Administering Lovenox

[twinmaker]

Hey everybody! It seems that I'm going to have to go off my Coumadin five days before my venogram next Tuesday. I will speak with my cardiologist tomorrow and I'm sure he will recommend bridging with Lovenox. I haven't had the greatest experiences with Lovenox. The last time I used it (over a year ago) I had terrible hematomas in my abdomen. They were so bad that I was in quite a bit of pain both standing and sitting. I still have the lumps in my abdomen from the hematomas. I guess my only other option is going in the hospital to go on Heparin which is something that I really don't want to do...especially during the holidays. Anyway, if anyone has any suggestions on how to make using Lovenox easier as far as getting hematomas, I'd really appreciate hearing from you. I rotate the sites and I don't rub after injecting but maybe there's something that I'm not doing or something that I need to do. Also, is it OK to use Lovenox with an mechanical mitral valve? It seems that there were some discussions on that. Thanks you all. LINDA

 

[tommy]

Try to keep the needle clean (no drips) as it enters the skin. This keeps the Lovenox from being active in the capillaries.

 

[Guest]

What Tom is saying is do not blow the bubble out of the syringe. This is a tiny bit of nitrogen and it will not hurt you. He is correct about no Lovenox on the outside of the syringe. The other thing is to stick the needle straight in. If you have it at an agle to the skin it is going to inject much closer to the surface and be more likely to bruise.

The only tests were done on the abdomen so that is all that the company recommends. However, that does not mean that it will not work if you use the thighs. I saw a lady today who has ovarian cancer and she has lost a major amount of weight. She used the thighs because she was afraid that she would go clear into her stomach or liver with the needle. It worked.

 

[terryj]

I administered the lovenox shots to my husband when we came home after his AVR because his INR was not coming up fast enough after 7 days. The only time I bruised him was when I got the needle in sideways. The nurse showed me to go one finger length away from the navel and always rotate the site. I guess one bruise out of 9 times wasn't too bad. It was that or stay in the hospital until his INR came up

 

[lance]

Lovenox injections suggestions

Lovenox injections suggestions

Hi Twinmaker,

These suggestions might help--I certainly hope so.

Hubby had to inject Lovenox prior to and following my surgery in October and this is what we learned:

Ensure the needle is in the upright position (pointing to ceiling) prior to removing the cap (ours is packaged in that position). Now remove the cap. The nitrogen bubble is at the top (next to the needle part). Examine the needle tip carefully--it's not a perfect point, but rather a wedge shape. Ensure the pointed end of the wedge enters the skin first. Reverse the position of the syringe and the nitrogen bubble will go to the top--in this case the plunger end and when it has you are ready to inject.


Pinch up a section of skin and push the needle straight in (pointed end of wedge first--in our case the leading edge of the wedge was at the bottom of the injection--inject and pull straight out when syringe empty. I think the leading edge part is important for comfort.

The first needle he gave caused what became a minor bruise about 1/2" across and that was the worst injection he gave. A small portion of the fluid entered the needle tip because he had the syringe pointing down and the suction caused when the cap was removal caused fluid to exit the needle. When the course of injections was finished you could clearly see each injection site marked by a puncture mark only. Well! weren't those doctors impressed. I suggested that if they want to do a decent job with Lovenox they are welcome to come to our place and practice pushing penicillin into horse's rumps. I haven't consulted the horses yet.

Also placing a cold pack over the site before and after the injection sometimes helps. I didn't notice any difference. Others might.

Anyway I hope this helps to make your injections more comfortable.

 

[Nan]

Just wanted to thank all of you, Lance, Terry, Al, Tom and Linda (for bringing it up!) for your suggestions on how to administer the lovenox injections. Using all of your instructions, I successfully managed my first one today! I really didn't think I was capable of doing it, but lo and behold, it is done!

I am still worried about the possibility of the doc wanting to hold anticoagulation for longer than usual after my colonoscopy, because there is definitely a problem of some kind as I have bleeding. He has already told me that is a possiblity. But, I guess it is all a roll of the dice in any event. Just hope I roll lucky sevens!

Thanks again for all of your great information.

 

[terryj]

Glad your colonoscopy is over with. My husband is due for his yearly exam next month and he is due for one this year(the first one since his AVR in 2001). I don't know yet how his doctor feels about doing them while on coumadin. I may be giving him shots again. Hope you feel better soon.

 

[Guest]

Nan,
We all hope that you will have a minor source of bleeding that is made worse by your warfarin.

 

[Nan]

Hi Al, thanks for your good wishes, that is what I am hoping also!

 

[ccrawford]

The only tip I did not see what that of making the injection very very slowly. If you do this, it will help minimze the bruising. I typically used to do it over at least a minute.

 

[Guest]

Good to see you posting again, Chris.