Wednesday, July 27, 2011

Cycle Day 7: I Start Ganirelix

This morning I had another ultrasound and blood test, this time with another doctor who I will call Dr. M.  I really liked him!  Though our meeting was brief, he took the time to show me how my follicles are doing on the ultrasound imaging monitor.  On the screen, the follicles look like globules within a much larger globule (the ovary).  The follicles are not all on a single plane, so you have to move the ultrasound wand around to find them all.

He said that it looked like I had six on the right and five on the left, with three smaller follicles (I forget which side) that "might catch up".  On Monday (Cycle Day 5), I was told that I had five on the right and six on the left (the reverse of today).  On Friday (Cycle Day 2), before I began injections, I was told it looked like "six on each side".  So here's evidence that follicle count is not always consistent from ultrasound to ultrasound.  Think of it like trying to count the number of golf balls and marbles held in a clear plastic bag-- you have to look at the sack from several angles to count them all, and even then, you're not entirely sure if you're counting some twice or missing the ones in the middle, etc.

The nurse called me this afternoon with my new dose:
  • three vials of Menopur at night (increased from two vials)
  • one Ganirelix shot at night
  • same dose of Gonal-F in the morning
I go back in for ultrasound/bloodwork on Friday morning.  The earliest I would trigger (with the Ovidrel) is Friday for Sunday retrieval.  By Friday, I'm hoping we have a better sense of my retrieval date because I have a lot of things I can't nail down at work until I know when I will be out of the office.

I was afraid that the Menopur would hurt more because of the higher concentration of medication, but I did not detect a noticeable difference.  I'm now convinced that part of the reason why the Menopur is so unpleasant is because I am working with cheap syringes.  While it's not painless inserting the needle, it's only when I press it all the way in that it begins to hurt.  I think this is because the area where the plastic syringe meets the needle is not well-formed, and I'm inserting some of the plastic molding into my skin.  Here is a picture where I've circled the offending plastic bit:  


I've asked the nurse if I have to press it all the way in, and she said I must.  Once I experimented with not doing that, and when I pulled the needle out, a little bit of the Menopur bubbled up to the surface.  So I'm not sure I have a choice but to plunge all the way in...

So after the Menopur, it was time for my first Ganirelix shot.  Ganirelix comes in a pre-filled 0.5 mL glass syringe.  Ganirelix must be refrigerated.

I did a quick side-by-side comparison of the Ganirelix against the Menopur.  The Ganirelix has a slightly longer needle, maybe ever so slightly thicker, but less medication to plunge.  I was not intimidated.  However, I had a minor snafu trying to get rid of the air bubble.  Ganirelix is a bit viscous, I guess, because when I tried eliminating the air bubble, the bubble "burst" inside the syringe and rather than fall back in, some of it spray out.  So I lost a couple precious drops of Ganirelix.


Then I had trouble inserting the needle into my skin!  I pressed the needle down firmly against my belly, and the needle wouldn't go in.  I tried several times, once just breaking skin, but it wouldn't go any further.  I might as well have been using a ball point pen.  At last, I pressed down really hard and the needle finally penetrated.  It didn't really hurt, thank goodness.  (I'm telling you, cheap syringes...)

So here's an image of the right side of my belly, so you can see the various injection battle scars, including my first failed attempt at injecting Ganirelix.
I'm running out of room...

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