Saturday, August 8, 2009

One PIO shot down, many more to go!

Last night was our first evil, dreaded progesterone in oil shot. I had really started to build up a lot of anxiety about this part of the cycle. I thought for a second I had mustered up the confidence to do it, but last minute, that backfired. As we were coming up with our game plan, I started to feel light-headed and nauseous.

In the end, I felt better knowing we'd done lots of reading online for various tips. I knew that we were prepping as much as we could and that we just had to go for it. Our approach is outlined below. I must give the disclaimer that I am not a nurse, nor claim to be one. If you are reading this and administering PIO, please consult your clinic and/or pharmacy for full, proper instructions.

  • Pick a time in the PM, that's not too close to bedtime. You'll see why below.
  • Numb area with an icepack before hand to ease the stick. I used those smaller freeze packs you put in lunches. Just stuck it under my pants (yes, I'll be sure to wash it before our next picnic) and walked around, replacing it with a new one every 20 minutes or so for about an hour. Looking back, that was probably a little excessive, but I my thought was I'd rather err on the safe side the first time around.
  • Identify the correct area on the cheek/hip to inject. A proper injection site, from what I've read and been told by our nurse, is extremely important. The upper 1/4 quadrant of the toosh, to be exact. We were specifically told it shouldn't really be "in the butt" at all. If you go too low, you're at risk for hitting your sciatic nerve, which can cause semi-permanent nerve damage and I'm sure hurt like a mutha. To find the right spot, we drew a horizontal line at my crack over one cheek, and then split that cheek vertically down the center, which allowed us to identify the upper 1/4 quad.
  • Take all of the weight off the muscle you're injecting into. I recommend lying face down. The more tense, the more it will hurt and the harder it will be for the PIO to disperse into the area. We did a trial to see what would work best. I tried standing and bending over slightly with one leg lose. I thought, at first, I would like that more because it would give me some sense of control, vs. lying face down. But, when I lied down on the couch, Jay was able to pinch a larger area of muscle and it really did seem to be considerably more relaxed. At this point I cried and literally cried out to God "Please, please help me!" I thought I was going to be able to hold it together, but right as he was doing it, I got so scared. :) Even still, we pushed on!
  • Pinch a good chunk of skin and insert with a swift, dark like motion. Stick it in only as far as you think you need, simply to ease some of the pain... For us, since my butt is on the smaller side, we probably don't need to put it in all the way (a whopping 1 1/2 inches!) in order to hit muscle. Obviously, this wouldn't work for everyone. They tell you to test, anyway, to make sure you're in muscle, so our thought was we'll be able to know for sure by doing the test. The test I'm speaking of is, after you stick it in, you're supposed to pull back every so slightly on the trigger. If there is resistance, and no blood coming back through into the syringe, you know you've hit muscle. If there IS blood, you're supposed to pull it out, replace the needle and re-stick. Otherwise, you will be injecting PIO into an artery. Not good. What wasn't too bad though, was the injection itself. After working myself up to tears, once the needle was in, I was like "it's ok, it's ok, it doesn't hurt" just so he knew he wasn't hurting me. Half of this, I feel like, was him being able to actually give the injection to me. I, for one, am not sure that I could have done it. I am so proud of him!! After all of that worrying, it really wasn't a big deal for either of us.
  • After sticking, hold still while the med is being administered. What a concept, huh. :) After he stuck me, which I barely felt most likely because of the icing technique, I could still feel the presence of the needle, but it didn't hurt at all. This is good, seeing as how it takes a bit of time to inject all of the PIO into the muscle due to the thickness of the solution. We are using the Watson brand PIO in sesame oil (got ours from IVP Care), which I've read others have had a better experience with. Who knows how much truth there is to that.
  • It is over!! Now celebrate. I told Jay "this was our Mt. Everest!" Some people jump out of planes or take life-endangering hikes to the highest points of the earth - we give/get PIO shots. :)
  • Massage, heat, walk around, massage heat and repeat! Ok, so maybe we didn't do all of that AND repeat, but you get the idea. The part, I'm told, of getting it not to hurt as bad the next day, is to do all of these things as much as you can. That's why you should chose a time in the evening that allows for all of this, vs doing it right before bed. Our time is 8ish.
Today, the area is sore, but it's not super bad to walk on; it mostly hurts if something pushes into it. My hope is that between alternating cheeks and our injection being only every three days (can't believe I just said "only" to that. lol), that it will heal the next time we get to the same spot. Only time will tell! I am going to declare that I hope we have to stay on them because that means we'll be pregnant! I think we do them through the first trimester. Yikes!

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The Swann's August 9, 2009 at 10:09 AM  

ROFL! yes. I laughed out loud and declared to Charles that you and Jay crack me up!!!! I totally imagine the ruler and sharpie and your but looking like graph paper!!!!! hahahaha! ZBut I am mighty proud that it is done and over with! :-) YIPPEE!!!!!

Polly Gamwich August 9, 2009 at 10:27 AM  

Can I recommend two things?

1. EMLA cream RX from your RE. It is a topical, that if put on for 1 hour prior to PIO will all but remove any "stick" feeling. And it's better than ice because you are dealing with an oil .... Ice makes oil less dissolvable.

2. The earlier you give your shot the better (for your butt) as long as you have time and things to do that cause you to walk ... You'll notice that on the nights that you move more after the shot ... The less pain you feel the next morning (and thereafter).

Ok and one more ... You should be pulling the skin tight for an IM ... But if you're so tiny you need to pinch, ask for a 1 inch long needle instead and pull the skin taught. I used these for my first cycle and they were better than 1 1/2'ers, but you do have to be thin.

Ok, unsolicited assvise over ... I'll continue stalking you!


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