Thursday, April 30, 2009

Panic in Needle Park

Well, it's been an exciting six days. Last Saturday, I began injecting a veritable cocktail of stimulation meds.

Possible cocktail names: A Stimulator? A Feisty Follicle? A Purple Bruise? A Hormone-tini?


1. Gonal-F pen. This one seemed a tad complex in the instructional videos, but is actually quite user-friendly. It's chunky and pen-shaped, and lives in the fridge. Each day, I pop a small needle tip on the end, turn the dial at the bottom of the pen so that a black arrow points to my required dosage, pull out the stopper and inject. The needles are pretty small and comfortable enough - the only odd bit comes when you've got one hand holding up a chunk of your skin and the other holding the pen; then you realize that you need to slide your hand up the pen (whatever the opposite of 'choking up' would be), to give yourself enough leverage to push the little stopper back in with a finger. It doesn't glide as smoothly as a syringe would, but all in all, no major complaints. 

2. Lupron, still, but now half as much. Same old.

3. Menopur. Jeepers. This one involves mixing, which introduces all kinds of chances for human error. First, you draw up a clear liquid diluent into a syringe, then you shoot that into a vial of white powder. You swirl the vial around a bit until the powder is totally dissolved into the clear liquid. Then, you put that in a spoon and heat it over a flame in your dark, seedy den of iniquity... MWAHAHA. Okay, no. Not really. 

When the powder is completely dissolved, you pull the solution back up into the syringe, switch to a smaller needle, and inject. The awkward part of it all is that they gave me a Q-cap, which pops over the tops of the vials and on the ends of the syringes, and which is meant to facilitate all the mixing and blending, without the use of a long mix-y needle. Somehow, though, I didn't get that from the instructions, so I popped a Q-cap over one vial, then stuck a needle into the Q-cap, and couldn't figure out why I couldn't use the needle to pull liquid through the plastic cap. As I said: USER ERROR. I have now, fortunately, mastered the use of the Q-cap, but still struggle a bit with these syringes, which seem specifically designed to collect giant air bubbles, then wiggle free from my fingers and shoot expensive liquid on my kitchen counter. 

Sidebar: this stuff is apparently made from the urine of post-menopausal women. I'm quite sure I could have obtained some of that on my own. Sadly, I bet I wouldn't have been able to save any money that way. 

So now: three injections, and one bad-ass hematoma to show for it. It's about the length and width of my pinky, oval-shaped, a rainbow of purple and pink, with some interesting circular shapes underneath. I don't know which needle to blame for that one. 

I have 19 follicles, which I saw on my ultrasound today, none of them up to 10mm yet. When I think about follicles, I imagine they look like tentacles, or like sea anemone fingers waving underwater. They're not nearly that cool. Seriously, they're just black spots on the ultrasound screen.
I got a small boost in my dosage amount two days ago, since my estrogen level was only at 89, instead of the desired 150. Today, though, it's at 300, so we're holding steady at current doses and seeing if those follicles get bigger by Saturday. I'm waiting for the steadily rising estrogen levels to make me suddenly freak the freak out and want to watch Hallmark commercials or "The Hills." Fortunately, I've felt pretty good so far. On the night I started these meds, I had a migraine and a bit of nausea, but that condition hasn't been repeated since then. 

One small complaint - I don't really know if my number of follicles is "normal" or something that I should feel good or hopeful about. As it was explained to me, they still needed time to fully mature before anything more could be done. They didn't really say how many they were hoping to see, or how many the average patient had, or how big they should be. The doctor implied that things looked promising, and the nurse told me "let's stay positive and see how things look on Saturday." What I wanted to say was that I was positive I wanted to know what was happening inside me. But I didn't. 

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