Re: nurse mixed my xolair improperly today

[Guest guest]

--- In , " mccallalton " <mccallalton@...>

wrote:

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her just

> to swirl it. next thing i knew, i could hear her banging the vials on

> the counter and shaking them as vigorously as she could and tapping on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

Good grief! A nurse must be properly trained on how to mix and inject

xolair. Evidently, this one wasn't.

In my 5+ years of having 2 shots every 2 weeks, I have always been

blessed to have well trained nurses. My doctor would have thrown a fit

and fired them on the spot if any of them EVER did that. I have had at

least 10 different nurses give me the shots through the years and. I

have also never had any pain or bleeding

You probably can't get anyone else to give them to you in your area. I

know I can't. I'd complain to the doctor if I were in your shoes.

Doug

[Guest guest]

I had the opposite happen when I was in Thailand. They had never mixed before

but as

Thai nurses can be were overly cautious. They saw bubbles that weren't really

there, so

the mix took about 1 hour. Anyway, you should be fine as long as she let the

Xolair settle

in the saline. That must shaking can cause excess bubbles.

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her just

> to swirl it. next thing i knew, i could hear her banging the vials on

> the counter and shaking them as vigorously as she could and tapping on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

[Guest guest]

do you think the xolair will be active if it were banged, shaken vigorously and

tapped so loudly i could hear it 20 feet away thru a glass door?

uca79iii <uca79iii@...> wrote:

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her just

> to swirl it. next thing i knew, i could hear her banging the vials on

> the counter and shaking them as vigorously as she could and tapping on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

Good grief! A nurse must be properly trained on how to mix and inject

xolair. Evidently, this one wasn't.

In my 5+ years of having 2 shots every 2 weeks, I have always been

blessed to have well trained nurses. My doctor would have thrown a fit

and fired them on the spot if any of them EVER did that. I have had at

least 10 different nurses give me the shots through the years and. I

have also never had any pain or bleeding

You probably can't get anyone else to give them to you in your area. I

know I can't. I'd complain to the doctor if I were in your shoes.

Doug

[Guest guest]

I'd call  Xpansions/Xolair help line ( used to be SPOC) and ask them to try to

have the drug rep who  is in your area come in  for a " service call " the next

time you have an appointment.  That way your new nurse can  be properly trained

to mix and administer Xolair.   You might even be able to get them ( Genetec or

Novartis) to give your doc an actual mixer!

--- In ,

" mccallalton " <mccallalton@ ...>

wrote:

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her just

> to swirl it. next thing i knew, i could hear her banging the vials on

> the counter and shaking them as vigorously as she could and tapping on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

Good grief! A nurse must be properly trained on how to mix and inject

xolair. Evidently, this one wasn't.

In my 5+ years of having 2 shots every 2 weeks, I have always been

blessed to have well trained nurses. My doctor would have thrown a fit

and fired them on the spot if any of them EVER did that. I have had at

least 10 different nurses give me the shots through the years and. I

have also never had any pain or bleeding

You probably can't get anyone else to give them to you in your area. I

know I can't. I'd complain to the doctor if I were in your shoes.

Doug

[Guest guest]

In one of the past postings it seems like we talked about having to be

" Gentle " with Xolair due to it's make up and ingredients being a

protein as to not bruise it. I think Addy had information on it, I was

unable to find the post. In the attached Xolair mixing instructions it

definitely states, " Do Not Shake " .

http://www.xolairhcp.com/xolairhcp/preparation_administration.html

On Dec 4, 2008, at 7:18 PM, mccallalton wrote:

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her just

> to swirl it. next thing i knew, i could hear her banging the vials on

> the counter and shaking them as vigorously as she could and tapping on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

>

>

[Guest guest]

I agree with KK about calling Xpansions and asking for the drug rep to

go by and give a lesson. Since anything you write or fax to the doc

will probably go through the new nurse, you might want to consider

making an appt to see the doc so you can discuss it with him directly.

If you can't do that before the next injection, carry the instructions

with you and ask specifically if he/she has read them or received

training.

Regardless tell your doc at the next appt.

Addy

Group co-owner

--- In , " mccallalton " <mccallalton@...>

wrote:

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her

just

> to swirl it. next thing i knew, i could hear her banging the vials

on

> the counter and shaking them as vigorously as she could and tapping

on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled

for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

[Guest guest]

I appreciate this post. This is an eye opener and a good reminder

for me. My allergist told me to turn the bottle up and down after

putting the sterile water into the Xolair " powder " . (This is the 3rd

allergist for me. I move from state to state often but that's

another story. My other 2 allergists always mixed the Xolair for

me.)

Now I am scared. I don't know if I have been doing this the correct

way. I usually mix the Xolair at home and take it to the allergists

office. I carry the Xolair as carefully as possible, but what

happens if the Xolair gets shaken by accident?

>

> > my doctor has a new nurse. usually i mix the xolair because i was

> > trained by a genentech rep at my old doctor's office. i told her

just

> > to swirl it. next thing i knew, i could hear her banging the

vials on

> > the counter and shaking them as vigorously as she could and

tapping on

> > them. i had to knock on the glass and tell her to stop. do you

guys

> > think she ruined my dose? i am very ill right with infection and

> > chronic bronchitis and on an iv everyday.

> > when she injected me, she pierced a vein or artery too and it

bled for

> > like ten minutes.

> > the medical profession is so very scary.

> > what should i do? any thoughts?

> >

> >

> >

>

>

>

>

[Guest guest]

I absolutely would not allow that nurse to do the same thing to me

again even if it meant yelling " no " and pulling away. Of course, if

she mixes properly then it's no problem. Definitely get in touch with

your doc and even Genentech before you go back for any more injections -

others in this thread have suggested the same.

I injected at home for 1-1/2 years and essentially let the Xolair

dissolve itself - which it did. It might take 45 mins or more but

there are no bubbles other than the foam initially (that disappears

too) that the nurse said was ok.

Someone else in this thread mentioned shaking it changes it because

it's a protein. That's what I recall reading also 2 years ago and that

the increase in potential reactions was greater if it was shaken

vigorously. At the very least it would theoretically be less effective

from what I've read.

Nurses do make mistakes - even those that are allegedly Xolair

trained. The one time I had a Xolair injection in an infusion center I

couldn't see the xolair being mixed and the nurse injected it too fast

and too quickly after the alcohol wipe. She curtly infomed me that she

is an RN and I curtly informed her that I train RN's (which I do but in

mgmt skills) That was my last Xolair injection. My arm had a painful

lump and 3 black bruises that lasted for 10 days. I had trouble

breathing the whole time I was there which she ignored. (It was from a

routine asthma attack - not the Xolair) Definitely get in touch with

the prescribing doc and Genentech as others have suggested in this

thread. You do not need to endanger your health ... or your

checkbook.

--- In , " mccallalton " <mccallalton@...>

wrote:

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her

just

> to swirl it. next thing i knew, i could hear her banging the vials

on

> the counter and shaking them as vigorously as she could and tapping

on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled

for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

[Guest guest]

<<She curtly infomed me that she

is an RN>>

I am sure that very few RN's are trained in how to give Xolair.

In a NON allergy or pulminory office they always say:

" What kind of injection? What the heck is xoliar? "

Had a procedure on my neck yesterday where they had to sedate me.

(Another chronic illness of mine that I will not go into on a Xolair

board. If ya wanna know more, email me)

The nurse asked what it was and then mispronounced it twice.

The IV she gave me didn't hurt a bit. She IS trained how to stick

people with those things LOL!

[Guest guest]

hi--the damage to the protein is exactly my concern. so many nurses assume the

patient is ignorant about procedures but the internet has empowered us. i just

came home from sinus surgery so i will call on monday and see who will give it

to me from now on. heck, i did better when i gave xolair to myself. the staff

at the hospital today was so wonderful i felt as if i were in the twilight zone.

we were all on the same page. after a string of bad luck, it was time for a

change!!!!! thanks, leigh

instdesgn1 <instdesgn1@...> wrote: I

absolutely would not allow that nurse to do the same thing to me

again even if it meant yelling " no " and pulling away. Of course, if

she mixes properly then it's no problem. Definitely get in touch with

your doc and even Genentech before you go back for any more injections -

others in this thread have suggested the same.

I injected at home for 1-1/2 years and essentially let the Xolair

dissolve itself - which it did. It might take 45 mins or more but

there are no bubbles other than the foam initially (that disappears

too) that the nurse said was ok.

Someone else in this thread mentioned shaking it changes it because

it's a protein. That's what I recall reading also 2 years ago and that

the increase in potential reactions was greater if it was shaken

vigorously. At the very least it would theoretically be less effective

from what I've read.

Nurses do make mistakes - even those that are allegedly Xolair

trained. The one time I had a Xolair injection in an infusion center I

couldn't see the xolair being mixed and the nurse injected it too fast

and too quickly after the alcohol wipe. She curtly infomed me that she

is an RN and I curtly informed her that I train RN's (which I do but in

mgmt skills) That was my last Xolair injection. My arm had a painful

lump and 3 black bruises that lasted for 10 days. I had trouble

breathing the whole time I was there which she ignored. (It was from a

routine asthma attack - not the Xolair) Definitely get in touch with

the prescribing doc and Genentech as others have suggested in this

thread. You do not need to endanger your health ... or your

checkbook.

>

> my doctor has a new nurse. usually i mix the xolair because i was

> trained by a genentech rep at my old doctor's office. i told her

just

> to swirl it. next thing i knew, i could hear her banging the vials

on

> the counter and shaking them as vigorously as she could and tapping

on

> them. i had to knock on the glass and tell her to stop. do you guys

> think she ruined my dose? i am very ill right with infection and

> chronic bronchitis and on an iv everyday.

> when she injected me, she pierced a vein or artery too and it bled

for

> like ten minutes.

> the medical profession is so very scary.

> what should i do? any thoughts?

>

[Guest guest]

I am a biochemist and I work with proteins and antibodies. One of the

reasons I am still allowed to self inject is that everyone figures the

drug is as safe in my hands as the folks that made it. Xolair is a

fairly large molecule, and it can be pretty fragile. It only works if

it is intact. One of the first things we learn in the lab working with

proteins is not to shake them vigorously because it can cause them to

break up into pieces. Bubbles are bad because the surface tension

along the outside of the bubble can pull the proteins apart as well,

so we avoid causing bubbles.

In mixing my doses, I add the sterile water slowly so as not to cause

any bubbles. Rolling the vials slowly between the hands is as

effective as swirling, but you don't want to heat the Xolair too much.

I have also used a " rocker " - a device that gently swirls the vials. I

keep watching the local university auctions for a surplus one.

While it is possible you got less than a full dose of Xolair this time

because the nurse mishandled your medication, it is likely your dose

was not completely ruined. The broken bits of protein, by the way, are

inert and pass through the system without adverse effects.

I think the idea of contacting Expansions to see if you can get a

trainer to give a demo is a good one. You should definitely complain

to your doctor or to the nursing supervisor. This medication is too

expensive to be in the hands of someone who treats it with such

disregard, and someone needs to know you are not happy with the

service you are getting. The medical profession is a service industry

and that nurse needs to be held accountable for her treatment of you

and your medication.

[Guest guest]

The worst thing that can happen is that the proteins are damaged and so the shot

doesn't help you the way it should. It won't hurt you because it was shaken.

Carol

 

 

Listmember wrote:

Now I am scared. I don't know if I have been doing this the correct

way. I usually mix the Xolair at home and take it to the allergists

office. I carry the Xolair as carefully as possible, but what

happens if the Xolair gets shaken by accident?

[Guest guest]

My allergist is EXTREMELY PICKY about his nursing staff! NO patient

gets ANY xolair shots until the nurse is thoroughly trained by a

professional that the xolair rep brings in. All nurses are then tested

on how to do the entire procedure correctly. They are also very nice,

compassionate, caring individuals. If not, out the door they go!

I have a set time every two weeks to get the shots. The nurse calls

me earlier in the day to remind me of my appointment. When I come in

for the shots, she has both needles ready to go when get there. She

takes my BP, I blow into the kazoo, we have a nice chat and I get

stuck two times and wait in the lobby for 30 minutes. LOL

I have had 7 different nurses administer my xolair in the past 5+ years.

All of them were trained by an expert brought in by the xolair rep.

No untrained nurses in my doctors office that's for sure! Also, NEVER

any problems whatsoever.)))

Doug

Group founder

Blessed to have such a great doctor and clinic

[Guest guest]

Lurkitty - this is a great post. I self-inject and did not realize

that the rate at which I add the SWI can effect the bubble " ratio. "

Thanks!

Addy

Group co-owner

Self-injecting successfully for 5 years

--- In , " lurkitty117 " <scruffy@...>

wrote:

>

>

> I am a biochemist and I work with proteins and antibodies. One of

the

> reasons I am still allowed to self inject is that everyone figures

the

> drug is as safe in my hands as the folks that made it. Xolair is a

> fairly large molecule, and it can be pretty fragile. It only works

if

> it is intact. One of the first things we learn in the lab working

with

> proteins is not to shake them vigorously because it can cause them

to

> break up into pieces. Bubbles are bad because the surface tension

> along the outside of the bubble can pull the proteins apart as well,

> so we avoid causing bubbles.

>

> In mixing my doses, I add the sterile water slowly so as not to

cause

> any bubbles. Rolling the vials slowly between the hands is as

> effective as swirling, but you don't want to heat the Xolair too

much.

> I have also used a " rocker " - a device that gently swirls the

vials. I

> keep watching the local university auctions for a surplus one.

>

> While it is possible you got less than a full dose of Xolair this

time

> because the nurse mishandled your medication, it is likely your dose

> was not completely ruined. The broken bits of protein, by the way,

are

> inert and pass through the system without adverse effects.

>

> I think the idea of contacting Expansions to see if you can get a

> trainer to give a demo is a good one. You should definitely complain

> to your doctor or to the nursing supervisor. This medication is too

> expensive to be in the hands of someone who treats it with such

> disregard, and someone needs to know you are not happy with the

> service you are getting. The medical profession is a service

industry

> and that nurse needs to be held accountable for her treatment of you

> and your medication.

>

[Guest guest]

The other point to be aware of when self-injecting (and nurses should

think about too) is taking the completely mixed Xolair out of the

bottle into the syringe. If one tips the bottle too fast or

withdraws into the syringe too fast that can also cause bubbles - I

can remember it happening once or twice although there weren't many.

Once the fluid is in the syringe it should be tipped or moved about

very slowly too in ordered to avoid bubbles. I quickly learned to

make that part of the procedure part of the " slow motion " process

too. It's worth it!

> >

> >

> > I am a biochemist and I work with proteins and antibodies. One of

> the

> > reasons I am still allowed to self inject is that everyone

figures

> the

> > drug is as safe in my hands as the folks that made it. Xolair is a

> > fairly large molecule, and it can be pretty fragile. It only

works

> if

> > it is intact. One of the first things we learn in the lab working

> with

> > proteins is not to shake them vigorously because it can cause

them

> to

> > break up into pieces. Bubbles are bad because the surface tension

> > along the outside of the bubble can pull the proteins apart as

well,

> > so we avoid causing bubbles.

> >

> > In mixing my doses, I add the sterile water slowly so as not to

> cause

> > any bubbles. Rolling the vials slowly between the hands is as

> > effective as swirling, but you don't want to heat the Xolair too

> much.

> > I have also used a " rocker " - a device that gently swirls the

> vials. I

> > keep watching the local university auctions for a surplus one.

> >

> > While it is possible you got less than a full dose of Xolair this

> time

> > because the nurse mishandled your medication, it is likely your

dose

> > was not completely ruined. The broken bits of protein, by the

way,

> are

> > inert and pass through the system without adverse effects.

> >

> > I think the idea of contacting Expansions to see if you can get a

> > trainer to give a demo is a good one. You should definitely

complain

> > to your doctor or to the nursing supervisor. This medication is

too

> > expensive to be in the hands of someone who treats it with such

> > disregard, and someone needs to know you are not happy with the

> > service you are getting. The medical profession is a service

> industry

> > and that nurse needs to be held accountable for her treatment of

you

> > and your medication.

> >

>