Let's talk PIO

I looked up this IVF calculator today. According to this, I am 3w3d pregnant. How weird is that?

With the retrieval and the transfer, I had every intention of discussing my PIO injections, but time got away from me. So I have been wanting to post this for awhile. Because anything involving a sharp needle, a booty, and an inexperienced husband deserves some recognition.

I have done 7 injections so far. For about a week before my first one, I was frantically searching the internet for PIO tips. Asking my infertile friends, reading blogs. "Does it hurt?" "What if he hits my sciatic nerve?" "Can I use a smaller needle?" "Oh gawd, please don't make me do this!"

To put it bluntly, I would rather ride the wrecking ball with Miley Cyrus than let him do these shots. The first IVF, we had to do one IM HCG shot before retrieval. I iced that area so thoroughly, I was numb for a week. So I didn't feel it. With the last trigger, this happened. So I wasn't quite ready to have him get behind me with a sharp needle again. Especially because the area is supposed to be warm, to allow the oil to spread out. Icing is out of the question.

I made him practice with a needle and a lemon first. I didn't like the way he continuously stabbed the lemon with that gleam in his eye. But time was ticking and we had to get at it. I stuffed the progesterone vial into my bra (I lied, I wasn't wearing one; I stuffed it under my boob) and slapped a warm rice pack on my butt and lied like that for 20 minutes.

We went to the bathroom and I put my elbows on the sink, concentrated and relaxed my butt and told him to do it.

And guess what? It actually wasn't bad. I think I squeed a little when the needle went in but it wasn't bad. Afterward, he massaged the area (our new version of foreplay), we put the heat pack on and then bundled up and went for a walk. Piece of cake. As long as he doesn't screw up.

When I was on bed rest, we just had me lay on my side and relax my butt. Obviously I couldn't walk but he did a lot of massage. Sexy. So far, knock on wood, we don't have any issues.

So I've decided to give you all the tips I know about PIO. I would love to hear your feedback and any tips of your own. I want to make a separate tab for it on my blog for reference.

Here's what I've learned:

Before the injection:

Heat the area with a heating pad, warm washcloth, or rice bag (that you heat in the microwave). A sock with rice in it would work too. Heat for up to 20 minutes, but I do 5 minutes sometimes and it seems to work.
Warm up the vial (I shove it into my bra for 10-20 minutes.) This makes the oil thinner and easier to draw out. I don't recommend using the microwave because it can get too hot and can actually burn your tissue. You could also run it under warm, not hot water.
I had someone draw out the injection area on both sides of my butt for my husband to target. You won't have to worry about hitting that sciatic that way. Otherwise, just make sure it's on the outer upper quadrant.
It doesn't matter what time of day you give the shot, as long as it is consistently at that time. Don't give your shot and go straight to bed, because the oil won't be able to spread and that is how those painful lumps develop. I chose to do them around 6:30 pm so that I can have the rest of the night to walk around.
The oil is going to be difficult to draw up. I have my husband keep the warm pack on the area while I am drawing up the oil, to heat the area until the last second. While he's doing this, I pull the plunger down past the 1 mL mark (the normal dose) and let the oil flow in and then push the extra out until you are at 1 mL (or whatever dose you are on). Then I switch needles. This means you will inject with a sharp needle, which hurts a lot less. Pushing the needle in the vial dulls the needle. Again, coming from experience, this HURTS.
When the new needle is on, push the plunger until a drop of the oil beads out of the tip. This will also help lubricate the tip. Don't ask. It works.

During the injection:

You can lie down, on your side is best, with the top leg (the side receiving the injection) slightly forward and relaxed. You can also stand, leaning over the bathroom sink. I wouldn't recommend leaning over the bed, as this was my mistake last time, and I think it stretches your butt muscle too much and it can hurt more. On the side the injection is going to go, make sure your leg and glute is relaxed, with your foot turned slightly inward (this relaxes the glute).
Right before the injection, I wrap the syringe with oil in the heat pack for a few seconds.
It helps to have the person inject while you are exhaling.
Slightly spread the skin in the area your injecting apart with your fingers. I have heard that pinching the skin can make it hurt more.
The injection should go in quick, like a dart. If you try to go slow, you are not doing the person any favors.
One the injection is in, you can pull back slightly on the plunger to check for blood. This means you are in the vein, not the muscle, and will need to start over. I have heard conflicting things about this. Some don't do this step, and hitting a blood vessel is rare. It takes only a second to do, however, so this is how I have trained my husband :)
The oil is THICK! It may take about 30 seconds to inject it all in. Inject it nice and slow.
After all the medication is in, leave the needle in for a few seconds so that when it's pulled out, the oil doesn't leak out. If that happens, it's ok.
Pull out the needle quickly. Again, pulling it out slowly is not doing the person any favors.

After the injection:

Massage the area with a piece of gauze, or cotton ball. Don't be timid. This helps spread the oil throughout the muscle.
Apply heat again, and heat and massage for several minutes. Walk around after for 20 minutes or so. The muscle movements also help spread the oil.
Award yourself. You deserve it. :)

Any other tips?

Labels: Infertility education, Shots, surviving days post-transfer, Two Week Wait