Friday, January 28, 2011

Why I'm stressed & down

In July I developed a blood clot (DVT) in my calf. Part of it broke off and traveled to my lungs, resulting in large blood clots in both lungs (pulmonary embolisms). I have been on blood thinner medication (Lovenox injections, two times a day) since then.

My OB said I had 2 options: 1) stay on Lovenox until 39 weeks pregnant and schedule an induction, or 2) switch to Heparin injections at 36 weeks and take them until I go into labor on my own.

I decided to go with option #2 because I’d like to avoid an induction if at all possible. I had an OB appointment scheduled for 35 weeks. I called the OB about a week before I would run out of Lovenox injections (which would be a few days before 36 weeks) because I knew how difficult it was to get those injections, and I wanted enough time to get injections before I ran out. I was reassured that Heparin injections would be much easier to get than Lovenox, and I was told I’d get a prescription at my appointment.

I have had difficulties with Target pharmacy since I started switching prescriptions to them in 2010 (I kept getting coupons for $10 gift cards to Target when filling a new prescription or transferring a prescription to Target, which is why I still did it despite the difficulties.), and so I had been thinking I should get the Heparin prescription filled elsewhere. But I was at Target running errands anyway, so I took the prescription to the pharmacy and asked if it’d be difficult to get it filled there. I was falsely assured by the employee that it wouldn’t be a problem. She said I should be able to pick up the medications the next day, over a day before I would run out of the Lovenox.

The next day, instead of getting the 90 vials (3 vials a day- a 30 day supply), they called to tell me they had 3 vials in that I could pick up but should have the rest of the medication by the following day (Friday). I decided not to take an extra trip to Target and take Lovenox another day instead. Friday came, and Target said they’d only received one box of vials, giving me a total of 25 out of the 90 vials. Still, no more would come in until Monday, and I would run out of Lovenox on Saturday, so I had to pick up what they had.

When I went to pick up my partially filled prescription, they learned I didn’t have any syringes at home I would need to take the medication (Lovenox came pre-filled, so this was all new to me). The employee "helping" me was kind of rude and frustrated about it, but I figured they’d just call my OB and get the needed prescription. I waited while they sorted things out and finally left Target with the 25 vials and 25 syringes. They said the rest of the medication should be in on Monday.

I hadn’t heard anything on Monday, and I’d had to go in to the lab to check the level of the Heparin in my system. I kept calling the OB office for the results, thinking it might be easier to get my prescription changed if needed (the doctor said he’d anticipated my levels would probably be a little low) before I picked up the rest of the vials. Unfortunately, I didn’t hear the results of the lab draw until Wednesday (the levels were indeed low). However, I hadn’t picked up the rest of the prescription yet (I'd gotten a call on Tuesday letting me know the rest of the vials and syringes were in the store and waiting). So I headed back to Target right after my appointment to see if they could adjust my prescription. I learned that they wouldn’t do it. They told me to simply take the new dose and then let them know when I was running out of the medication. Then they’d fill my new prescription, letting my insurance company know the early refill request was due to a dose change.

But I let them know that the syringes that were ready for me to pick up were too small for the new dose I needed to take, so I would need different syringes. And that started a bunch more drama and complications. The COMPLETELY unhelpful pharmacist sent me away from the store about an hour later with 5 syringes that she figured would be adequate enough to last me until they could order and get in a more appropriate size.

By the time I left Target, it was already past time when I should’ve taken my next dosage, so I decided to inject myself in my car. I pulled out one of the syringes Target sold me (yes, the pharmacist made me pay 25 cents a syringe, saying the rest of the syringes should be cheaper since I’d be buying them in bulk or through my insurance or something) and pulled out a couple vials. When I took the cap off the needle, I realized this had to be wrong.

My injections are supposed to be subcutaneous. The gauges are larger for subcutaneous needles (meaning the needle isn’t as wide around), and the needles themselves aren’t very long. This needle was very long and wide. I started crying out of frustration, since I'd been told by the pharmacist this was all they had. I knew I had to use it if I wanted my injection. So I started pulling up the medication into the syringe, which was challenging enough, and injected myself, only pushing the needle in about 1/3 of the way. The area continued to bleed for several minutes, even with applied pressure. And I realized that a fair amount of the medication was actually stuck in the syringe, meaning I didn't get the new dose anyway.

I called my OB office while I was still sitting in my car to see if they had any syringes I could use until Target could get the right syringes in. One of the nurses there put me on hold while she looked, eventually telling me that she found a box. I headed back to the office to pick them up. When I got there, Target pharmacy was on the phone with my OB office saying they needed a prescription for the syringes and trying to find out what the specifics were for the syringes I would need. I looked at the syringes the nurse gave me and was confused, because it didn’t seem possible that the syringes themselves were anywhere NEAR large enough to fit my entire dose (the old or new dose) in it. However, I accepted them gratefully anyway and left, when the nurse said they should work just fine, hearing her tell the pharmacist I wouldn’t need syringes through Target after all. I figured I’d know in another 8 hours whether or not the syringes would work, and I had 2 syringes that would accommodate my old dosage if all else failed.

Sure enough, the OB’s syringes were way too small. So instead of starting my new dosage, I had to take my old dose. And I saw all the bruises on my stomach and cried out of all the stress and frustration I’ve gone through this pregnancy in general and the past couple weeks more specifically. While crying, I started grieving, realizing that I don’t think I have it in me to go through an entire pregnancy’s worth of injections plus an additional 6 months post-pregnancy of blood thinners, blood draws, etc, and all the health risks again. I’m all but 100% certain this will be my only pregnancy, and I grieve for that loss. I want more kids, but I don’t think I can physically, mentally, and emotionally go through this again. I cried myself to sleep while my husband tried to comfort me.

Yesterday I started making some calls to find out what size syringes I needed (how the heck am I supposed to know?) and where I could get them. I had to drive about 30 minutes each way to get syringes, but I was glad to have them when all was said and done.

This picture shows a standard sized pen for comparison’s sake, followed next by the original syringes I got from Target (they hold 1 ml of Heparin, my old dose and have a ½ inch length needle and a 27 gauge), followed by one of the 5 syringes Target gave me for my new dose (they hold 3 ml of Heparin, much more than my new dose, and have a 1 ½ inch length needle and a 21 gauge), followed by the syringes from my OB (they only hold 3/10 of a ml, I realized, and they’re supposed to be for insulin, I guess), followed by the new syringes I picked up yesterday (they also hold 3 ml of Heparin, but the needle size is only 5/8 inch and the gauge is 25).

So I went back in to the lab today to check my Heparin levels again. The lab was short-staffed, and I ended up getting my blood drawn 4 ½ hours after my injection, instead of the 4 hours it was supposed to be. Grr! Hopefully that won’t affect my levels too much! And hopefully I don’t have to adjust my levels anymore before the baby comes. I do plan on going back to Target to get that prescription they haven’t filled so I can have it filled elsewhere and canceling all my auto-refill medications with Target and transferring them elsewhere too.

But I still grieve that this will be the only pregnancy I likely experience, and any more children we have will likely be adopted. I worry about my baby’s health, even though things look okay with her on ultrasounds. And if something is wrong with her, I will fully blame myself and hold myself accountable for the rest of my life.


jenn said...

Oh Debra, I am so sorry you have to go through all this crap!!!! Pregnancy ALONE is difficult enough, to add in all this nasty business your dealing with breaks my heart. Just remember, if things look good on your ultrasounds then I am sure everything is fine with your baby. And even if something was "wrong," you should in no way blame yourself for the rest of your life. God has a plan for you, Joe, and your baby. Things will happen the way they are supposed to..... There are enough things that moms feel guilty about in life, and I don't think the problems you are having during your pregnancy need to be added to them!! Hugs to you and I hope you find as much comfort as possible over the next few weeks before your little bundle of joy arrives!!!

Mrs.Flabby and Unfabulous said...

I am emailing you.

Amber said...

Debra, I love you!! This brought me to tears. I have no doubt that you will have a perfect, healthy baby girl. God has a plan for all of us, and just know that you are blessed to go through this pregnancy. All of this crap you are experiencing, while tough right now, will all be worth it in the end. You are such a strong woman to deal with all of this, and I know that Heavenly Father wouldn't put you through this if you couldn't handle it and come out stronger in the end. I am so excited for you and Joe and your precious baby girl. I miss you so so much! Can I come and visit you in the next few months? I will call you, it has been way too long and I can't wait to catch up. Thinking of you. xoxo

Debra said...

Amber, you can call or visit any time! I'd love to have you come visit!

Amber said...

Yay! It probably would have to be just me because Stu will probably have to work, but I'd love to come for at least a few days and help you out. Just let me know when would be good! =)

The Goodmans said...

deb, i am so sorry. i have finally had the time and courage to read your whole post. this makes me so sad, too. i do know that each pregnancy is different, but yes you would likely have to take the blood thinner shots for each pregnancy. however, YOU CAN DO IT!!! i didn't have the same problems in my pregnancy that you have dealt with, but i did have my share of problems and frustrations. i also shared the same anxieties/worries that you have mentioned as far as the baby's health. i hope that all is well for you and your baby because if it is like my similar situation, all will be fine, and Joy will be a perfect baby. i was told just yesterday that it's okay to be worried because any wonderful mother would be worried about their child's health. it's just part of who we are. please, if it is your dream to have more kids of your own, don't decide now whether or not you will have more of your own. wait until after you have Joy. if you don't set your mind now, you may see just how strong you really are after she comes and be re-assured that although it was uncomfortable and frustrating at times, you did it, and you can do it again. i love you! call me or text me if you EVER need anything.

Mommyof2changas said...

Deb, evey baby is a blessing! Do not blame yourself. I have had years of telling myself this with Arianna and her Autism.

The baby will be fine, you will be an awesome mom! I have you both in my prayers!

Crystalbell said...

I'm so sorry you're having to go through in such a challenging way. It just goes to show how much you're dedicated to your daughter and how much you must love her already!

The paranoid thoughts are a completely normal part of each pregnancy. It sounds like you're doing everything right for your baby and your situation. And for that, you are blessed and will continue to be blessed. Heavenly Father knows your heart. Remember, not only are you a daughter of Heavenly Father, but so is your darling baby!