Sunday, January 13, 2013

For the love of lovenox

Brief update, all. Beta #2 = 469. Doubling time of 31.48 hrs. Grey is almost recovered from the shock of all of this (poor guy, this cycle has been hard on him) and we're preparing to get through this next week. After 2 miscarriages, both of which happened during this time, I'm cautious. But I'm still maintaining the attitude that I am doing everything possible to make this work. Balanced thinking; not for the faint of heart.

Back in October, following the APA panel that revealed I probably have Antiphospholipid Syndrome (can't diagnose formally until after 3 miscarriages and all have to be after 8 weeks . . . bastards), Dr. Smile and I talked about me starting Lovenox. For those of you who are unfamiliar with this medication, it's common name is Enoxaparin (commercially known also as Xaparin and Clexane), which is a low molecular weight heparin. The purpose of this is to inhibit the formation of clots and is also believed to help with substaining a pregnancy. Hence Lovenox is commonly prescribed, even to women how have not been diagnosed with APS.

Grey and I weighed the risks of the medication (none to pregnancy, but I am now wearing a medical alert bracelet in cause I get into an accident) and decided that adding this medication made sense.

What I wished someone had warned me about was how painful this injection is.

Let's go back to Dec. 31, 2012. After feeding the cats and changing the Vivelle dots, I prepped my stomach for the Lovenox injection. As this one is subQ, I didn't think anything of it, so I did what I always do with subQ: clean area with alcohol wipe, pinch the skin, insert needle in dart-like motion, and inject.

Immediately, I doubled over in pain. My belly was on fire and the pain had caused my vision to become blurred. After what seemed like an eternity (read 60 secs), I was able to see again. Shaking, I capped and disposed of the needle and sat down on the floor until I could move without shaking. I then spent the next 30 minutes trying to figure out what I had done wrong.

Later that night, I noticed this.


Considering I've NEVER had a bruise that big (which completely freaked Grey out) and because I didn't want Grey to be wrongly accused of beating me, I figured it was time to do some research.

As a reminder, SQ is filled with lots of great information about administrating medications (among many other things), so I was slapping myself for not visiting the site before I started these injections. I do have a few additional tips to add, but first I wanted to give you the video.


Couple of additional tips.

1) Prepare a reward for yourself prior to doing this injection. For me, this is a tall glass of good orange juice (no concentrated stuff).

2) Ice the area. This is especially true for those of you who ice prior to any of your other injections, as you will be inserting the needle slowly.

3) As mentioned in the video, inject slowly. I've actually started singing "Twinkle, twinkle, little star" while I am injecting, as it slows me down. Whatever works, right?

4) Have gauze pad ready and apply light pressure after you have slowly removed the needle. Do not rub in circles, as you will make any bruising much worse.

5) After cleaning up, indulge in your reward (trust me, you've earned it). In general, I found it takes about 60 secs for the burning sensation from the medication to subside. Enough time to drink my juice and think about breakfast.

6) If bruising is still bad, contact your RE. Keep them updated about any problems you are having with the medication.

To date, since slowing down the injections, I only have a series of pin-sizes bruises. Definitely not attractive, but much more easy to manage.

Anyone else on Lovenox? Have you found a way to cut-down the stinging or do you have any tips?

33 comments:

  1. Congrats on another great beta! Wow I can't believe the size and color of that bruise. Ouch!

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  2. Great news about the second beta. And OUCH. That bruise looks bad. Glad your subsequent injections went much more smoothly than that first one!

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  3. Holy mother! That is impressive! Take care of yourself!

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  4. I feel like when I ice the bruising is way way less....and honestly after a week or two I don't even sting at all anymore, and I have done nothing differently!

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  5. Whoo-hoooooooo on the BETA!!! So happy for you!!!

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  6. Good lord that is a lot of bruise! You poor thing! I knew Lovenox was killer to inject, but I had no idea it was that bad. So glad you have found a better way to handle the injections and I so hope that it gets easier in time. Also, congrats on a rocking second beta!

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  7. I am super excited about that second beta. Hooray! I know it's still early, but I am sending nothing but good thoughts your way!

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  8. Loving that beta number! But hating the bruise. In on heparin and have had the pain issue, but the bruising for sure. It goes in stages for me. Every now and then I get in a rough patch and am really sore and ugly for a few days then it clears up and I'm fine for a few days. It's definitely true that the slower you can inject the better.

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  9. Congrats on a fabulous 2nd beta!!! Yay!!! And seriously, the Lovenox is such a pain. I was on it for my whole pregnancy (till I switched to heparin at 37 weeks, that isn't much better and it is twice a day). I never used ice beforehand but have heard it is helpful also. My only tip pertains to when you start getting a belly... Make sure to move the injection closer to your sides as the tummy starts to get tight. It will feel a lot better. Good luck!!!

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  10. AMAZING 2nd BETA!!!
    I am so very excited for you!!!
    Sending you TONS of hugs and happy thoughts!

    HUGS!!!

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  11. Beta = awesome. You = super awesome.
    That bruise is insane. I can't believe the size! I'm sorry you had to endure that.

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  12. Oh my gosh! How did I miss your news? Congrats! I will wait, cautious and optimistic with you. Fingers crossed! (and that bruise looks awful!)

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  13. SO happy to see such a great 2nd Beta. CONGRATS!!!

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  14. Looking at that picture, I can almost feel your pain. Ouch!

    Congrats on a great second beta!!!

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  15. Great 2nd Beta!!!!! That bruse will be soooooo worth it in the end!!!! CONGRATS!

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  16. Ahhh!!!!! So exciting! Congrats on the second beta -- so happy for you guys. That bruise is one nasty looking thang, but hardly matters if this pregnancy works out. Fingers crossed a million times!

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  17. congrats on the beta. i have used lovenox several times. the icing helps, but after awhile the bruising is what it is. just a heads up it can make your skin more sensitive even after the bruising heals. but i do think it is a missing piece to IF. my re uses it whether you have aps or not for failed implantation. the dose is minimal compared to the gains! also trying spreading the skin rather than pinching one of my rn told me that and also do a slow count to 5 before taking the needle out after its been injected

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  18. After last weeks pod cast, I was trying to envision this bruise of yours [keeping in mind how HUGE you kept saying it was]. And honestly... I had no idea. Nothing like a visual to truly show how really HUGE HUGE it is. Good grief lady, you deserve a free trip to Florida for a whole gallon of freshly squeezed OJ!

    Beta #2 makes me smile big and wide. Sitting over here with so much hope and good vibrations for you.

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  19. Congratulations on the second beta. Here is hoping you get a take home baby.

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  20. Excellent second beta! Sorry I have no input on Lovenox but holy sh*t that's a nasty bruise! You are such a super woman!

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  21. I'm on lovenox twice a day and it sucks. Sometimes the bruising seems random - one day not a pin prick after, the next day I look like I was run over by a truck. I haven't tried ice, but I have noticed the less/softer I pinch my skin, the less likely I am to bruise. Try picking a place on your stomach that you are sure is fat and not muscle and just barely squeeze the skin together. Good luck!!

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  22. Yay Beta #2!!!!

    That is a serious bruise. I'm terrified of my first IVF coming up in about a month as I bruise easily and I feat that I will have those all over my stomach!!

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  23. Ouch! But yay on the second beta! Almost makes it worth the pain?

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  24. Smiling ear to ear. Not about the bruise, of course (ouch!) but about your news. Wow! I am SO happy for you and Grey!

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  25. That is a BIG bruise! Ouch, hope it calms down for you. Congrats on great beta numbers, that's fantastic :)

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  26. Just catching up from the past week... congrats and yay for good betas! Stick baby, stick! And holy bruise! I'm sorry :(.

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  27. Oh my gosh Cristy! That is BRUTAL! You are a rockstar, and that baby is going to be SO lucky to have such a tough mama!

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  28. Ouch! Hopefully it will be worth all the pain

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  29. Just read your good news!!!!!!!! So so happy for you and Grey, it's finally your time, enjoy it! Ouch, that bruise looks so super painful.

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  30. Sorry I've been so MIA for so long but just popped on and saw your news! OMG OMG!! I'm keeping everything so tightly crossed for you that you have a very very boring 9 months ahead!! Ahh yes lovenox bruises are brutal! So happy for you my friend!

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  31. Cristy, Cristy, Cristy!!!!!!!!!! Aaahhhhhhhhhhhhh!!!!!!!!!! You're pregnant! OMG OMG OMG! So stoked for you and Grey!

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  32. I haven't been in the blogosphere for the past month...but OMG!!!!!!!!!!!!!!!!!!!!!!! I AM SO SO SO SO SO HAPPY FOR YOU AND GREY!!!!!!!!!!!!!!!!
    Seriously. congrats! wishing you a VERY healthy and happy 9 months!

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