I am happy to report that the PIO shots continue to go smoothly and (very nearly) painlessly. They hurt about as much as the old GonalF injections, which is to say, not much to speak of. I can honestly say I'd take the PIO shot instead of a flu shot any day! I also tend to bruise if you look at me too hard, but my backside remains unmarked.
Since this is notably unusual, I thought I would share our technique as best I can. Keep in mind, neither of us is a medical professional and your doctor may have different instructions for you. Below are the instructions our doctor gave us.
1. Warm the PIO to body temperature by tucking the vial into my bra for about 30 minutes pre-shot.
2. Swab the top of the vial and then the injection site with alcohol.
3. Using the larger needle, pull out the syringe plunger to 1cc (my dose) and insert into the vial.
4. Push plunger in completely and then draw the dose into the syringe, taking care to eliminate any bubbles.
5. Switch to the smaller (injecting) needle and push the plunger carefully until a bead of oil appears at the end of the needle.
6. I bend over the back of a chair, resting my ribcage on the chair back and my elbows on the table, putting all my weight on my left leg for a right-side injection (or my right leg for a left-side injection).
7. Prof uses one hand to pinch up the flesh in the target area and the other hand to work the syringe.
8. Needle goes in all the way, and quickly.
9. Prof maintains the "pinch" with one hand and shifts his grip on the syringe to be more stable/steady.
10. Pull back on the plunger. If blood appears in the syringe, pull the needle out and reinsert in a different spot. If the plunger resists and there is no blood, proceed with the injection (maintaining the "pinch" at all times).
11. When the full dose has been injected, remove the needle and apply pressure with a sterile gauze pad.
12. Massage gently, stroking outward from the injection site to disperse the oil.
13. Apply a band-aid (just in case). The band-aid also helps me remember which side was done last.
PSA - Never reuse needles and always dispose of them in an approved sharps container.
In discussing this with Prof, we've decided that confidence on the part of the person wielding the needle goes a long way to minimizing pain.* Don't hesitate! Get the needle all the way in quickly, in one stroke, then keep the syringe steady (no wiggling). While injecting, push the plunger in slowly and evenly. Prof takes nearly 10 seconds the push through the 1cc dose.
*If the person doing the injecting needs some practice to build their confidence, an orange makes a good target (just use water in the syringe). This will provide an opportunity to work on quick insertion and maintaining a steady hand while managing the syringe one-handed.