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unbearable zoladex injection

User
Posted 06 Aug 2015 at 10:28

hi,dont post much but read a lot anyway yesterday i had my 3monthly zoladex jab prior ones i had no problem with same nurse,but yesterday new nurse she did not numb the area with spray ,when she injected i had the most unbearable pain people in waiting room heard me scream nearly passed out,i could not even get up off the couch for a while,honest i am not exagerating if i knew that would happen again i would refuse to have it,still a bit painful now even when i cough,nurse kept apologising these days it is hard to see your normal gp or nurse different people nearly every time i go too much pressure these days on nhs.anyone else have same experience.

User
Posted 06 Aug 2015 at 18:59

thanks even if it has not injected properly surely it still be doing its job.

User
Posted 06 Aug 2015 at 20:38

For it to slowly release it needs to be under the skin. With the pain you describe did the nurse go far deeper? However even if so the nurse could have pulled back before ejecting pellet so hope all is ok. I would seek GP reassurance but that's up to you.

Ray

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User
Posted 06 Aug 2015 at 11:40

Hi Radar

I am sure you are not the first person to be caught unawares by a difficult Zoladex injection.

Zoladex is a pellet injection unlike Prostap and some other HT injections which are fluid injections, that is, much like what you expect when you have an injection. Giving an injection is what some nurses do everyday.  A Zoladex pellet injection is different and this injection should only be given by nurses who are trained to do this. GPs are trained in this. Perhaps the nurse who gave you your last Zoladex injection was not trained to do so. 

There are two ways out of this. First tell your GP what happened and ask who is trained to do this and make an appointment with that nurse in future. Second. ask your hospital medical team if you can change to Prostap which does the same job. There is not much difference in the cost of these two injections. I have had both Zoladex and Prostap injections over the years  and for me the choice is simple - have Prostap. 

Even if you are given the Zoladex injection by a nurse who is trained to do this there may still be an issue with discomfort or pain,  or the pellet may not be injected properly.

I hope this is helpful. 

Alan

Edited by member 06 Aug 2015 at 20:59  | Reason: Not specified

User
Posted 06 Aug 2015 at 13:48

Radar

From own experiences it's all down to the experience of those who administer it. Had 2 at hospital, no spray etc, whilst talking in out hardly felt it.
At surgery the nurse used to insist we applied a cream under a plaster with a clear opening for 30 mins beforehand. Only had one issue of note with a new nurse. My concern is if it hurt that much is the pellet in the right place?

Take note of Alan's comments on what to do.

Ray

User
Posted 06 Aug 2015 at 18:59

thanks even if it has not injected properly surely it still be doing its job.

User
Posted 06 Aug 2015 at 20:38

For it to slowly release it needs to be under the skin. With the pain you describe did the nurse go far deeper? However even if so the nurse could have pulled back before ejecting pellet so hope all is ok. I would seek GP reassurance but that's up to you.

Ray

User
Posted 06 Aug 2015 at 21:10

int it strange how we all react with same treatment, me and prostap dont go togeather, yet zoladex have not had any discomfort from the injections

nidge

run long and prosper

'pooh how do you spell love'

'piglet you dont spell love -you just feel it'

User
Posted 06 Aug 2015 at 21:20

I second what Ray just said

Barry

User
Posted 06 Aug 2015 at 22:29

I had my third zoladex implant on Monday and never felt a thing, the nurse was the same as my last one and again no problem.

The first 3 monthly one hurt just a little as the needle went in but no real discomfort and the three one monthly implants were ok as well. My surgery do not use numbing creams or sprays and I not perturb by the next 18 months future ones either.

I think some people have lower thresholds of pain and also there are probably some nurses that might be a bit heavy handed.

Sorry to hear that you found them painful, I hope the next ones will be given by someone with a soft touch.

Chris/Woody

Live is seen differently upside down take another viewpoint.

User
Posted 06 Aug 2015 at 22:47
Radar

I agree with Ray too

Zoladex is a capsule or pellet designed to sit just inside the layer of subcutaneous fat under your skin but not any further. It slowly releases its contents through an absorbtion process. If it is injected too far in it might get absorbed more quickly than it should. This may not cause any actual harm in the here and now but it might affect your longer term benefit.

In any event nobody should endure a seriously painful administration, done considerately this should only be mildly uncomfortable like being pinched briefly. The only residual soreness or discomfort is usually a slight reaction to the drug rather than the procedure.

Ring your GP and get it checked out. The nurse probably feels awful for causing you that much pain and will be glad of training to ensure it does not happen again.

best wishes

xx

Mo

User
Posted 06 Aug 2015 at 22:52

Trying to remember who it was whose PSA shot up and it was put down to an incorrect administration of Zoladex. I think a check with your GP or nurse specialist would put your mind at rest.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 Aug 2015 at 08:29

thankyou will ring gp and macmillan nurse today.

User
Posted 07 Aug 2015 at 10:11

As a check GP might agree to monitor testosterone for awhile.

Ray

User
Posted 07 Aug 2015 at 10:40

gp phoned me back she apologised for suffering i had but said the injection will be okay,also spoke to my macmillan support worker and she said i will be okay,but i will be back to my normal nurse next time for which i had no problems,if i thought i would have that pain again i would refuse it thats how bad it was the best word to use would be torture i nearly passed out things went black for a moment. thankyou.

User
Posted 08 Aug 2015 at 16:38

Hopefully your bad experience is a one off never to be repeated.

I had 3 years of 3 monthly zoladex implants and did not experience any reaction other than a little redness at the site of injection.

Fingers crossed for you.

Tom

User
Posted 08 Aug 2015 at 17:14

I have had seven three monthly Zoladex injections all using freeze spray and all totally pain free.

I did have a strange incident with the one I had to get just before I went on holiday this year. The nurse put the freeze spray on the area and proceeded to inject the pellet, when she withdrew the injection the pellet came straight back out. She said she had never seen anything like it before. This resulted in a frantic phone around local chemists to see if anyone had a spare injection as I was leaving to go on holiday the next morning, most don't carry any extra as they are so expensive (£1,000 I think she said). She managed to find one chemist who only had a monthly injection so I went and collected it and it was administered without any problem. I went and got my next three monthly injection the following month and that was also administered without any problem.

I have also tolerated Zoladex very well with only the occasional flush, I think my last injection will be in October as that will be the eighth and I was told I would be on it for two years.

I was diagnosed Dec 2013 (PSA 59, T2C contained), I started Zoladex Injections in Feb 2014 and had EB Radiotherapy in July/August 2014 and flew through it with no issues, my latest PSA is still less than 0.2 which Oncologist is very happy with.

Gerry.

User
Posted 08 Aug 2015 at 20:45

£1000 seems a lot to me for a Zoladex injection even allowing for inflation. I needed my final one in 2008 whilst having RT in Germany. I collected from a pharmacist there and it cost around £200.

Barry
User
Posted 09 Aug 2015 at 19:28

Barry

I also think the cost of £1,000 for a 3 month Zoladex injection does not look right. There is not a lot of difference between the cost of a 3 month injection of Prostap and Zoladex . See the link below for Prostap – bottom of page 2. The cost a couple of years ago was £75.24 for the monthly injection and £225.72 for the 3 monthly injection.

http://medisis.com/client_docs/pdf/Prostap_DCS_June_2012.pdf

I remember about 4 years ago an NHS body published costs for 3 monthly injections -. Decapeptyl was about £210, Prostap was about £225 and Zoladex was about £240.

Alan

User
Posted 09 Aug 2015 at 20:03

The current cost in the USA is $2600 per 3 month injection and it is listed for private prescription in the UK at £470. I am not sure about this but our newspaper recently ran an article about the NHS having to pay drug companies more than the individual patient would be charged for a private prescription - something about the middle men that NHS orders are placed with.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Aug 2015 at 20:07

It could conceivably be claimed that an injection costs £1000 if the hospital finance director or GP practice manager is factoring in the cost of someone ordering the capsule, appointment time taken, a qualified (& specifically trained) person to administer it and then whatever the LA charges for the removal of sharps waste?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Aug 2015 at 20:20

Barry, Alan,

I did say I thought she said it cost £1,000 for the injection. I don't have a clue about the cost, but I think Lyn might have made a good point, the nurse may have been talking about the all in cost of the injection and I have misinterpreted what she said as the cost of the injection alone.

User
Posted 09 Aug 2015 at 22:33

£65 for a 28 day Zoladex syringe quoted here in 2012 so would not expect the 12 week one to cost more than £200. (Same jab as for PCa and given in abdomen). If the NHS can escalate this to anything like £1000 allowing for a short time to order, administer and appropriately dispose of the syringe, it's another reason why the NHS is in trouble. http://www.ljf.scot.nhs.uk/SharedCareofMedicines/SCP/scp/goserelin%20%28breast%20cancer%29%20v5.pdf

Barry
 
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