Thursday, May 26, 2016

Day 7 of Stims

Top: Gonal-f
Bottom: Cetrotide in its "Lunchables" pack
I started stims on Friday (5/20/16), had a check up on Monday (5/23/16), and again yesterday (5/25/16). On Monday, during the u/s, the sonographer found 9 follicles in my right ovary and 10 in my left, and was able to measure a number of them that were 10+ mm. That afternoon, my nurse called and told me that they were surprised to see how quickly I was progressing (she assured me this was "a good problem to have") and that the doctor wanted to dial back on my Gonal-f (from 175 IU to 150 IU), to increase my Menopur (from 75 IU to 150 IU) and to add in a morning injection of Cetrotide (0.25 mg). My estrogen (estradiol) level was at 109 pg/ml. Yesterday, the u/s showed that more follicles were enlarging, and when my nurse called she said that my estrogen level was now at 781 pg/ml. My next appointment is tomorrow (Friday, 5/27/16).
Stims: Day 6 - 2nd morning of Cetrotide (25 mg),
5 nights of Gonal-f (175-150 IU) & Menopur (75-150 IU)
Starting Cetrotide
I was a little nervous to inject the Cetrotide, as I've heard it also burns and can cause an itchy rash at the injection site, but I found it to be pretty unremarkable. It is refrigerated, and comes in its own little "Lunchables" style pack, with syringe pre-filled with sterile water, powder vial, and alcohol swabs--I like how convenient this is. My only problem with it is getting all of the powdered medicine to dissolve completely. The injection itself didn't burn for me and only itched a tiny bit the first day, but nothing like a mosquito bite or anything. I did bruise at the first injection site. This morning when I did the injection, I accidentally stabbed my middle finger as the needle bent and went through the cap. I'm not sure if it was the throbbing pain in my finger or the medicine, but I got super nauseated and dizzy, and it was all I could do to rifle through my parents' bathroom drawers to find some Neosporin before I passed out. Luckily, I just barely made it to my bed before falling over. It was a rough morning.

The trigger
I got some good news from my nurse. I have been a little anxious about my upcoming trigger injection, as most of what I've read has stated that they need to be injected intramuscularly (i.e., in the butt muscle). We were prepared to hire a nurse who would be on call for 3 consecutive evenings (cost ~$125-$175) to come give me the injection, which could very well be in the middle of the night. My nurse told me that all my medications including the trigger injection will be given subcutaneously in my abdomen. She explained that there are 2 types of trigger injections: Lupron and HCG. "The reason why some physicians use one over the other is the mechanism of the trigger. For those patients who have a lot of follicles or are at risk for developing ovarian hyperstimulation syndrome (OHSS), you would use the Lupron, as this medication is in your system for a short amount of time. The HCG trigger is for the patient who will have an average response to the stimulation medication as the HCG medication is in the system longer." So I don't need to hire a nurse, and I can do the trigger injection myself!

I was told I could continue my normal cardio and strength training during the early stages of injections (days 1-5), but by day 6, I would want to decrease the intensity and focus on non-impact exercises (yoga, light elliptical, swimming, etc.). Yesterday was day 6, so I took Noah for a 2 mile walk. Today I am going to do the same, but also hit the gym for a light elliptical workout (decreased intensity/time). I did an entire week's worth of cardio/strength from Saturday-Tuesday, so I was at least able to get that in...but it's going to kill me a little to not be able to do strength training as usual. Oh well...I'll live.
Mickey Collector's Series Band-Aids

Little treats
I've decided to reward myself after my nightly injections with a little treat: popsicles. I am loving these little Outshine Fruit Bars. They're only 35-45 calories a pop (ha!). I also got some Mickey Band-Aids, because who doesn't love Mickey? Little things like that, walking the dog, and working out, have helped keep me sane. I've been getting daily headaches which I am able to treat (for the most part) with Extra Strength Tylenol, lots of water, and naps...I've been taking lots and lots of naps!

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