Wednesday, September 7, 2011

egg on my face

I just talked to the nurse and I messed up my meds last night.

I was admittedly distracted when the call came in yesterday afternoon with my new doses, so that was the first strike. Then, it was not my normal nurse (who is very conscientious about explaining things slowly and checking for understanding along the way) and I got totally confused listening to her instructions on how to reconstitute the Menopur. I realized about 1/3 of the way in that I had no idea what she was talking about - she pretty much lost me at "Q-Cap." I told the nurse I wasn't following but knew there were videos on my pharmacy's website that I could watch. She said the videos are good but cautioned me to only use half a mL of diluent instead of the full mL shown. End of call. I wasn't overly stressed about it, but I did leave work early so I could look over all of the injection supplies while watching the video before my class to make SURE I had no questions.

The problem is that I was thinking of Menopur as a fixed dose med, like a trigger shot - one vial of diluent, one vial of powder and voila! I thought my only concern was how to mix it, not how much to mix. My stomach dropped when I watched the video and learned that you can dilute up to six vials of Menopur in a single mL of diluent because, you know, some people are supposed to use several at a time. Oh, shit. I had this very vague memory of the nurse saying something that might have been "and then you inject all of the liquid into the other vial," but I was so confused by that point I hadn't really absorbed it. What was it she said? What was it she said?! I picked up the phone and called the clinic immediately but it was just past 4pm and all of the phones were already set to nights. I called every number I had for various clinic staff - all straight to the main recording with no inbox to leave a message. My question didn't seem worthy of calling the exchange and I knew they probably wouldn't have access to my chart anyway. I did a quick Google search to see if I could tease out a "most common" initial Menopur dose - no dice. All I learned was that there is waaaaay more variety in people's IVF drug protocols than I ever imagined. I could not for the life of me (and still don't) recall the nurse ever articulating a numeric dose for the Menopur, but it's entirely possible she said it and I missed it. I eventually settled on using one vial with the rationale that it seemed like a more easily-corrected error to under-stim than to over-stim.

I was supposed to do two vials.

The nurse is checking with the doctor on whether it's worth it for me to run home and inject a second vial now or just let it go and start the full dose tonight. I know this is not a big deal - the worst case scenario is that I stim for an extra day. I just really hate making mistakes, especially those that could have been easily avoided with a little more preparation on my part.

The backdrop as all of this plays out? My officemates' loud and lengthy debate about who is most likely to be pregnant next. *sigh*

Update: The nurse called back. No catch-up shot today, just start the 150 tonight.


Anonymous said...

No worries. I totally was confused with the Menopur too and I'm fairly certain I screwed up more than one shot. The E2 levels and your follicles will respond and one day of half a dose (which is probably all you really need anyway since they totally try to overstim you on purpose for IVF) isn't going to make or break a cycle. I promise. As much as they make it seem like an exact science, it's not.

Breathe, momma. You've got this.

anofferingoflove said...

what she said ↑

im sure those ovaries got plenty of stimulation yesterday and are growing like crazy! :)

Inlocoparentis said...

I was completely overwhelmed by the Q cap things too. I just made S handle that part because it stressed me out. Why can't they put it in a pen???

tbean said... one point last summer I counted and we had, between us, experienced 6 different kinds of IVF-med related shots. It is crazy complicated. Especially with things like menopur that need reconstituting. Why can't it all be like the easy-peasy follistim pen???

At any rate, you were only off your dose by a tiny amount and it SO won't affect the outcome of the cycle so no worries. (Easier said than done, I know.)

Also, I LOVE love love the stories you tell about E. He is so freakin cute. The part about him needing to stay in the car to "listen to the cellos"? I LOVED that. Makes me look forward to the turtles being old enough to say similarly cute things to us one day.

Meegs said...

Ugh, its amazing how one little slip up can throw you off, huh? But as pp said, don't beat yourself up about it... you should be just fine.

Good luck with the rest of stimming.

tireegal68 said...

Oh the beloved Q cap - I remember that from the time I thought my ovaries could be stimulated!!!
Try not to worry too much about being human, it's usually not a bad condition:) Good luck - big time fingers crossed over there.

Maria said...

good luck!