This won't hurt a bit - yeah, right...

Ouch. I had my flu shot yesterday. Our pediatrician offers them to the families, including adults. This is good for us considering only one of the family is still under 18 and under his care. It’s always hard to tell if the injection will leave a sore arm or not. Some years, I barely feel it, other years, it’s like I got a – well – a needle stabbed into my arm.

When I had the series of 3 injections (spread over a few months) for the hepatitis vaccine they give healthcare workers, I barely felt the first one, the second one hurt like the dickens, and the third was felt, but it wasn’t terrible. The same person gave all three injections.

When I gave my first injection to a patient, it was to a mentally handicapped girl at the Children’s hospital, where I was doing my pediatric rotation. The way my instructor watched me made me even more nervous than I already was and I had a really hard time doing it. I am sure I wasn’t too delicate and it’s funny, all these years later, I still feel badly about it; it must have hurt.

So, why is it that some injections hurt and some you barely feel? It’s a combination of technique, experience, the type of injection, and the serum being injected.

There are three types of injections, two of which most of us come across. The subcutaneous (s/c) injection is one that goes just under the skin. When the medication is injected into this tissue, it has a slower release into the body than if it is given directly into the muscle. The most common medication given this way is insulin. The needle used is very tiny and short. S/C injections are usually given in the upper arm, but can be also given in the abdomen (heparin is usually given this way), and the thigh. Usually, you should pinch the skin to make a bit of a tent and inject the medication into the skin, usually, at a 90 degree angle. This reduces the chances of the needle reaching the muscle. Because the needle is so thin and doesn’t reach the muscle, the injections are usually rather painless.

The other injection that most people are familiar with is the intramuscular (IM) injection. Those are the ones with the longer needles that go directly into the muscle, such as the vaccines and antibiotics, for example. These are most commonly given in the buttock if it’s a pain killer or antibiotic, the outer upper quarter in order to avoid hitting a nerve. For vaccines, it’s usually given in upper arm. For babies, it’s usually given in the thigh. Unlike S/C injections, the skin remains flat. The needle also goes in at a 90 degree angle.

Intravenous (IV) medications, medication injected directly into the vein, are usually only given as part of an IV infusion of fluids, although they can be given directly, usually in an emergency situation. Medications given by IV act very quickly.

Some medications don't sting or burn, while others can be painful. The tetanus vaccine, for example, is known for being uncomfortable. Some antibiotics can be painful too.

Very few people like getting injections, but they are a necessary part of life these days. But, with the on-going research, one day, they may not be standard any more. Wouldn’t that be nice?

Today's News:

Walking prevents bone loss caused from prostate cancer treatment
Cancer Patients not getting live-saving flu and pneumonia shots
Women with breast cancer have less dermatitis when treated with IMRT
Smoking does not lead to more aggressive or advanced breast cancers
New study shows smoking increases risk of psoriasis

Childhood diseases making a comeback

Measles, mumps, German measles and chicken pox: all are childhood diseases that may seem to be benign, but that’s only because we haven’t really seen them – and their effects – for a long time.

When the vaccines for mumps, measles and German measles (rubella) first came out, the medical community had to convince the general population that it was safe and beneficial to have children vaccinated against these diseases. As time went on, it became standard and people just did it. Unfortunately, that became a bit of our problem because since so many children were vaccinated, the number of these cases dropped drastically. With the drastic drop, there’s a whole generation of people who had no idea what it was like to have these diseases and there was a whole generation of people who didn’t know anyone who died or suffered severe disability because of them. Many parents began to choose not to vaccinate.

Add to that the onset of autism and the fear of a link between the vaccines and autism, now we have kids who are open to developing these diseases not just as children, but as they grow into adulthood.

Childhood diseases are not benign. According to the Centers for Disease Control and Prevention, in an article from the mid 1990s, (Measles) one in 10 children who get the measles get ear infections, as many as one in 20 develop pneumonia and about 1 in every 1000 children develop encephalitis, an inflammation of the brain. People who get encephalitis can have seizures, deafness or mental handicaps. Encephalitis can also cause death.

If a child is infected with mumps, about one out of every 10 develops meningitis (German Measles). While the children may not have the severe effects that measles and mumps can have, if a pregnant woman is exposed to German measles during the first trimester, there is a chance of miscarriage and as high as an 80% chance that the baby will be born either deaf or blind. They could also have other abnormalities with their heart or brain, and there could be brain damage.

Chicken pox is the most recent childhood disease to have a vaccine made available. This is particularly important because anyone who has had chicken pox can develop a painful condition later on in life called shingles, or herpes zoster. Having had shingles myself, I can assure you, it is no picnic.

While most children who get chicken pox come through relatively unscathed, save for some scars on the face or elsewhere, there are some who get significantly sicker. Although rare, encephalitis can occur, as can Reye’s syndrome and myocarditis, an inflammation of the heart muscles, pneumonia and even arthritis. Children with low immune defences can become quite ill, even die, if they get the chicken pox. Mothers who catch chicken pox while pregnant can deliver babies with congenital infection, meaning babies born with infection.

People who have shingles later on in life can develop a very painful condition called post-herpetic neuralgia. Seniors and people who are immunocompromised are most at risk of developing shingles. People who are vaccinated against chicken pox will not have the virus in their system and cannot develop shingles later on in life.

And now, in 2007, mumps is making the rounds in universities. A recent outbreak in a university in Canada has begun to spread as the students are making their way home for the summer. You can read this Globe and Mail article to learn more: Mumps outbreak moves from the Maritimes to Ontario.

News for today:
Skin Patch Approved for Early Parkinson's
Higher Dose of Clot-Buster Is Better Before Artery Procedure
Daily Aspirin May Prevent Bowel Cancer New Study