About 6 months into tx, I thought I had my week down to a predictable schedule - shot Friday night, a couple of good days followed by a couple of not-so-good ones. After that, it was pretty much a craap shoot and I stopped planning things more than a day in advance. I really hated canceling out on people. I think just learning to roll with the punches is important, much as I'm relearning now during post-tx.

I did my shots in the stomach for the most part, the thighs always seemed to show more, but it didn't seem to affect my sx.
Helpful - 0
475300 tn?1312423126
There are so very many on here that treated so much longer than my measly 24 weeks, to those I salute you!!!  I did 24 weeks and that was hard enough and I can't imagine (but would have done it) treating longer.

My bad days were always different.  If you don't mind me asking where in the world did you get the idea that belly fat made any difference?  Just curious

Denise
Helpful - 0
179856 tn?1333547362
Michael do you remember the folks who felt worse the two days of the week they were going through withdrawl from the shot before their next shot arrived?  It just goes to show it's all just what your body responds to after all and there is just no way to predict any of it except for yourself.

I barely made it through my one little treatment - I know you had no choice however the strength and determination that you showed should in no way be negated or lessened by that fact.  You are a MONSTER when it comes to treating liver disease (which is why I finally learned to listen to you LOL).
Helpful - 0
Avatar universal
I'm not tough at all Deb - I had NO choice. I could not watch and wait. That wasn't an option for me.
Helpful - 0
1225178 tn?1318980604
Thanks for that link. It does look like that 72 -96 hour window is pretty consistent.

Yes... a little over a week and I'll know if I got the all important UND. I hope, I hope, I hope!!!

Diane
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179856 tn?1333547362
Jez Trin we're talking about 72 weeks and then look at Michael........"the first two years of treatment" "harder than the last 73 weeks"....! What whiners we sound like huh?!!!!  Still I think the Intron was horrible yet can't even imagine doing Infergen for 72 like DebC did.  It makes me realize what a big baby I was about the whole thing.  Or a Beagle Bailey with that serious hemo crap - man oh man how did he handle that?  Yes Michael you put it right into perspective for real!

I 'thought' the first few months were difficult (especially right after the hemo nightmare) until after week 48 when I thought I was going to go out of my mind believing it was never going to end and being so tired of all the contiuous new / never ending problems.  But it worked and that is what matters in the end. If people hadn't told me to suck it up and just not focus on that stuff I might not have.  Best advice I ever took!

We made it.........somehow............we are some tough cookies ;)
Helpful - 0
Avatar universal
For me the fist two years of TX were a lot harder than the last 73 weeks. I attribute that solely to the switch in Pegs from Peg-Intron, which practically killed me, to Pegasys which made those last 73 weeks so much easier.

Mike
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Avatar universal
That extra 6 months was a whack in the head hey?
Helpful - 0
Avatar universal
I never thought about that!

I rotated among four areas, thighs and stomach sides, with fat content on thighs higher than tummy.  I don't recall whether thigh days delayed my reaction or not. :)

Knowing roughly when you'll be hardest hit during the week is so important for you, I know, because you do a lot of running around at work. I didn't have that kind of pressure, so one day just slipped into the next and it didn't impact my job (what job?).

And you have a position that demands alertness that is so costly if you goof. :(

As my hemoglobin dropped and dropped and dropped, I found it hard to stay on my feet for long. And harder to think straight, whether my days were  'good' or bad.

The thing I remember most about feeling crummy was that as soon as I'd figured out how to handle what one day or one week had dished out, the crumminess would morph into something different and leave me scrambling to fix the next set. There was no point hanging on to old strategies because they stopped working.

Whether the fat delays your reaction or not, side effects suck BUT (and I'll bet you) one day, you'll barely remember them. (My dil just had the worst labor without any meds and five days later, almost all the 'bad' is forgotten.)

Here's something about serum peaking (window of 72 to 96 hours) and 'worst days'. I seemed to feel crummy within the first 48 hours, anyway, which didn't fit the conversation about the 72 to 96 hour window:

http://www.medhelp.org/posts/Hepatitis-C/Worst-day-poll/show/722721

Twelve-weeker test coming up, I know, I know.....fingers and toes crossed...

xoxo

Susan






Helpful - 0
179856 tn?1333547362
If fat had anything to do with it by week 20 I would have had no sides at all cause I had no more fat (or vice versa). It followed me all the way through week 72 and past as well and some were extremely drastic sides.  They come, they go, they come, they go, they change, they come back.......not the naseau or lethargy but the autoimmunes and the hemos - living hell.  But being cured, it seems ridiculous to have complained after watching people with worse ones than I who did not succeed.

Aren't your numbers still quite strong for getting so far into tx - I thought you had avoided the anemia and stuff very well so far?
Helpful - 0
1253246 tn?1332073310
Hope that you are gonna have a good week this week!
Helpful - 0
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