My trigger shot was to be at exactly 9:30 PM on Thursday, November 21, 2013. Earlier that day, I gave myself the last Ganirelix shot.
I had now been on hormones for well over a week. How was I feeling? As it turned out, I was feeling surprisingly normal. I had been concerned that the hormones would affect my mood and that I might experience strange crying jags or temper flares, but that did not happen. Physically I was also feeling pretty good. I was not particularly bloated, and though I thought I could feel my ovaries, I was never quite sure if it was just a figment of my imagination brought on by the suggestion that I should be feeling heaviness in the ovaries. I was however moving differently than usual, in an effort to heed the nurse’s cautions about the risk of ovarian torsion from certain movements. I was supposed to avoid anything that caused bouncing, so I walked more slowly than normal. I had also started taking the elevator up instead of the stairs up to the clinic. I tried to be careful to avoid twisting movements, though I always toss and turn a lot during my sleep so I’m sure I wasn’t able to completely eliminate twisting motions.
The nurse had suggested that I start mixing up my HCG (the trigger shot) at 9:20 PM, to be sure it was ready for 9:30 PM. When I picked up the box, I noticed it said “For intramuscular use only.” I have picked up from other egg freezing blogs and forums that some clinics have their patients do intramuscular shots for the HCG, but at Stanford we are supposed to do a subcutaneous shot. I certainly didn’t have either the training or the needle necessary for an intramuscular shot. I was concerned that I had ended up with the wrong variety of medication. I didn’t know what to do, so I paged the on-call fellow to ask.
When the fellow called back, it was apparent that she hadn’t heard of this exact problem before. I would have loved her to say, “Yes, I know it says “for intramuscular use only” on the box, but it is fine to do the subcutaneous injection.” Instead, she asked me to read her what it said regarding what kind of medicine was in the box, she told me that it sounded like the correct medication, and told me it should be fine to do a subcutaneous injection with it. An answer, but not quite as confidently reassuring as I had hoped for.
Anyway, I set about mixing up the medication and transferring it out of the vial into the injection syringe. I was able to get around two-thirds or three-quarters of the medication into the injection syringe, but I absolutely couldn’t get the last bits out. I remembered the nurse had taught me how to do it after my last ultrasound, but I couldn’t remember what exactly the secret was. I was running way behind now, between paging the on-call fellow and trying to get more medication into the syringe, it was well past 9:30. I finally decided to inject what I could before it got any later. After injecting myself with most of the medication, I set about getting out the last one-quarter to one-third of the medication which was stubbornly stuck in the vial. I held the vial and the syringe at various different angles, desperately trying to get all the medication out. I finally managed to get most of the remainder and gave myself a second injection (thank goodness the clinic had prescribed extra needles, as you need a new needle for each injection). By this time it was well past 10:00. That’s right, I had managed to screw up the timing of this most-important, absolutely-had-to-be-at-9:30 shot.
I emailed the clinic to explain what had happened and then got ready for bed--I would have to leave for my retrieval appointment around 7:00 AM the next day.
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