Fun Times avec Fragmin

Fragmin is a type of low molecular weight heparin- a blood thinner. I am on a 5000IU daily dose of it, which I inject at bedtime. While I don’t enjoy needles, I have come to accept that they are a necessary part of our baby-making plans, so I have gotten over it.

Two nights ago however, a disaster occurred, involving my hip, a syringe, and DW’s thumb. Oh, and a whole lot of blood.

So at around 10:30pm, I’m in bed, finishing up my bedtime routine of late, with my last task being my Fragmin injection. I find some fat on my hip, wipe down the area with an alcohol swab, pull off the cap over the Fragmin needle, and ease the needle into my flesh. Some people prefer to do a quick jab, but I just can’t bring myself to do that and fare better with the slow constant pressure approach.

I get the needle all the way in, and slowly inject the Fragmin because if I push too fast, it burns. When I’m done, I push on the plunger a little harder, as there is a spring mechanism that quickly withdraws the needle from the site and then encases it in some protective wall. It is very fancy for an injectable medication.

But the spring mechanism doesn’t engage, which is no big deal, but means that I need to manually pull out the needle, which is of a thick gauge, and seems to be stuck in my flesh. Actually, I have been finding this recently with the Fragmin- that the thick needle is difficult to penetrate my skin, and also difficult to pull out of my flesh.

With the needle feeling stuck, I take a deep breath, brace myself, and pull a little harder.

Finally, it comes out. I am relieved, until I notice a continuous parabolic stream of bright red blood spraying out of my hip, onto our bedsheet 4 inches away. I am frantic and call out to DW, who is conveniently laying about 3 inches from the spray. Calm and unphased, and totally nonchalantly, she plugs the spraying hole in my hip with her thumb, her other hand still holding her phone, reading the news.

The needle demonstrating its protective spring mechanism- after all the action.

For about 15 minutes, her thumb kept constant pressure on the spot until it finally stopped leaking.

Her thumb, and the spray spot.

Then she found some cotton pads and medical tape, and patched me up real nice:

Ooppps! My bad. I must have hit a vein.

FET#4: Protocol

There are a lot of meds involved in our FET this round, and I thought that I’d like to document it, both for myself, but also to help anyone else who is also going through this. The days refer to cycle day, and non-medical supplementation is in brackets (Chinese Medicine herbs).

Days 3-16: Estrace 6mg daily

Days 3+: ASA 81mg daily

Day 13: Intralipids

Day 17+:
7:30am: Prednisone 10mg, Estrace 2mg, Pink PregVit, 100mg Endometrin, (1000IU Vitamin D, Yuan Support Formula- 4 tablets)
3:30pm: Endometrin 100mg, (Yuan Support Formula)
Dinner time: ASA 81mg, Blue PregVit Folic 5
11:30pm: 5000IU Fragmin, 2mg Estrace, 300mg Prometrium, 100mg Endometrin, levothyroxine 25mcg, (omega 3 fish oils, Yuan Support Formula)

Day 21: Frozen Embryo Transfer

Day 31: HCG beta test

Day 33: Repeat HCG beta test

Sometime after Day 33: Intralipids

Tips:

– Set time alarms on your phone so that you take your meds at the proper times.

– But a pill schedule case like this to organize yourself:

– inject the Fragmin super slowly

– protect your underpants from leaky Endometrin using long and wide, but super thin panty liners. Better yet- make your own cloth ones, they are so much more comfortable

– clean your lady parts after Endometrin messes, or else it seems to burn down there

I just started the huge combo of meds today, and let me tell you, the Fragmin burns like a B$&@H! I was perfectly fine with the Lupron, Follistim, and Ovidrel injects during my stimulation phase, but this needle would not break the skin without significant force, and while I plunged very very slowly, the medication itself causes a strong burning sensation. I had DW hold my fat roll for me because I needed two hands to steadily depress the plunger, and it felt like she was pinching me as tightly as she could with fingernails (she wasn’t- that’s just what the Fragmin felt like going in). Anyway, I will find a way to make it work, as it needs to be done daily, but right now it is a not-so-distant unpleasant memory. Some advice: have someone else inject it for you, inject the drug very slowly, stop and catch your breath after the burning feeling, inject some more, and so on.

We also keep a stash of homemade organic tea tree and witch hazel wet naps by the toilet to help me “wipe up” any nasty Endometrin leakage (vaginal suppository). I am back to wearing large Cadillac-sized panty liners again too (so as to not ruin my underwear), so the wipes help to prevent some of the chaffing I experienced last pregnancy.

Happiness Cycle Day 13: Intralipids

I’ve got two hours to kill while hooked up to an IV bag of intralipids, so I thought I’d type up a post with my left hand. It’s harder than it seems!

I had a crappy sleep last night, as something’s up with my digestive system. I had the worst bloating and gas, which continued overnight and into the morning (poor DW). My diet is so clean right now, that I have no idea what could be causing it. My colon felt like a balloon that was inflating and reaching its maximum stretching ability. As I lay here hooked up to a bag of mayonnaise, all I wanna do is fart. But because they’re checking my vitals frequently, and I’m in a closed room, I’m trying to hold it in. Unpleasant!

Anyways, I’m happy to be doing the intralipids. It gives me some hope for this FET. While I wish we had two embryos to transfer, that’s nothing I can change. All I can do is give all of my love and hopeful energy into this embryo. The RE finally reviewed all of my immune results and wants to put me on prednisone, fragmen, and baby aspirin, in addition to the estrogen and progesterone that I will be starting someday soon. I’m happy that it seems like we’re finally being taken seriously now. Fingers crossed that our embryo is a good one, and that he/she thrives inside me.

As for the intralipids, today I’m having 100mLs injected into a bag of saline, to create a 20% mixture. Then the mixture is introduced to my bloodstream via IV cannula. I’m glad that I brought a blanket, because I feel so cold not being able to move. I also brought my iPad, a decaf vanilla Earl Grey Tea almond milk latte, and two slices of the paleo banana bread that I made last night. I haven’t been able to do much other than type on my iPhone.

Once I get a positive beta, there’s another infusion (approx four weeks), and then one more after the six week ultrasound. Each treatment is $750, and out of pocket.

The cannula hurt going into my arm, but is fine now that it’s in. I can’t feel the intralipids at all, though I feel colder than usual overall.

The nurse comes by every 30 minutes to check my temperature, blood pressure, and heart rate,

It’s been about an hour and a half, and I’m almost done:

Tomorrow I have to go in for monitoring blood work and ultrasound again. Hopefully we will find out when our transfer will be. We also meet with our family doctor, who will hopefully agree that it’s in my best interest to continue being off work until I’m in the right state of mind to deal with those additional stresses. DW has taken the day off tomorrow to support me.

More updates tomorrow!

My RE’s Immune Testing

The above blood tests are what my RE checks to evaluate the immune causes of recurrent miscarriage. I know that NK activity is missing from this list, as I think the blood needs to be sent to the States for testing.

I would love feedback on what other REs have tested for for RPL (recurrent pregnancy loss) or miscarriage with a normal embryo.