Lovely Lovenox & Comfy Crinone

It occurs to me that advancing in a pregnancy is similar to the wisdom on advancing age that Garrison Keillor once mentioned on NPR: "Getting older is a cinch, you just wait around." And that's what I've been doing, waiting around. I go to work and I come home and I lie on the couch and I fall asleep immediately. I eat something bland every two hours and try very, very hard not to throw up. I review the stages of embryo development on Wikipedia. I obsess about miscarriage, missed miscarriage, birth defects, stillbirth, and what will happen at my ultrasound next week. And I read other IF blogs - more on that in a moment.

But in the meantime, as a sort of public service announcement, I want to write down a short synopsis of my experience with the two newest drugs I've been taking, Crinone and Lovenox. Your mileage may vary, but this is what I wish I could have told past-Charlotte back when she was eyeing these prescriptions suspiciously.

Things to know about Crinone: even though I was promised that it was a unique bio-adhesive gel, it's more like a regular old cosmetic cream. It's white and has the consistency of my facial moisturizer (although I have yet to confuse the two!) It's in a little tampon-esque applicator and it makes a farting sound when you apply it, which continues to crack me up because I am Not Mature. I haven't had any problems with it causing a huge mess, but it is true that it doesn't dissolve 100%, and what is left tends to look like cottage cheese. But since there's not a huge volume going in, there's not a huge volume coming out, either. And the absolute best thing about Crinone (with the exception of the fact that it is hopefully providing the progesterone support that my embryo needs to keep growing) is that it doesn't hurt. Not one little bit. It's a total non-event.

Things to know about Lovenox: this didn't go so smoothly for me at first. Shot #1 with the modified Lindsey protocol (ice for 10 minutes, in fast, push slowly, wait 15 seconds, out fast) was a success, but shots #2 and 3 were a nightmare. Giant, painful bruises that upset me to no end and prohibited me from wearing pants for a few days because they were right where my belt would have been. After some trial and error, I think I've identified the two factors that led to the bruising: one is that the ice, while numbing the initial sting of the needle going into my skin, actually drew more blood to the surface that then bruised spectacularly when exposed to a little Lovenox. Harry pointed this out to me one night when I took the ice pack off and got ready to inject - "You know your skin is all red now, isn't that from more bloodflow going to the cold area?" When I tried it without icing first, sure enough, I got a tiny pea-sized bruise instead of one measuring 3 inches across. The other thing that made the bruising worse appears to have been my pinching technique. As I had with the speedy Lupron and Follistim shots, I was pinching the skin to get the needle in and then holding it in the same position as I injected. The only thing is, when you're injecting a blood thinner over the course of a full minute, that's a long time to be pinching your skin. And that pinch was injuring the blood vessels in my belly just enough that when the Lovenox hit them, they had a field day. I tried not pinching at all as suggested in this video, but that made the needle entering my skin hurt like hell. So my new technique is to forget the ice pack, pinch briefly just long enough to get the needle in, then release, inject the medication very slowly, count to 15 with the needle still in my skin, and take it out quickly. I usually have little to no bleeding from the site afterwards, so I don't put pressure on it or anything, I just fan it a bit and maybe swipe lightly with the alcohol pad if there happens to be a dot of blood. Oh, and make sure you tap the air bubble all the way to the top of the tube before you start the injection, and inject it last rather than first. I read somewhere that it may actually help keep the medication under the top layers of skin where the rainbow bruises would form, and yes, it is safe to inject air subcutaneously. (Not a great idea to inject it into a muscle, vein, or artery, but hopefully that's not where you're aiming your Lovenox anyway.) My tummy is slowly looking less scary and I've even had a few injections go so well that I couldn't identify the exact site 15 minutes later.

Finally, we come to this crappy, crappy week in the world of IF blogging. Most notably, of course, is Mo losing her son at 22 weeks, but there's also Jenny, who had a miscarriage at 9 weeks, and so many BFNs: JM and Lola and Emily and far too many others.  Your words have touched my heart and I have struggled with how to respond - I feel guilty and angry and I wish I could reach out across the screen and give everyone a hug. Since I can't, I will just say that a community is a community in bad times as well as good times, and I'm honored to be a part of it. I hope things get better soon.