Twinject

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Hi everyone, I was at the allergy dr yesterday for monthly allergy shots for DS. We saw the dr b/c DS had a rash on his arm that I wanted to confirm was eczema.

Anyway, the doctor reviewed meds, how everything was going and asked me about EPI pen expiration. I looked and it was 8/07, but the two at school will expire on 12/06, so I'll need to refill in a couple of months.

He gave me a quick twin-ject demonstration and trainer. Told me to become familiar with it because that is what he will be prescribing from now on.

It is confusing and complicated in my opinion. I told him it looked confusing. He said, no it's virtually the same as epi pen. He likes the twin ject because of three things....the expiration dates are apparently longer, the fact that there are two doses and that there is a detailed instruction thing that rolls up inside the case and is attached to the pen.

I don't like that I will have to re train everyone, family friends etc on this new pen, plus I'll probably have to give up the two I have when the ones at school expire and carry the twin ject. UGH. I would prefer to carry my two epi pens and call it a day.

basically, you take it out of the hard case, remove a green cap that is the end with the needle, remove the red cap which would be like the grey cap on epi pen. then it says to press down on the thigh and it will auto inject. Then, it says to get ready for the second dose, you unscrew the end with the needle, the syringe comes out, you remove a yellow tab and push the end which is a syringe and stick the person with the needle. I have the trainer apart on my desk right now and there are two parts for the case, two caps, the grey part with a spring, a syringe. Anyone else try it or see the trainer?

[This message has been edited by saknjmom (edited October 17, 2006).]

On Oct 17, 2006

That sounds like a pain in the neck. And reading instructions when a kid is possibly wheezing and unable to breathe seems difficult... training should come before ever using one. Epipen has an instruction on it too, doesn't it? (We still have our new ones in the protective greenish case and need to take them out to look them over).

Can you ask him to please keep you on the epipens because those you've trained feel most comfortable with those?

If he really resists I'd consider going to my pediatrician or family doctor and asking for the other as a prescription.

Amy

On Oct 17, 2006

My school nurse showed me the trainer after she went to a presentation. While showing it to me, even she got confused. This is nothing that I am interested in.

I would make it clear to him that you are not willing to re-train and take the chance of confusion in a life threatening situation. If he still refuses, I would just say "I'm sorry, then we will have to go to a different doctor." This is something you need to be comfortable with, and he should be flexible based on that.

On Oct 17, 2006

just a quick note --- many schools (nurses/teachers etc) are not allowing the Twinject b/c of the syringe second dose, or, won't give the second dose. There was discussion of this on another thread.

Honestly for myself --- I'll carry a Twinject and a regular epi as my "3 doses that go everywhere" and save the syringe til last. I mean geez...if I am alone there is no way that I'd be able to give the syringe if I'm still reacting and having trouble (and shaking hands from the first dose!)

Adrienne

------------------ 30-something survivor of severe peanut/tree nut allergy

On Oct 17, 2006

I think that if I really resisted, he might give in, he is a wonderful doctor. I think that he really believes this is a better alternative because he was so matter o fact and so here, start learning it, this is what you'll be using.

I usually roll with the punches and accept change in life. BUT, with this, I don't want a change. I just want my normal epi pens in my normal case, with one step...remove grey cap, swing and jab. Not, pull off the red cap, pull of the green cap, take the whole thing apart and get ready to manually inject a second shot.

I think that once i tried it a couple of times, I could get the hang of it. The thing that worries me is that there are more steps to this than the epi pen. The epi pen is very clear cut....would be difficult to screw it up. (i have heard of people thinking the needle was at the end with grey cap), but it is much more simplistic and easy to demonstrate to people who care for my son. I know that the school uses the faan form for epi pen, there are new forms for school on the site that have directions for twin ject.

On Oct 17, 2006

I got the Twinject trainer and the training DVD a few months ago and I thought it was really hard to use. I think in an emergency things need to be as simple as possible, both for you and the teachers. After practicing with a regular epi trainer, I`m sure I would know how to use it six months later in an emergency. A Twinject, six months from now I won`t remember how to use it.

On Oct 17, 2006

I'm sticking with the epi because that's what our insurance will pay for. If/when the insurance decides to cover only the twinject I will switch to it.

If both were covered, I would carry the twinject myself, but I would have the epi-pen at school.

********

My son's school will use either the twinject or the epi-pen -- but only the first shot of the twinject. They still want a second auto-injector in the office in case the student forgets to bring it one day. (I can't imagine them needing to give a second shot because the ambulance should be there by then, but if a second shot is required they would only give an auto-injector, not the second shot of twinject.)

On Oct 17, 2006

When my own epipen needs to renewed I will carry the twinjet for my allergies, but DS will have the epipen at school and for himself. I am tired of having so many epipens floating around in my bag.

Ali [img]http://uumor.pair.com/nutalle2/peanutallergy/cool.gif[/img]

On Oct 18, 2006

Quote:

Originally posted by Carefulmom: [b]I got the Twinject trainer and the training DVD a few months ago and I thought it was really hard to use. I think in an emergency things need to be as simple as possible, both for you and the teachers. After practicing with a regular epi trainer, I`m sure I would know how to use it six months later in an emergency. A Twinject, six months from now I won`t remember how to use it.[/b]

I second this, we just got a trainer last week because DS is insisting that he wants to carry one instead of epi-pen when he goes to HS. I looked it over and couldn't believe how complicated it was. So I told DS to read all the instructions and if he could train me how to use it we would think about it for HS.

After about 1/2 hour he said, I don't think I want one it's too hard. He just liked the idea of the case that they come in, it looks like a big writing pen. He wants to stop wearing his epi-belt, but that is a discussion for another topic.

On Oct 18, 2006

Just use the first dose only. Just take off the caps and inject like epipen. You are not required to use the second dose. Twinjects come in a two pack like epipens. You can just carry two twinjects instead of two epipens. It doesn't seem that different to me. I have some.

Cathy

------------------ Mom to 7 yr old PA/TNA daughter and 3 1/2 yr old son who is allergic to eggs.

On Oct 18, 2006

But if only the first dose is used, then there is no point in having a Twinject. May as well just keep on using the Epipen.

On Oct 18, 2006

For some people, Twinject is cheaper than Epipen because of their insurance.

Cathy

On Oct 18, 2006

I don't find it all that difficult. I got the demonstrator because if/when my insurance decides that's what they're paying for I wanted to be prepared. I didn't find it difficult.

I showed it to my adult son who also seemed to figure it out easily. He teaches first/aid CPR and borrows my epi trainer. Now he also borrows my demonstrator so that people are taught how to use both.

On Oct 19, 2006

I have been playing around with it and once you get the hang of it, it is not hard. Remove red cap, remove green cap, auto inject. I guess I am more concerned about the fact that I initially found it to be confusing makes me worried that others will too. The epi pen was so straightforward, remove grey cap swing and jab into thigh. I could get the second dose ready, but again there could be some confusion for someone who hasn't really studied this twinject thing. Now it's remove red, remove green, the needle end is grey, push into the thigh for auto inject. I don't want people to not want to have DS for playdate or feel intimidated because they are afraid or this thing is too complicated. KWIM?

On Oct 19, 2006

Just for the record, the correct order to remove the caps is green then red. They actually have numbers on them to remind you which one goes first. The green cap is just a cover for the business end of the autoinjector. The red cap corresponds to the grey safety cap on an epipen.

So to use a Twinject:

1. Remove green (#1) cap. 2. Remove red (#2) cap (same as grey cap on Epipen) 3. Inject into thigh (same as Epipen) 4. Hold in place 10 sec. (same as Epipen)

[url="http://www.twinject.com/patient/howuse.asp"]http://www.twinject.com/patient/howuse.asp[/url]

Cathy

[This message has been edited by Momcat (edited October 19, 2006).]

On Oct 19, 2006

I was part of the focus group for Twinject. I actually almost felt badly for the presenters because the people in the audience were very VOCAL about thier dislike of their product. It was overwhelming the amount of people who did not care for the Twinjet. It was interesting.

On Oct 19, 2006

I think the bottom line is that the Twinject is harder to use than an Epipen. Yes, there are people on this board who could learn it today and remember it six months from now when their child has an ana reaction. But will the teachers/caretakers remember it six months from now? I think that is really the key issue. I don`t think most of them would.

On Oct 19, 2006

Even though the Twinject has more steps in it's use...I still like having one in my arsenal. Why? Because I like having an actual syringe of medication that does not rely on a plastic auto-injector. Things can jam and break.

I do though, carry 2 regular Epipens and my Twinject is my last resort spare. I like having the syringe in a dire emergency.

Adrienne

------------------ 30-something survivor of severe peanut/tree nut allergy

On Oct 20, 2006

It is interesting what you said about the syringe. The more I was playing around with this twinject, the more I wondered if the little yellow clip was reliable enough to stay put when giving the first injection. I guess it is a stopper so two equal doses are used. I didn't think about the fact that if the twinject didn't work for some reason, it can be disassembled and used just as a syringe. Good point.

On Oct 20, 2006

Here is a video demonstration on how to use the twinject:

[url="http://www.youtube.com/watch?v=1hLuyvzvqVQ&mode=related&search="]http://www.youtube.com/watch?v=1hLuyvzvqVQ&mode=related&search=[/url]

On Oct 20, 2006

Here's another video from Twinject Canada.

[url="http://www.twinject.ca/en/stepbystep.php?video=sbs"]http://www.twinject.ca/en/stepbystep.php?video=sbs[/url]

Cathy

On Oct 20, 2006

Quote:

Originally posted by saknjmom: [b]It is interesting what you said about the syringe. The more I was playing around with this twinject, the more I wondered if the little yellow clip was reliable enough to stay put when giving the first injection. I guess it is a stopper so two equal doses are used. I didn't think about the fact that if the twinject didn't work for some reason, it can be disassembled and used just as a syringe. Good point. [/b]

well - that's what I hope/think you can do. I haven't tried to unscrew the grey cap if the autoinjector didn't work to shoot out the first needle...can't do that with a trainer!

so - I would assume you can still unscrew the cap to get at the syringe. Maybe I'll write and ask them.

Adrienne

------------------ 30-something survivor of severe peanut/tree nut allergy

On Oct 20, 2006

Quote:

Originally posted by ajgauthier: [b] well - that's what I hope/think you can do. I haven't tried to unscrew the grey cap if the autoinjector didn't work to shoot out the first needle...can't do that with a trainer!

so - I would assume you can still unscrew the cap to get at the syringe. Maybe I'll write and ask them.

Adrienne

[/b]

ok - just called and the woman didn't know (got put through to a medical pharmacist). So she is going to research and then call me back. Pretty much, they can figure it out if they try it with a pen...just try to unscrew the grey cap if the first shot doesn't fire...and be careful doing do...but I didn't want to waste my pen to find out.

So -- I'll post again when I find out.

Adrienne

------------------ 30-something survivor of severe peanut/tree nut allergy

On Oct 20, 2006

ok - got the info...

If the auto-injector DOES NOT FIRE (even after repeated tries), then you CANNOT take the grey cap off. The pen needs to fire in order to get at the syringe. It's a safety lock on the syringe part...if you could unscrew it normally, huge safety issue.

Darn. Understandable, but darn.

Adrienne

On Dec 5, 2006

reraising

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