mini-fret, stim version

Is this a side effect of stims, the lack of blogging? I don’t know.

I guess for whatever reason, I needed to drop out of the online world for a few days there. Not that you were all sitting on the edge of your seat, rending your garments wondering where the hell I’d gone. It’s only been a few days.

Anyhow, today will be my fourth day of stims, and I can’t say it’s been terribly eventful. My weight seems to be moving downward in spite of the fact that Sue brought me cupcakes yesterday (I ate three) and brownies, too (I ate three of these, too). You should all count yourselves lucky if you have a friend like Sue who will not only bake you delicious cupcakes and brownies, but who will also get in her car and drive almost two hours to bring them to you, and then sit and repeatedly talk you off of the “MORE INFORMATION NOW PLEASE” ledge for an hour or so. Awesome, truly awesome, is what it is.

I have been tired as all hell lately. I’ve been having a hard time dragging myself out of bed to take my 8 a.m. Lupron dose. And I’ve also been quite headachy. But that could do with the lingering cold that has planted itself on my chest. Or maybe it’s been the weather or something, but today, we seem to have mostly clear skies and a little bit of sun, so hopefully that will help me get over this overwhelming urge to pull the covers over my head and burrow in for several extra hours every day.

I’ve also been feeling a touch (just a touch) of something going on in my lower abdomen. It may be my overactive imagination, but it could also be the fact that they started me on 225 units of Gonal-f (along with the Menopur). I was supposed to start with 150 iu, but at the Friday morning RE clinic meeting, they decided that since I had been suppressed a little longer than usual, they wanted to be a bit more aggressive in their stimming. In the message from the nurse, I was unclear as to whether or not this dosage increase was because they were trying to keep me on some sort of schedule (sorta sounded like it), or whether or not they were using a higher dose because my ovaries had been down-regulated for so long that I need a little extra to wake them up. About the former, I would typically be a little pissed, but since I’m ready to get the show on the road as well, at this point, I’m sort of okay with that. Either way, I have my first follicle scan on Tuesday morning, so I’ll know more at that point about what’s going on in there and how much longer this is going to be happening.

So far, the biggest issue I’ve had with the stims has been the way in which I get them ready to be delivered to my body. I am a fairly dextrous person, but I am just barely getting the hang of mixing the drugs in the way my clinic wants them to be mixed. For those who haven’t yet been to this place of insurance-injectables (no pens for you! no sir!) and/or multiple drug blends, the drugs come in tee-tiny vials, one of which will be the drug in a powder form and the other of which will be a sterile solution of some sort that becomes the medium for the delivery of the drug.

So the Gonal-f comes with the powder in a tiny vial and a separate glass syringe filled with bacteriostatic water with attached needle, and you inject the fluid into the tiny vial, and then draw from that vial the solution which you will inject to deliver the drug to your body. And generally, Gonal-f is measured in IUs, which means that there is no standard this-many-IUs-to-that-many-milliliters, etc. because IUs differ from drug to drug. And so, Gonal-f comes with it’s very own syringes measured in IUs of Gonal-f so that I can accurately draw out 225 IU Gonal-f.

However, I do not just use Gonal-f. I also use Menopur. Menopur is like Gonal-f in that it comes as a powder into which you mix a liquid. In the case of Menopur, the liquid is also in a teeny tiny vial and you use a mixing needle to draw the liquid (in this case, saline solution) into a syringe and then inject it into the tiny vial of powder. And the saline solution in the vial is typically two milliliters. However, my nurse wishes for me to only use one milliliter of the fluid, because she says that you only need one milliliter to dissolve the powder, and that you can use the whole two, but it’ll just take longer to inject (‘cos you’re injecting more fluid). So, I suck one milliliter of saline and inject that into the vial of Menopur powder. And then, per my nurse’s wishes, as to reduce the number of injections I have to give myself, I also inject my separate syringe of 225 IU of Gonal-f into the vial of Menopur, and then I suck all of it into the mixing syringe, take off the mixing needle, put on the injecting needle, and then H injects me with the two drugs together.

If you’ve ever used a mixing needle (22 gauge, er, correction EIGHTEEN gauge…), you know that they are large and they are long, and the vials are tiny and it is SO FRICKIN’ HARD to get every last drop of medication out of those little tiny vials with a giant needle (don’t touch the needle! keep the tip submerged in the liquid! don’t pull it too far and spill anything!). And, with all the different “inject this here, put this drug there”, etc., it is also damn near impossible to get a final, accurately-filled syringe with no air bubbles and no spillage. Each night finds me standing over the kitchen sink violently flicking a syringe and cussing, trying to keep every drop of precious (and expensive) liquid inside the syringe while also getting the correct-sized needle in the right place, and uncapped (without bending it or accidentally unscrewing it from the syringe) and then into my body.

So, I’ve started using the Q-Cap thing that comes with the Menopur, at least for dealing with the Menopur (and final suction of the whole shebang into the syringe), and that seems to help with getting as much as possible out of the vial. It doesn’t seem to help with my ability to do so with no air bubbles, or to prevent small drips from escaping while I change needles, but it does help to make me feel like I’m not leaving too much in the vial after I’m done. And yes, I know that the manufacturer creates these drugs and their packaging with the understanding that the end consumer will not be able to get each and every drop out of the vial, but if I’m precisely measuring one drug, and injecting that into a solution of another drug (a more concentrated solution, thus meaning that drops left behind should be recognized as twice as big, since the solution is half as dilute as the manufacturer intended), it makes me more concerned about ensuring that I am getting the intended dosage.

I guess that means that last week’s weepy-stress and fret over weight gain has been replaced by still-slightly-weepy-stress and fret over medication dosages. Oh, well. If I’m not worrying about something during this process, I’m probably doing something wrong, eh?

Lastly, in a small bit of news, I may (may) be going back to work. My old boss actually became a sort of friend of mine, and we have kept in touch as time has gone on since I left my old job. She has been having back problems for a number of years now, and she has finally decided to have surgery, and intends to be out for a couple of months. As some of you who have been reading for a while know, my old job made me crazy, but as I made the decision to leave, they were kicking around the idea of bringing me back in for ten or so hours a week, just to keep my basic job tasks from falling through the cracks. And at that time, we agreed on $40 an hour. And then the market fell to shit, and as this was a job that fell in the arena of government budget, there was no extra money to pay for me. And that was that.

In the mean time, my boss, with the help of the reporting database manager, has been able to maintain the processes that I built and even to modify a few of them to meet new needs. But without her, there’s seriously no one who can retrieve the information from the database in a remotely efficient manner. And so, they thought of me. And they have been willing to offer me $35 an hour. Which sort of sounds like a lot (for this area), until you build in the fact that being self-employed means that you can basically take half off the top for taxes (though being that this is so short-term, that figure may vary slightly). Oh, and until you factor in direct job experience and technical skill and the fact that I was making more than that before and I didn’t have a degree and now I do. But anyhow, my old boss asked, and I told her yes, and now, we’re just waiting to see if it will come through.

And in truth, I have very mixed feelings about all of this. I’m not entirely sure that I want to go back to working, even if it is just ten hours a week. I hate working outside the home. I really do. I hate having a boss and I hate feeling tied to someone else’s definition of progress and success. And really, of all times, right now is really not when I need to be adding any kind of stress to my life.

But (HUGE BUT) uuuuugh! That extra money would be really, really nice right about now, and in turn, that would take a pretty nice chunk of stress off of me, or off both of us, actually. And they at my old workplace are very aware of the treatment I am undergoing right now, and my boss understands that nothing, absolutely NOTHING is more important than this cycle right now, and so understands fully that I will need to set my own hours and possibly try working from home as well. And that (presuming this works…) if the doctor says that I should so much as *think* about taking it easy, I will instantly head straight into bed and not move from that place until she says I can do jumping jacks all day without worrying.

So I’m not necessarily concerned about that medical factor. I’m just concerned because I remember how incredibly unhappy I was being in that place at that time. I remember sitting in the car while H dropped me off one morning, sobbing, refusing to get out of the car because I did not want to go back to this place (see blog entries, spring 2008 for more…). And of course, there were other factors swirling in my life at that time, and maybe not being so beholden to the almighty employer, being a contractor who can ultimately set my own terms and leave at will, would be different. But I get the sinking feeling that it may not be all that different, that things may not have changed that much, that I may still be very affected by this work environment, by this type of work.

But oh, the money! It would be so nice to have that part-time income right now.

Granted, I’m putting the cart before the horse at this point, since we aren’t even positive that it will work out (it looked pretty sure last time as well, but it didn’t happen then). But still. It’s something I’m really concerned with right now and I’m just not sure what to do. And I probably need to get a tentative decision made soon. And I just don’t know.

money vs sanity… what to do, what to do, what to do…

Ah. So that’s my world right now. And yours?


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11 Responses to mini-fret, stim version

  1. Samantha says:

    I realize I've kind of fallen off the planet in terms of blogging, but Sue told me you were undergoing an IVF cycle and just wanted to drop by and give you some words of encouragement.Good luck with cycle!I'd probably do the job – for 10 hours a week, it will help keep your mind occupied without being too stressful.

  2. Sue says:

    10 hours a week sounds doable, and if you really hate it, you can always walk away. The most important thing is to take care of yourself.Talking to you Sunday reminded me of how exciting and scary that first cycle is. I don't know if you ever really get off the ledge either, at least not during your first go round. I really feel for you and H. Here's hoping your first cycle is your last.

  3. Tracy says:

    So much to comment on and my time is limited…Anyway, as far as mixing of the meds, the way I calmed myself down was to remember they wouldn't trust patients to do it if it was SO IMPORTANT to get it exactly right down to the drop. I'm sure they assume some user error, so try not to stress too much.And as far as the dosage, don't worry about that, either. With all three of my cycles they tinkered with dosages along the way, and they may do the same with you after your first scan.Smooches.

  4. Lupron made me so tired, too. And yeah, add a cold….Stimming made me feel like a moron! I never got it right. Job money would be neat-and 10 hours a week would keep you in the loop? xoxo

  5. Deep down I always believe that I should choose sanity over money, but in the end I choose the money. Mostly because we are broke and I think the money will bring sanity. That's how I wound up with three 4 hour a week jobs right now along with school full time. Fun! I did not do the other drug you mentioned, but you may remember that I did 5 vials a day of the menopur… And they did not give me any cuecaps? So, it was a lot of sucking up the fluid, and injecting it into the next vial… repeat. I got really good at it in the end, with a neat-o air pressure trick and everything. Save up the westwardly good thoughts until December. You don't want them colliding with all my easterdly good thoughts somewhere over Valdese. Sounds like you are doing great so far… 1/2 way over!!! As super husband kept saying over and over "You can do this! see? you're doing it!"

  6. Kait says:

    That medicine regime sounds incredible stressful and frustrating. I give you serious props for sticking with that. As for the job thing, I say try it out. It sounds like you can leave at any time, and if things get bad, do just that. Good luck with everything!Kait @

  7. Dealing with measuring the meds like that would drive me nuts. It would feed right into my "control what very few things you can control in infertility treatments" neuroses.I think having a 10-hour a week distraction…that understands your priorities lie with the IVF cycle…could be great.

  8. jill says:

    Not sure if you ever tried part-time before but it might be a good balance between the crapiness of this job and what you are currently doing. And hell, as someone else said, you can always walk away if it sucks. If it were me, I'd definitely give the 10 hours a week a try.And omg mixing the medications sounds like a nightmare.Hoping for good news for your follicle check tomorrow! 🙂

  9. says:

    praying for some good follies!!10hrs/week while you pick your hours?? that sounds awesome, especially if there are people there who are complete alive, the mixing of meds sounds so frustrating

  10. Ellen K. says:

    Hope this morning's scan goes well, Kate. I'm with Tracy — there has to be a little room for patient error with med mixing. I think I started off at 225 iu and then was dropped down pretty quickly — my RE called this "simmering."

  11. jenn says:

    I agree that the med tinkering along the way will even out any possible patient induced drop leaving behindedness. I think you will be fine & I hope your scans will calm you down & amp you up for the next phase all in one!I would personally do the 10 hours a week. It's not all that much & it's true that being a contractor has got to leave you the 'out' if it gets too bad. You have already got the medical stuff covered & wouldn't have to repeat everything should you need (or choose) to stop working due to that. I think it's the best of all world's & could help distract you from obsessing over tiny droplets of medication… well- maybe just a little bt! ;o)i nominated you over on my blog by the way…

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