Wednesday, February 29, 2012

Puregon injektion Nummer eins, aka: First Follistim injection.

I started the FSH injections today. I am not a person who is comfortable with needles and blood. Whenever I have to give blood for a test, I look far away from my arm. The person who is drawing blood always asks if I'm okay. I get pale and I am a flincher.

Yesterday, after figuring out how to put together the injection pen, I found a couple videos on Youtube that showed how to do an injection properly. The one from Follistim was really helpful, because it showed me that I should pinch my fat. I think this is more necessary for people who do not have much fat around the middle. This is not a problem I have.

(I hate videos when the hands have a manicure like this. My fingers are rarely manicured, and even when they are, they don't look like this. Can't they skip the french tips? It looks so...sleazy. Like at any moment that woman is going to break out the toys.)

One video, though, freaked me the fuck out. This woman is obviously nervous, but the way she shrieks during the injection made me blood run a little cold. It was funny and scary at the same time.

I read on message boards and blogs that it helps if you numb the area with cold first. So, I got my pen out of the fridge and grabbed my alcohol swabs. Then I got the cold pack out of the freezer and put it on my stomach. I washed my hands and sat down in front of my supplies.

My hands were shaking and I was very nervous. I put on some Modern Family via Hulu so that I would be a little distracted. I cleaned everything I was supposed to, took off the ice pack, pinched my fat, and slid the needle in.

It really wasn't too bad. I felt the needle go in, though, if I didn't know it was happening, I doubt I would have felt it. I let go of my stomach, pushed the plunger, and waited the five seconds. There was a tiny bead of blood, but other than that, really not a big deal.

I'm glad to have the first injection over. I am hoping that that this is the only time in my life that I ever have to do this. I would not want to do this every day for years. This has a very good purpose at the end of it.

This weekend, I'm going to be on a sewing retreat with a bunch of women in the middle of the woods. I'm looking forward to it. I haven't been on one of these for about a year and a half. It will be a good way to get to know some people. I'll have to do two injections while I'm there and I'm hoping I'll be able to find some ice for the numbing, but if not, I'm sure it will be fine.

So, self injection. Not awesome, but not the worst thing ever by far. And Herr Doktor has promised fewer effects than Clomid, so I'm looking forward to that. I don't expect this treatment to work the first time out, because nothing else has, but I am glad to be at this stage.

CD 3

Tuesday, February 28, 2012

Besuch in der Apotheke, aka: visit to the pharmacy

Yesterday, after DH and I had finished with Herr Doktor and gotten some lunch, I went to the Apotheke (pharmacy). Actually, first I went home because it was CD 1 and I hadn't taken anything for the pain yet. I got home, took three Advil, called the MTF pharmacy to see if they had the medications (They didn't.), and then headed back out to the Apotheke.

The Apotheke I went to is not in my town. It's not in a town that I have ever been to before for any reason. Now I've been there twice in two days.

I follow the map I've been given by the Tricare office and make it to the general area. I see two Apothekes on my way in, so I find parking and grab my prescriptions and other paperwork and attempt to find the correct Apotheke. I'm looking for Rathaus Apotheke. (The Rathaus is the town hall.) The ones that I see are Center Apotheke and Turm Apotheke. I can't find the Rathaus. My map says that the Rathaus Apotheke is just behind the Rathaus. I'm stumped.

I go into a building that says "Information" on it. I ask the gentleman inside where Rathaus Apotheke is. He points, but all the windows are covered up and says a lot of things in German. He points toward the Center Apotheke, but Turm Apotheke is that way to. Hmmm.... I thank him and go back outside.

I try the door of Center Apotheke. It's locked. Ooookay. I head over to Turm Apotheke. Also locked. And this one looks like it's been locked for a while and may never reopen. So, back to Center I go. Still locked. Then I pull out my map and realize that there is a phone number for Rathaus Apotheke on here. Wonderful! I call the number, and am treated to an answering machine message in German. The only thing I understand is "closed". I hang up. Studying my map closer, I notice it has the hours for Rathaus Apotheke as closed from one p.m. to three p.m. Ah...I forgot about the lunch hour. Germany.

It's about quarter til three, so I go back to my car and read until a little after three. I walk back to Center Apotheke and go in. When I'm called to the counter, I practice the little bit of German I know and tell the woman, "I need medicine," in German. I hand her my prescriptions and she tells me that they have the progesterone, but not the FSH or trigger shot, at first speaking in German, then switching to English when I show her my deer in the headlights look. That one always works. She tells me that I should go back to my town to get the medications because they don't have them there and it will be easier for me. I explain that I was told to come here. I show her my map. She tells me I need the Rathaus Apotheke; this is Central Apotheke. Uh huh.

She kindly shows me which way to go. It isn't far. I thank her profusely and resume walking. I find the building that she said is the Rathaus. It's a school. The building next door is the Rathaus. The Rathaus Apotheke is supposed to be behind the Rathaus. I walk all the way around. No Apotheke.

I walk back the way I came and then a little further down the street. There's a side street I notice. It even has a sign! (This is a rarity in Germany. It's all well and good to have a map with street names, but when only half of the streets are marked, it doesn't do too much good.) It's the street that Rathaus Apotheke is on, according to my map. Sure enough, I walk around the corner, and there it is. Hooray!

(I'm reminding myself between finding the doctor's office and finding the pharmacy that I only have to find them for the first time once. Next time it will be easier.)

I go in and give them my line. "I need medicine." They ask for my papers and I hand them over. We do the routine with the German, deer in headlights look, and then English. They have the progesterone and give that to me. They do not have the FSH or trigger shot. Those will be arriving at 6:15. It's about 3:30. I can pick them up tomorrow if that's more convenient. Great!

Then I ask how to take the progesterone. "Didn't the doctor tell you?"

"Well, he told me to take it and when to take it, but not how many to take or if the time of day when they are taken mattered."

"Let me see your paper." She wants to see the paper I got from the doctor. I hand it over. There's information on there about the FSH and nothing else. She seems a little panicky.

"Do you have the doctor's number?"

"I have it at home."

"Let me give it to you." She's writing it down off of the prescription. I protest a little, but let her do it. I'll see the doctor between now and when I need to take that med, so I'm not worried about it. Okay, great. My meds are on the way, and I'll pick them up either tonight or tomorrow morning.

The next morning:

I putter around since the Apotheke isn't open until 8:30. I head out and get there around 9:15. I park in a closer location and put up my parkschein. (It's a little blue thing that shows when I got there. When you park on the street, you put that in your window instead of having a parking meter next to every space.) I try to go put money in the ticket machine so that I will be legal to park there. My coin jams in the slot. I try to push the button to get a free ticket for thirty minutes. It asks me to "Please numbers". I know what these words mean, but I do not understand. Whatever. I just leave it and go get my meds.

My meds are in. Again, not much information here. I ask if I need to clean the area before injecting. Yes. I buy some alcohol swabs and I'm on my way. No ticket on the car either. Success! I haul ass outta there.

When I get home, I open up the boxes. I've never seen any sort of medication dispensing pen like this before.
There are needles and a vial of medication and the pen thing, but I don't know how to put it all together. And the information packet with it is all, you guessed it, in German! Whatever, I'll get to it later. I head out to the library where I volunteer a couple of times a week.

At the library I ask if the German guy is there today. No. Does anyone else read German? Yes, H and J do. I explain I have some medication that is injectable and I'm not sure how to set it up. H offers to help me read the packet and put the thing together. She asks what it's for. I never know what to do in this situation. I don't want to tell everyone that I'm going to start jabbing myself with medicated needles at home to try and get pregnant, but I really don't know how the hell to put this thing together. I tell her it's personal, and that seems to be okay. To be honest though, I felt really rude.

After I finish at the library, I run home and grab my stuff. I run back to the library where H tries to help me. She's totally intimidated by the language because it's all technical medical stuff and advises me to go back to the pharmacy. I decide to go in the back and see if anyone there can help. M's "gentleman friend" is back there and has spent time nursing an ailing parent. I introduce myself (we've never met before) and ask him to help. He kindly does. I thank him profusely and leave.

Now I'm at home watching videos of follistim injections. I'm totally freaked out. DH offered yesterday to do the injections, but I'm going to be at a retreat this weekend, so I need to figure out how to do it on my own. Tomorrow is the first one. I'm nervous, but I'll try to keep the end in mind.

What a day.

CD 2

Monday, February 27, 2012

Bitte schön, Knock me up, Herr Doktor aka: first visit to the RE

DH and I went to the RE this morning. Actually, he's the professor of Obstetrics and Gynecology and the Head of the Gynecological Endocrinology and Reproductive Medicine. Quite a mouthful. We'll just call him Herr Doktor for short.

First, we went to the women's clinic next door. DH was coming from work, so we drove separately. The GPS was trying to take me some crazy route, but I pissed it off and made there anyway. So, the women's clinic. I tell the woman at the front desk that we are there to see Herr Doktor. She says fine, but we need to check in at administration. We go into the office after knocking. No one home. There's talking in the office next door, but I'm not sure if she's on the phone or with someone. So, after a little while, I knock on that door. There's someone in there (who I'm pretty sure was a pharmaceutical rep), so we keep waiting. It's about 10 minutes from our appointment. Finally, I can tell the visitor in the office is getting ready to leave. Just as she's wheeling out her suitcase (this is why I'm guessing the pharm rep thing), the office that we originally knocked on is entered by a woman, presumably the office's resident. We are beckoned in and sit down.

"Sprechen Sie Englisch?"


It's always a challenge, being in a country where you don't speak the language.

"I'm here to see Herr Doktor." I hand her my paperwork.

"Ah, Herr Doktor. Go next door to (German words I don't know). You know?"

Alas, I do not know. "No."

"Ah..." while pointing up high and more German.

"Top floor?"

"Ja, in the (German words) building."

Okay. Top floor of some building across the street with German words I don't know. Got it.

We hotfoot it over there and walk around the building, trying to find the words she said. We see a sign that looks promising and follow it down the street. No building that has the German words we were hearing down here. We've gone too far and go back. "Let's just try this building."

We go inside and head into the first office we see. "Herr Doktor?"

"Ja, up two flights." (I'm translating here.)

We head up the two flights and find the sign for Herr Doktor's secretary. We check in, are asked our birth dates and occupations; Hausfrau for me and military for him. Then we're shown to the waiting room. DH heads to the toilet, and I sit down.

Now, I have not been in a civilian waiting room for a long while, so I don't know if it's this way at non-military facilities in the States, but it is quiet in this waiting room. There is a group consisting of one man and two women (maybe mother and daughter, or possibly surrogacy?) and a woman alone. It is completely silent. No one is talking. There is no music. Most amazingly, there is no TV. DH sits back down and the group of three talk a little. We wait, and wait. The woman gets called back. More waiting.....and more. After a while, the group of three gets called back. Waiting...waiting. Another woman shows up, then another couple. They say "Hallo" when they come in. (Oops, guess we were supposed to do that. Oh, well.) More waiting. Finally, after about an hour (not exaggeration, by the way), we get shown into another room.

This room is about the same size as the waiting room and the nurse is in there. She looks like what you imagine nurses to be. White shoes, white shirt, white coat, white pants, white watch. And she has a green scarf. So, we sit in there a while longer, watching the nurse walking between this room and the doctor's office, which is next door. After another ten to fifteen minutes, we are shown into the doctor's office. He introduces himself by his last name only (This must be a German thing.) and we sit down.

Then the questions. First, why are you here? I said the only thing that made sense to me, that I want to have a baby and haven't been able to get pregnant so far. Then the medical questions. Any surgeries? No. Any pregnancies? No. Have you been on Clomid? Yes. How many cycles. Six. You've had the HSG? Yes. And your tubes were clear? Yes, from what I've been told. Was it painful? Yes.

When was the start of your last cycle? Today. I really thought, as I always seem to, that the last cycle was The One. I ovulated on my own in a reasonable amount of time. (Or seemed to.) I was two days late. Some of my PMS symptoms weren't there, and there were some other symptoms that made me hopeful. Alas, it was not to be. I just kept holding on to this appointment as my hope for the future, at least when it comes to making babies.

Now DH's turn. He's pretty good, thankfully. Herr Doktor seems happy with him. At least one of us is okay.

Herr Doktor talks to us about PCOS. He says he's going to put me on FSH. There will be a pen, I will do injections daily. We'll have an ultrasound in a week. Since it's CD1, they can do blood tests without having to wait, so the nurse will take my blood and then we're to stop by the secretary's and schedule the ultrasound.

Another difference from military treatment facilities (MTFs) is that the doctor's nurse is the one taking my blood. At an MTF, they would put the order in and then you would head over to the lab and sit in another waiting room and have the blood draw there. It's kind of nice not to have to go to another office, especially when I am not yet familiar with this hospital. I have a feeling I will get to know it though.

Then we stop by the secretary's office and schedule the ultrasound. 7 a.m. Ugh. I don't have to get up early, and so usually I avoid it. I think this will be worth the effort though. Prescriptions in hand, DH and I head out and get some lunch. I'll go and get the meds after eating something and going home and taking some Advil for these cramps.

So, that was the appointment this morning. And that's what I'm posting for today. I'll get to the pharmacy fun times tomorrow. I'm glad we've finally gotten to this point. It's been a long road, with several unexpected turns. I have hope that there is an end in sight to this path and a new road on the horizon.

CD 1