Harm Reduction IV complication. Warning signs to stop during injection. Question about specific scenario.

[DopaminePrincess93]

I was wondering what are some not so common signs that means i should stop pushing on the plunger and remove the point.
I attempted to iv a .27 shot of meth mixed with about 30 units of water. Shot was around 45 units. I tied off went for my median cubital because my cephalic has valve problems and scarring that causes it to hit slow and thick shots cause it to block. This is my second time using the median cubital on this arm. The first time was months ago and something similar happened.
I got a flashback in the rig positoned my needle and steadied my rig/hand securely, released my tie and registered. At first the shot was going smoothly about halfway through there was a slight preszure change, pulled back a couple units, blood plumed in but it was slightly darker than before. Once I was 3/4ths in a more severe pressure change. Reregistered and pulled back a plume of extremely dark blood. I pushed in a few more units then I decided to abort.
About 15 seconds later my skin wasnt swollen like a miss but had a red tint over a 5 inch circle starting about one and a half maybe two inches up from the iv site.
My guess is my vein blocked somewhere upstream where there must br scarring.

So I'm guessing pressure change with a darker reregister means you may want to abort the iv.

Anyone have any insight or other idea of what happened?

Anyone have other signs that scream abort shot that aren't commonly talked about?

 

[Sertürner]

It sounds like you infiltrated your vein. It could have been due to the angle that you had the needle in relation to the vein, as well as how hard you were pressing on the barrel. The really dark blood is of course a sign that you are in the vein, but I see this all the time at work, good flash back only to see a golf ball of blood swelling up around the vein.

What angle was the needle at? And was it parallel to the vein? How hydrated were you, really dark blood is a sign of dehydration, and dehydration can cause weak vein walls that can rupture from the injection.

 

[Jekyl Anhydride]

^ This sounds spot on, as most of Sir Deeds posts are.

The only thing I'd add is after the flash when hand position changes to pressure on the plunger from suction to produce the flash, it's easy to change the needle position, even ever so slightly.

This along with slight, unintended shaking or movement can be all it takes to infiltrate a shot that was positioned correctly, but may have been very close to the far wall of the vessel. when the flash was made.

 

[Sertürner]

The only thing I'd add is after the flash when hand position changes to pressure on the plunger from suction to produce the flash, it's easy to change the needle position, even ever so slightly.

This along with slight, unintended shaking or movement can be all it takes to infiltrate a shot that was positioned correctly, but may have been very close to the far wall of the vessel. when the flash was made.

^ Very true. Weak veins tend to fail when switched from negative pressure (registering) to positive pressure (injecting solution). Both of these cause a significant difference in vein pressure, with the suction causing up to -150mmHG and injecting increasing venous pressure up to 250mmHG and higher. Combined with the uncontrolled shaking, it would be very easy to shoot the solution straight through the vein if it was close to the top or bottom walls, or if you press hard enough the entire area will swell and rupture.

 

[DopaminePrincess93]

Thanks! I find the information about the pressure change involved in registering. That very well could have been an issue i've had in the past.
One major concern is when this happens. I feel not only no rush but practically no high from the shot at all that is noticable. This leads me to a couple questions.
If the point ends up buried in scar tissue after the vein constricts from irritation from the solution or the vasoconstriction effects of the stimulant. Would this cause the vein to rupture or the shot to miss?

There have been times I have shot into the cephalic vein halfway down my lower arm. After a bit I notice an itchy sensation and a patchy red blotch around my cephalic that in the past took some abuse. Any thoughts on this?

Would it be possible for a concentrated shot of meth to irritate veins and cause them to become inflamed to the point where blood flow is highly impacted resulting in a blown vein or the solution to leak back out the iv site?
On one occasion of this happening I saw clear liquid drip out of my IV site after slowly removing the point. Also in the first occurrence of this I aborted after reregistering successfully out of concern.

From the moment I begin pushing down on the plunger I don't notice any signs of a miss until approximately 25 to 30 seconds after. The sign I miss when this occurs is a slight tightness over a much larger area than a direct miss and then a slight burning that gradually gets more severe but doesn't get as intense as a direct miss of only 1 or 2 units.
I'm trying to narrow down the causes of this occurrence and learn what I could be very possibly overlooking or doing incorrectly so I can assess the functionality of my veins and their condition to the best of my ability. I believe I have a few places where my vein collapsed in one area for a period of time or is permanently closed off because in the sunlight I can see what I'm pretty sure are testicular veins blue in color and spider veins that appear red or purple.
All help is appreciated. Thank all of you.

 

[Sertürner]

If you are not feeling a rush then you are either not doing enough (which I'm sure you are because even small amounts of MethAmp IVd will cause a small rush and definite stimulation) or you are missing your shot. The redness is from irritation of the vein, and meth is very caustic and will erode the walls. If you have been using the same vein over and over, the meth will eat away at the vein and you will have a leakage from the vein into your subcutaneous tissue. This may be the reason that the irritation isnt presenting right away as well, a slow leak might take a while before the reaction becomes noticable. But I can guarantee you that if you are having redness/irritation 30min or so after your shot, your vein is allowing fluid to escape from the second you inject. Switch veins would be my advice.
Almost every single vein i have (had) is gone so I can give you a little timeline of how they became permanently blocked. A few misses are not going to deately your veins, but missing or using caustic substances continuously will damage the vein. The damage will set in motion a process of healing the vein which will cause scar tissue to form. Using the scarred vein over and over will inflame the vein and make it become very hard and cord-like, this hard swollen state is phlebitis. Blood flow will be slowed in the vein with phlebitis because the inside of it will have narrowed significantly, and blood will be redirected to other veins. If you still continue to use the vein, more scar tissue will form until it is almost completely blocked, a state known a sclerosis. A sclerosed vein is a hard bumpy vein that feels like a rock; it will hurt to shove the needle in and the blood flow is very dark and thick because the blood inside of it is clotting because it is trying to heal as best it can. Continued injections in a severely sclerosed vein will result in complete blockage and all blood will be redirected to other veins. Most of the tissue in and around the vein will be swollen by this point and you might not even feel the vein anymore from the inflammation around it. As the missed injections scar the surrounding tissue as well and ultimately the vein will cease to exist from lack of flow. New tiny veins will have formed (too small to see in my case) to allow the blood flow to continue. You could try and try again to find the vein but it wont ever pop up, because the body has gotten rid of it. How it gets rid of it though, I'm not sure, I have seen my veins via ultra sound and the ones that have dissapeared are still there but they are completely flat and blocked. They collapse in on themselves like a flattened straw.

 

[DopaminePrincess93]

If you are not feeling a rush then you are either not doing enough (which I'm sure you are because even small amounts of MethAmp IVd will cause a small rush and definite stimulation) or you are missing your shot. The redness is from irritation of the vein, and meth is very caustic and will erode the walls. If you have been using the same vein over and over, the meth will eat away at the vein and you will have a leakage from the vein into your subcutaneous tissue. This may be the reason that the irritation isnt presenting right away as well, a slow leak might take a while before the reaction becomes noticable. But I can guarantee you that if you are having redness/irritation 30min or so after your shot, your vein is allowing fluid to escape from the second you inject. Switch veins would be my advice.
Almost every single vein i have (had) is gone so I can give you a little timeline of how they became permanently blocked. A few misses are not going to deately your veins, but missing or using caustic substances continuously will damage the vein. The damage will set in motion a process of healing the vein which will cause scar tissue to form. Using the scarred vein over and over will inflame the vein and make it become very hard and cord-like, this hard swollen state is phlebitis. Blood flow will be slowed in the vein with phlebitis because the inside of it will have narrowed significantly, and blood will be redirected to other veins. If you still continue to use the vein, more scar tissue will form until it is almost completely blocked, a state known a sclerosis. A sclerosed vein is a hard bumpy vein that feels like a rock; it will hurt to shove the needle in and the blood flow is very dark and thick because the blood inside of it is clotting because it is trying to heal as best it can. Continued injections in a severely sclerosed vein will result in complete blockage and all blood will be redirected to other veins. Most of the tissue in and around the vein will be swollen by this point and you might not even feel the vein anymore from the inflammation around it. As the missed injections scar the surrounding tissue as well and ultimately the vein will cease to exist from lack of flow. New tiny veins will have formed (too small to see in my case) to allow the blood flow to continue. You could try and try again to find the vein but it wont ever pop up, because the body has gotten rid of it. How it gets rid of it though, I'm not sure, I have seen my veins via ultra sound and the ones that have dissapeared are still there but they are completely flat and blocked. They collapse in on themselves like a flattened straw.

Thank you for the timeline. I've studied a good bit on the subject but the way you put it gives me a much better understanding. It seems I have definitely been shooting into sclerosed areas of my cephalic vein in the, you guessed it, cubical fossa ofcourse.
I have small veins that always require a tourniquet to hit anywhere outside of my crook and even a vein or two in my crook requires a tie most of the time. I recently put into practice vein raising techniques and also acquired several types of proper tourniquets as well as how to properly use them. I am almost certain if I release the tie before I administer I will lose the vein but I shooting before releasing makes me cringe...

Would a slow release tourniquet help prevent me from losing the vein? Also I assume once the vein is infiltrated I should attempt to get the needle at an extremely shallow angle, almost parallel to the vein, and then proceed to slide the point up the vein for stability and to help me stay true once I release my tie?
If you have any tips on that process I'm all ears, if I am mistaken in any way please correct me.

And my sclerosed cephalic vein areas....

A few hours ago I shot a very small, less than .1g of meth mixed with 20 units of water into my upset cephalic vein about 2 and 1/2inches above the problem area. I slowly administered and released my tie. Slight rush, more than .25 to .35 shot near the sclerosed portion.
All that being well and good.
Should I lay off injecting above the sclerosed area on my cephalic until a few months have gone by so it atleast has a bit of a chance to heal and hopefully increase the flow in my cephalic?
Also I thought "leaky veins" had to do with valves being severely damaged or destroyed and the blood flow isn't all in the same direction and even like normal? Sort of swirling around and gushing up and down the vein on it's way to the heart?

Below I'm attaching a pic of my arms current state so maybe you can have a better idea of the shape they are in regarding misses phlebitis/sclerosis from what's superficial at least.

I feel in my heart I need to lay off my arms period for a good while but it would help me to hear your opinion since you are quite knowledgeable on IV use and HR.

I apologize for the long posts but this is the first time in months of searching forums and HR information all over the web as well as asking the folks at my local clinic/needle exchange where I've heard anyone say anything about my IV complications that truly makes sense and seems to fit quite well into the puzzle piece. Very interested in what exactly a leaking vein is physiologically. Is it a thinned and corroded vein wall where the solution escapes via something similar to osmosis?
So far your knowledge has been a blessing as it's started to answer a 3 or 4 month year old nagging question.

 

[Sertürner]

If you are pretty careful while releasing the tourniquet then you shouldn't have too much of an issue with the needle slipping out of the vein, but this is much easier said than done of course. I personally wouldn't recommend starting the injection until the tourniquet is completely removed or else you are still increasing pressure in the vein. If you are only feeling a slight rush after a .25g+ injection and getting irritation then switch veins completely. It is always better to go ABOVE the miss or hard sections of vein because of the direction of blood flow, but using a different arm or vein will be much better on your body.
You wont really have to worry about damaged valves causing too many issues unless you are repeatedly injecting into them, and most valves that you have to worry about are at intersections at major veins, which I hope you not injecting into. Never inject at a vein junction, this is where blood flow will alter its course and repeated injections will cause damage and increase the likelihood of infiltration.
Your arm has a pretty good miss on it, maybe 2 if I'm seeing it correctly. Allow that arm to heal up before using it again. Switch to the other one for a bit and use hot compresses on the misses until they are gone. It doesnt look bad on the surface which is good, but beneath the skin the whole area is bound to be inflamed and blood flow is probably restricted across the whole anticubital area.