Wednesday, July 18, 2012

Groggly II

It's nearly 9PM in our backwards-ass household, where people sleep in the daytime and collect syringes.  And that backwards ass has big circles in the upper-right quadrant of each cheek.

Heather is still in bed and not excited about getting up.  "You can go right back to sleep," I told her, but she muttered that she needed thirty more minutes.  Listen, lady: I am more than happy to let you sleep while I watch unending re-runs of Big Bang Theory, but let's knock out these new meds first.  (That, anyway, is how it goes in my head; I'm not sure how to approach someone as drugged and sleepy as she is.)

Now that it's what passes for dinnertime in our household, Heather's got to take two pills.  One, Medrol, is an anti-inflammatory she will take every evening; the second, doxycycline, is an antibiotic, of which she'll take two a day.  We follow up the fun part with progesterone in oil (PIO)-- one shot per day.  Heather is very anxious about this one because it features fucking enormous needles which are inserted "to the hilt" in her hip.

The vial is just like Lupron: a little glass jar with a rubber top.  With PIO, however, you need a syringe and two needles: one is realllllly long and has a pink cap, and the other is still pretty long and has a gray cap.  The first is attached to the syringe when you unwrap it, then used to draw the medication into the syringe; then you take the pink-capped needle off the filled syringe and replace it with the gray-capped one.  Undoubtedly there's a reason why you can't just draw the stuff up with the smaller needle, but I haven't bothered to look it up.  Still, we used the same needle for drawing and injecting Heather's Lupron, so it seems kind of lame.  Mostly I think it drags out a process that already puts Heather on edge.

Per various nurses' instructions, I am to hold the filled syringe like a pen, then shove it deep into Heather's muscle.  I believe them when they say that there's a muscle in there, but it all looks like a big expanse of skin to me, any part of which could have muscle underneath.  And they're adamant about this location, too; with Lupron, they'd said that some people use the thigh as an injection site, but we have been universally commanded to aim for the hip.  I think that's part of what makes Heather crazy: she can't see what the fuck I'm doing.

Of course, it's of no help that there's so much hoopla about all the ways to reduce pain, the logic being that, given all these suggestions, the injection probably hurts pretty bad.  They wouldn't talk about muscle massage and hot baths if the worst-case scenario was a bruise.

And I have a lot of notes about it from the IVF class we attended a few months ago.  It was the nurse's description of methods that work or don't work that left me overwhelmed at the prospect of any injections at all.  Some ladies, she said, will ice the injection site beforehand to numb the area, but it's actually counter-productive since it slows the PIO from dissolving into the muscle.  "There's just going to be a little cold bubble of oil under your skin," she said.

Instead, we're supposed to warm the vial beforehand-- 30 seconds in the bra or something similar-- then follow the injection with a heating pad, muscle massage, or a hot bath.  Somewhere in between are all these suggestions about how you press your fingertip hard into the injection site to "distract the nerves," creating a little divot as a target.  Today's nurse in the surgery center (yeah, the Nashville clinic is fucking enormous, and they have this complex with waiting rooms and exam rooms up front, and a bat-cave of labs and ORs in the back) said that she preferred just to get a good pinch of skin instead of fussing with all the skin-shifting and whatnot.  I guess we've got plenty of chances to test divots and pinching. I just have to get Heather out of bed first.

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