Sunday, August 31, 2014

So, Needles Are Kind Of Important

I dislike traveling with needles. If I can help it, I avoid it at all costs. Something about receiving injections on a hotel bed, the inconveniences of needing a refrigerator for some meds and a freezer and microwave for others, and just the whole I'M ON VACATION, AND INJECTIONS ARE NOT RELAXING thing. But, this summer, we have vacationed with needles, twice.

The Maine trip made me feel like this wasn't actually that big of a deal. It was Lupron, which is a nothing shot. I mean, it's still sticking a 1/2 inch needle in your belly yourself while not actually being medically certified to do so, but all things considered it's low key. I felt pretty confident about it. It turned out just fine.

The Vermont trip, though, that was a different story. I had to pack supplies not quite as minimal as for Lupron (sharps container, alcohol swabs, insulin needles, lupron vial). I had to pack supplies for Lovenox and PIO (progesterone in oil). Lovenox is easy--they're prefilled syringes. I'm on 40 units, and the syringes I got are the coolest. I don't mean to get all excited over a syringe, but these look cool with their circular yellow plunger and their boxy body, and then when you push the plunger all the way in, the barrel of the syringe locks over the needle for safe disposal using a crazy spring-loaded mechanism. SO COOL:
The Needle of the Future! Cyborg Needle! 
The PIO requires an arsenal of supplies. The vial of thick, oily hormone; the shot glass I use to warm it in very warm tap water so it is easier to draw up, the ice pack I use to make sure that I don't feel that 1 1/2 inch needle in my butt (I checked with my nursing staff and they said icing before is just fine and it won't interfere with absorption, since it's going in your big ol' muscle and if you massage and heat after it's especially fine); the butt heater whose original purpose was a neck heater; the alcohol swabs; the gauze; the medical tape (because apparently I am allergic to the adhesive in the little round bandaids and I get horrible hives from them, so if I have a bleeder we use just plain tape); the sharps container.

What? You say I'm forgetting something? Something important? OH YEAH. You need the 3mL syringe with a 1 inch, 18 gauge needle for draw up and a 1 1/2 inch, 22 gauge needle for injecting. That's kind of important, as you can't just rub your butt with PIO and expect it to get where it needs to go. It needs to be violently introduced into your system to do its magic.

Apparently, when packing for Vermont, and getting all the supplies in the bag, I used the packing list above. Because when we were sitting in one of the many cozy sitting rooms at the gorgeous inn where we stayed, catching up with Bryce's dad and his wife before heading out to lunch (which is an ordeal in itself: finding reliable GF food in a new area), I spaced out while we were talking about all the poisonous critters that live in Texas, where they're from, and all of a sudden I must have thought, Scorpions, black widows, rattlesnakes, fangs, needles, OH SHIT!!! NEEDLES!!!

Yup, that's right folks, we were 5 hours away from home in the beautiful green mountains of southern Vermont, and I realized I FORGOT THE NEEDLES. Oh holy jeezum. I was a mess. I got a deer-in-the-headlights look, interrupted the story by staring at Bryce in a panic and saying, "I FORGOT THE NEEDLES. OH SHIT, I FORGOT THE NEEDLES. OH MY GOD, HOW ARE WE GOING TO GET NEEDLES?" I ran to our room and checked, and sure enough, NO NEEDLES. Ladies, I have to say, I am never ever ever going to take injections on vacation again without having someone else check that I packed EVERYTHING. I immediately dissolved into tears. It was bad enough that I had spent my 24 hours of modified bedrest getting ready for a car trip and packing, something that was OK'd by my medical team but still felt less than relaxing. Now I was singlehandedly responsible for the inability to deliver the serum of life to my little babylings, that were supposed to be hatching and attaching RIGHT NOW, and without the PIO they'd surely die. Because without PIO my body doesn't even remotely do what it's supposed to. (Honestly, even with PIO it hasn't had the best track record.) I was devastated.

Luckily, Bryce was not on a bazillion meds that mess with your ability to handle setbacks, so he was like, "Go to the front desk and ask about a pharmacy. They have to carry needles at the pharmacy. And then call our doctor's office." I of course did it the opposite way, texting my lovely doctor with a panic emergency text and then asking the front desk about pharmacies. We were so, so, so lucky that I discovered this little omission in the early afternoon, and not later when the pharmacy was closed and the doc's office was closed. I shudder to think what would have happened if I realized it at 8:30 in the evening, when we do our shots.

The innkeeper was just wonderful, a soothing British lady who could make the vilest of curses sound warm and inviting. She let me use their phone to call both the Rite Aid 10 minutes away and the clinic in Buffalo, since cell service was spotty. Rite Aid could fill a prescription for syringes, and the wonderful IVF nurse who reminds me of Paula Poundstone was able to fax over a prescription. I called from the pizza place we ended up going to, that had THE BEST gluten free pizza I've ever had, and there was just one more hiccup. They had the 3mL syringes. But they didn't have the dizzying array of gauges that the specialty pharmacies do. They had 20 gauge needles only. Well, I figured, It's just one up from the draw up and one down from the injection. It will be a little harder to draw up and a little ouchier to inject, but that should work. I had them fill the prescription with the 20 gauge needles. (In case you're wondering about gauges, the higher the number, the thinner the needle. You need a thick, strawlike needle to draw up the viscous progesterone in oil, but you DO NOT want to inject with that one! You need a thinner needle so you can stand to be punctured over and over in your posterior.)

The 20 gauge was fine--it was a bit more difficult for Bryce to draw up, but it worked. And it was a bit pinchier, but so subtly so that I barely could tell. CRISIS AVERTED. It only took about 3 hours of complete panic until those needles were in my hands, and the combined efforts of about 8 people, but we managed to not completely ruin our cycle just one day after transfer. AHHHHH.

I also cannot stress how important is was that Bryce kept his cool and didn't freak out when it was apparent I'd made a horrible mistake that could cost us everything. I am forever in awe of his ability to keep calm and carry on when I am a blubbering, screaming, banshee of a mess. He is such a grounding force, and I am so grateful for his cool in the face of disaster. In that moment I knew that he will be awesome throughout any childbirth craziness. Somehow we have this unspoken rule that we can't BOTH be disasters at the same time. I don't know how we manage, but we do! (He told me later how scared he was and how horrifying that whole situation was, but I really appreciate that he kept that locked up in the moment...)

The rest of the vacation went smoothly after that -- the 8:30 injection time we'd picked because we thought it would be most convenient did cause a bit of a snag in dinner plans and we had to go up to our room during dinner to take care of business both nights, but whatever. Small price to pay for a uterus that will hopefully keep my babies in this time.

Vermont was beautiful, and relaxing, and by the end we definitely looked like we had been on a vacation -- not a frazzled face in sight:
We went to a Grandma Moses exhibit at the Bennington Museum, we went to Bennington Potters and got to see how they make all that beautiful pottery, we went to the Olallie Daylily farm and ogled end-of-season lilies and picked the last of the blueberries, we had delicious meals, we had a good visit, and on the way home we stopped at the Robert Frost House in Shaftsbury, where he wrote "Stopping by Woods on a Snowy Evening," apparently on a hot June morning. Ha. It was good times, and I spent a lot of it reassuring myself: "You are pregnant. You are nurturing these babylings. You are pregnant." and just sending lots of warm, inviting energy to my babies. I hope they are listening. I hope they are burrowing. I am refusing to examine every little feeling and trying to just feel warm and inviting and let what's going to happen, happen. Easier said than done, especially when I seem capable of creating my own disasters. But, all's well that ends well.

My advice to you, should you vacation with needles:
1. Have your partner in reproduction double and triple check that you packed everything.
2. Check that you have everything again when you get to the hotel/inn/B&B.
3. If you forgot your needles, know that gauge can be flexy... you can go in the middle and it will be ok in a pinch. (ha, ha, in a pinch...)

I am so happy and grateful that we were able to take a very scary situation and make it work. There's always something every cycle, and this was a doozy! Between the retained embryo in the transfer catheter and the PIO needle disaster, I am hoping that all the drama is over and it is smooth, smooth sailing from here on out.


  1. Oh my goodness- that's plenty of crazy for one cycle-- I agree, smoothie sailing from here on out!

  2. Oh bloody hell. I would have DIED. I'm so glad it all worked out!!

  3. heartrate picked up just reading about this dilemma! I am so glad it all got worked out. I just realized Friday afternoon that I only received one bottle of PIO and the clinic was closed so I couldn't call until tomorrow for another prescription. Why can't it all just go smoothly?

    I am so glad the rest of the vacation left you feeling relaxed!

  4. Wow...that was like speed reading a thriller type novel to find out what happened next. I would have freaked out as well and so glad that Bryce had the presence of mind to think it through calmly. Glad the vacation actually ended in a great vacation feeling. Hope it's all smooth from here on out for you both.

  5. Hi there,

    I just came upon your blog. We did a donor egg cycle last year in Mexico and had the good fortune of getting pregnant with b/g twins. I want to wish you much luck. I hope this turns out for you.
    Oh yeah, and I had similar shenanigans with my day after transfer. We took a side trip to see Chichen Itza and while there I suddenly realized that my suppy of progesterone was going to run out! Luckily we were able to finagle something from a nearby pharmacy but the language barrier made for some interesting craziness. Glad you got your needles, best of luck!