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Question regarding Immuno Globulin

Messages
59
What i would like to know is that online there are people who inject themselves without the aid of the nurse, what i notice is that every single example i find online of people doing this are using a tube instrument to feed the globulins into themselves.

Is the tube a necessary thing? why not just inject directly? Is it safe to do that?

Where are these people getting the kits from that contain all these items?

Thanks,
J
 

wigglethemouse

Senior Member
Messages
776
You can learn about IVIG vs SubQ IG in this video presentation from Jill Schofield. "Kits" are provided by specialty pharmacies. It has to be a slow infusion process to limit adverse reactions and due to the quantity of fluid. Hence the need for a pump and tubing.
 

Gingergrrl

Senior Member
Messages
16,171
It has to be a slow infusion process to limit adverse reactions and due to the quantity of fluid.

In addition to the quantity of fluid, IVIG is a very thick substance with lots of little bubbles that can clog up the IV line. Doing a slow infusion speed also reduces the risk of blood clots, strokes, aseptic meningitis, etc. (I did not watch this specific video and apologize if I am stating something said in it)!
 

Gemini

Senior Member
Messages
1,176
Location
East Coast USA
Where are people getting the kits from that contain all these items?
@jay185, this 50-minute video for patients/caregivers reviews different types of IVIG and how it's administered.

Dr. Mark Ballow, MD and Dr. Elizabeth Younger, CRNP, PhD presented the information at the 2017 "Immune Deficiency Foundation Conference":


@Janet Dafoe (Rose49) side effects incl. fatigue and how they are managed covered at 31:00 on the video.
@Gingergrrl
 
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Messages
59
i will look at all this later, unfortunately my energy levels will not allow me to sit through all of this right now.

There is one main question i have above all and this is something i am wondering, i notice a lot of people are using a tube to feed the globulins through but i have not seen anyone injecting it directly without a tube.

Is there any danger or problem to inject myself directly through a syringe and needle subcutaneously without the tube? What is the difference there?

I understand it must be done very slowly though, the problem i have is having a nurse do this for me since so far i cant find a nurse that will do it, then there is finding the kit that is necessary to give this to myself.

It is odd that all nurses i have asked thus far are saying they cannot give it unless they are the one dispensing which leaves me in a very problematic situation.

Thanks all
 
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Messages
59
IT appears i have made a mistake by purchasing immuno globulin, i cannot find anyone who would administer this and self administering isn't quite as simple as B12 shots.

It appears with Immuno globulin you cant just stick a needle in yourself, or at the very least that is what i have gotten from watching videos.

I have been making some very clumsy decisions of recent due to Lyme being in my brain thus my brain does not operate in a way i need it to, difficult when there is no one around me at home to guide me through better decision making.

It appears i have wasted a lot of money by buying IVG since there is no one who can administer it which leaves me confused as to why a doctor would prescribe this for home use if only his team can administer it.

Very disappointed and angry at myself.
 
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zzz

Senior Member
Messages
675
Location
Oregon
There is one main question i have above all and this is something i am wondering, i notice a lot of people are using a tube to feed the globulins through but i have not seen anyone injecting it directly without a tube.

Is there any danger or problem to inject myself directly through a syringe and needle subcutaneously without the tube? What is the difference there?

Yes, a tube is absolutely necessary. I haven't seen the exact reason mentioned, but I assume that it's related to the high viscosity of the immune globulin, the necessity of injecting it slowly, and the necessity of keeping the injection site stable.. The fastest injection speed recommended is 2 ml/minute, and that's as fast as I'm physically capable of injecting using the proper equipment.

I haven't looked at the videos above, but I learned how to do SCIG injection mostly through the following video:


The tubing is actually something called an "SCIG needle set." Such a needle set requires a prescription, which you can obtain from your doctor. However, I found that the site that had the needle sets I wanted (DiabeticsTreatment.com) did not ask for a prescription. It is important to note that there are many types of needle sets used in SCIG, and it is essential that you purchase the correct one for your needs.

For best results, most people are going to want a 27G x 9mm needle. A larger needle width (24G or 25G) may be used for a somewhat faster infusion, but you want to make sure not to exceed the 2 ml/minute speed, as you don't want to damage the tissue at the injection site. A larger needle width also makes use with a pump potentially easier.

The 9 mm needle length is for adults of average build. Children need to use a shorter needle, often 6 mm, while adults with a lot of extra fat at the injection site will often find that a 12 mm needle or larger works best.

The needle set that I have been using for months, which has worked perfectly for me with zero problems, is the Emed Technology - SUB-109-G24 - SUB-112-G24 - SCIg Set, Single Needle with One Site Dressing. (Note that this link is for a pack of 50 sets; a smaller pack is available.) This set is ideal for doing small-scale injections without a pump - the "rapid push" method that is illustrated in the above video. This needle set also comes with full instructions for doing the complete SCIG infusion, from start to finish.

Depending on the brand of immune globulin you're using, the amount that can be injected per site varies slightly. (I found all this information on the Internet when I was first researching this topic.) However, you should be able to inject at least 20 ml/site. If you are using Gamunex-C, for example, this comes out to two grams. Much higher doses per site are possible, but they have to be injected over a period of time long enough not to stress the injection site. Google "SCIG maximum per site" or the name of your immune globulin for more information on this topic.

Note that the first link in this post shows many different types of needle sets; in addition to single needle sets, there are sets that range from bifurcated all the way up to hexa-furcated. These needle sets are used with pumps, and are generally necessary when you have a very large amount of immune globulin to infuse.

As I said, I have had no problems doing this completely on my own, under the supervision of my doctor. But it is essential that you know what you are doing here, and that you follow the proper instructions exactly. If you are unsure about something, either do the research necessary to find out the exact answer, or consult with your doctor if you are unable to do so. Never guess about any part of this procedure. SCIG injections are extremely safe if done properly, but if not done properly, they can be quite dangerous. For this reason, you should not do this procedure if you are not completely clear on how it is to be done.

You should also always have an EpiPen (or equivalent) by your side any time you do one of these injections, and you should be well acquainted with its use beforehand.
 
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SunMoonsStars

Senior Member
Messages
159
IT appears i have made a mistake by purchasing immuno globulin, i cannot find anyone who would administer this and self administering isn't quite as simple as B12 shots.

It appears with Immuno globulin you cant just stick a needle in yourself, or at the very least that is what i have gotten from watching videos.

I have been making some very clumsy decisions of recent due to Lyme being in my brain thus my brain does not operate in a way i need it to, difficult when there is no one around me at home to guide me through better decision making.

It appears i have wasted a lot of money by buying IVG since there is no one who can administer it which leaves me confused as to why a doctor would prescribe this for home use if only his team can administer it.

Very disappointed and angry at myself.
Where did you purchase IG ?
 
Messages
39
You need to get SCIG through a specialty pharmacy with a prescription. Your insurance chooses which specialty pharmacy you will use. You can do an SCIG injection yourself but there’s a lot of steps so usually a qualified nurse will come for the first few to train you.
 

valentinelynx

Senior Member
Messages
1,310
Location
Tucson
As others have pointed out, gamma globulin prescriptions are handled by specialty pharmacies that supply not only the medication but the equipment and the home nursing needed to administer it. It's also incredibly expensive.

I'm wondering if perhaps the OP obtained a different type of immune globulin called GamaSTAN: the type used for post-exposure prophylaxis for viral diseases such as hepatitis A or measles. This is given as a single intramuscular dose of 0.1 or 0.2 ml per kg, or about 7-14 ml in a normal weight person. See this page from the CDC for more info on this type of immune globulin.

GamaSTAN immune globulin would not be expected to help in cases of immune deficiency or autoimmune disease.