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05/20/2004
Stupid PIO tricks
This cycle marks my first exposure to progesterone in oil. I'd always heard how agonizing the injections are, and although I considered myself lucky to have avoided them thus far, I also felt a certain superiority to those who complained. Really, how bad could it be?
Paul dutifully delivered the first injection to my right hip with little fanfare and no pain. This is a breeze, I thought smugly.
The second injection came due after he'd already left town, so I twisted myself into spasms to deliver the injection to my left hip. Because the angle was so awkward, I didn't plunge the needle straight in and ended up wiggling it more than I should have — that is to say, at all. Although the shot itself didn't hurt, the next day the injection site was a bit sore from my deep tissue noodling. This will be a breeze, I thought, if I do the next one in my thigh.
Now, I was told that the injection should be done in the upper outer quadrant of the buttocks. (If you were referring to someone with actual muscles in her ass, you might say "glutes." But we're talking about me, so "well-marbled rump" is more apt.) But you can deliver intramuscular shots into the quadriceps, and I thought I might be able to drive the needle with more accuracy and finesse if I wasn't concurrently herniating a disc. Because, hey, I'm clever.
So today I set to. I warmed the injection site with a hot, damp cloth. I drew up the oil into the syringe. And I plunged it deep into the meat of my thigh.
Don't ever, ever do this.
The injection didn't hurt. But the senation of driving the needle in was extremely upsetting. If you would like to simulate the experience at home, assemble the following:
Now stick the straw into the steak. Now imagine, if you will, that the beef is intimately tied into your somatic nervous system.
Yeah, that's the stuff.
I felt a wave of queasiness as I looked at the 1 1/2" needle entirely embedded in my leg. But because I am ten kinds of mighty badass, I steeled myself to complete the injection, which must be delivered slowly...slowly...slowly...ahhhhhh.
This wasn't really such a breeze at all, I concluded as I massaged the injection site with my warm, limp washcloth.
But, again, the shot didn't actually hurt, and once I'd massaged the oil out of its stubborn lump into the depths of my muscle, I was fine, and went gaily about my business.
Now, a scant eight hours later, I am practically crippled.
My right thigh is as sore as if I'd been stabbed with an icepick — not surprising, considering that I was stabbed with an icepick. The muscle throbs even at rest. When I try to walk, I have to fight the urge to drag my leg behind me Quasimodo-style. When I flex my knee, a dull but insistent ache washes over my entire leg. When I put my weight on it — well, look, it just hurts, okay? Jesus, do I have to paint you a picture?
I'm guessing this is why they recommend doing the injections in the upper outer quadrant of the well-marbled rump, a muscle that does significantly less work than the lean, unlarded upper thigh. With newfound humility, I hereby join the ranks of women who complain about how painful PIO injections are. Almost as painful as my stupidity.
Posted by Julie at 07:03 PM in I've learned a lot...but I'm not sure it's worth it. | Permalink
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Comments (71)
We made this mistake once. Exactly once. Every time after that when she needed an intramuscular injection, either I did it (complete with a ceremony involving removal of her jeans and panties, followed by a series of soften-it-up kisses to the affected buttock quadrant, a swipe of the alcohol followed by as quick a stick as I could make it, and lastly followed up by some more kisses) or she found a friend who was willing to jab her in the butt with a long sharp spike. I think we had to go through a friend exactly once, and the friend was horribly embarassed looking at the pin-cushion bruises.
Our ER's office offers the service for like $20 per injection, and you supply the medication.
Oh, and did you draw it up using the little (24g?) needle you stuck yourself with, or was your pharmacist kind enough to give you something like an 8g or 10g to draw it with?
I think the other reason they tell you to do it in the posterior is so that you don't see the bruising that often results. It's really quite distressing to see your wife's butt, which hopefully would be an object of admiration if not outright affection for her husband, covered in red and purple and black and green splotches, with nobody to blame for inflicting them than yourself.
I hope you can walk soon. :)
Posted by: RainbowW at May 20, 2004 7:52:32 PM
Heating the oil in the vial helps it go in a wee bit faster too. I heat mine under hot running tap water, but my nurse said that's not the best way to do it because the oil can get too hot and burn you. So she said to put it in my bra for 10 minutes instead.. which I did last night.. and it didn't go in nearly as fast. I haven't sensed any burning as of yet.. unless that's why I'm craving Bacon all the time. Hot tap water I shall continue.
Posted by: BrendaS at May 20, 2004 7:58:53 PM
I need a smoke after reading ranbow's first paragraph... and I don't even partake in the nasty habit.
Great... Thanks.. Fucking Pelvic rest.
Posted by: BrendaS at May 20, 2004 8:02:07 PM
OMG, I can't believe you actually stuck yourself in the thigh with that big needle. Then again, after a few days of sticking your rump with that same needle, it will start to feel the same way.
I even developed a callous on my ass from the injection around the injection sight, along with a gorgeous array of purple bruising.
Posted by: Jodi at May 20, 2004 8:04:43 PM
Julie, you are my hero for having the courage to thrust such a huge needle into your thigh muscle. Never could quite figure out how anyone could do that. There just doesn't seem to be enough meat in that area, and I always imagined hitting a bone - although I know it wouldn't happen, just the thought makes me nauseous.
As for the rump injections, I finally got the nerve to give myself PIO injections on my last cycle and was surprised at how easy it was.
Also, I always use a smaller guage needle than recommended. It takes longer to inject the oil, but I tend to be able to walk much easier the next day. Much less bruising, too. Massaging the injection site agressively, and sitting on a heating pad for half an hour or so has helped immensely. When I don't do those two things, I pay for it the next day.
Hope you can walk again soon...
Posted by: Danae at May 20, 2004 8:59:10 PM
Julie, I'm so happy to hear that the transfer went well. Sorry about the PIO injection. I never had to give it to myself, and I wondered what I could possibly do if I had to. It is quite possible that I would draw the line of infertility-related-self-inflicted-torture at IM injection! Maybe try picking up the phone and calling the concierge. They may have that as a room service. You never know!
Posted by: Bella at May 20, 2004 9:06:17 PM
PIO funny for ya...
I was stupid enough to let my MIL in on the last cycle (huge mistake, btw). So on one of her nightly phone calls to see if I was pregnant yet, she asked how the shots were going. I replied.. "fine, except I have a lump on my ass for every shot he gives me"... she paused, then said.. "it's ok hon, just tell him to fill in the celulite"
Posted by: BrendaS at May 20, 2004 9:22:16 PM
PIO funny for ya...
I was stupid enough to let my MIL in on the last cycle (huge mistake, btw). So on one of her nightly phone calls to see if I was pregnant yet, she asked how the shots were going. I replied.. "fine, except I have a lump on my ass for every shot he gives me"... she paused, then said.. "it's ok hon, just tell him to fill in the celulite"
Posted by: BrendaS at May 20, 2004 9:23:42 PM
We had a routine that worked beautifully (until Dave got me in the sciatic nerve - OOPS!)
First, we requested the progesterone in SESAME oil, which was slightly thinner than the peanut oil, and causes fewer skin problems, as many people have mild allergies to peanut oil. I would ice the injection site to the point of pain, stinging and numbness (which wasn't nearly as painful or stinging as the shot itself). Then Dave would swab and jab (butt only, thank you - no thigh). Then I would keep a microwaved hot washcloth on it. As it would get cooler, Dave would nuke another wet washcloth and exchange mine out - we'd do this repeatedly for about 5-10 minutes, all the time mildly rubbing and massaging the spot.
Never had lumps, pain was EXTREMELY minimal.
Posted by: Liz at May 20, 2004 10:18:25 PM
Golly Moses, Julie, I could barely stand giving myself a sub-q injection in the thigh! You are heavy metal, all the way, just for giving it a go.
Rock on.
(And furthermore: what's with the giant-bore McDonald's straws? Gaw, it's almost like they want you to drink your entire watery pop in three good pulls, so you make sure to super-size the next one. It's like sucking on a toilet paper tube.)
Posted by: Jo at May 20, 2004 10:22:46 PM
Julie! Ow! Ow! Ow!!!
What everyone else said is right on. I had to give myself a lot of PIO shots, all in the butt. The twist isn't that bad---use a mirror, if you can. I followed every single superstition I could find online: warm the oil in the bra, ice the butt, massage, heating pad, practice throwing the needle into a grapefruit...
... and, the ice wasn't especially necessary, because there are basically no nerves in that part of the butt. But all the heating stuff was actually helpful.
Remember to draw back and see if you've hit a blood vessel. I didn't always remember, and forgetting sometimes led to more ooze and more bruising.
Posted by: Emma Jane at May 20, 2004 11:35:55 PM
Oh, Julie, promise me you won't get "creative" again.
sigh.
Hoping more than ever that it all turns into a kid in the end.
Bisous.
Posted by: mollie at May 20, 2004 11:49:42 PM
They hurt like shit. I have huge lumps on my upper right quadrant. And I do all the right things, hot cloth afterwards, heat oil up (I also do it under a hot running tap), and I still get lumps. I have resigned myself to lumps.
Now wait until you have to do this for the next 12 weeks!!!
Posted by: Tertia at May 21, 2004 12:08:23 AM
Oh my gawd. I know how you feel. I've used PIO for both my pregnancies (the first one, not progressing further than 18 weeks). And when I do do it myself, it hurts like hell. My thighs have never been the same since. At least when my hubba does it, I can blame him for the pain it causes. For the second pregnancy, I had to the PIO even longer.. 16 weeks. Oh geez, but so worth it. ;)
Posted by: maricar at May 21, 2004 1:09:10 AM
Oh, holy night.
I went through 36 hours of labor unmedicated, and I have no doubt that I could *not* do the PIO.
Ouch.
Posted by: Moxie at May 21, 2004 8:00:11 AM
This only confirms that I should be afraid of PIO. Very afraid. You're a brave woman Julie.
Posted by: Lisa at May 21, 2004 8:25:24 AM
Nooooo, I am not brave! I am deeply, deeply stupid. And still halt and lame this morning.
Posted by: Julie at May 21, 2004 8:43:39 AM
I can only say one thing....::sniff sniff::....I so wish that I had 'lean, unlarded upper thighs'.
;o)
Fervently wishing for a baby for you, from over here in Texas!! (And envying those thighs!)
Posted by: shaunacat at May 21, 2004 8:54:29 AM
I'm not sure whether to laugh, cry, or pee my pants! Okay I did all three. Holy cow what an insane idea! It took me a few days before I could master the left hip without shifting gears into 3rd & 4th. Just be aware, that in a week, you won't be able to lean up against kitchen counters or desks without an immediate reminder that you've been perforating your glutes with PIO.
Hoping it's all good.
Janet
Posted by: GalaxyGirl at May 21, 2004 9:17:27 AM
Sorry. Hate to break it to you, but it just gets worse. After a while, you can't even find a place to stick those darn things. Once I'm at that point, then the bleeding starts. I big old trickle after every shot.
Honestly, I think it is the worst part of the whole IVF process (after 5, I think I've analyzed the whole thing to death so I should know). For me the progesterone made me terribly sick, heartburn and it made me puff up like a balloon. It sucks.
Only thing I hope for you is that you end up taking the stuff for the full 10 weeks. It will be worth it in the end.
Love you,
S.
Posted by: S. at May 21, 2004 9:28:35 AM
Can you ask them about oral progesterone? This last cycle, after the sciatic scare, they put me on lozenges and crinone gel instead.
Maybe?
Posted by: Liz at May 21, 2004 9:59:52 AM
Julie,
I'm around this weekend if you need an old welty ass pro to do the sticking honors. Seriously.
Joanne
Posted by: joanne at May 21, 2004 11:03:57 AM
Julie,
I'm around this weekend if you need an old welty ass pro to do the sticking honors. Seriously.
Joanne
Posted by: joanne at May 21, 2004 11:05:54 AM
Holy crap, I think I have hives just reading the post. Thank goodness I've never had to do that. I've broken my ankle three times and gone through a total of almost a year in casts and I would take that over one instance of PIO. Jesus.
Posted by: jen at May 21, 2004 1:19:21 PM
Geez, I got so agitated I totally forgot to say good luck. Good luck.
Posted by: jen at May 21, 2004 1:26:01 PM
That sounds SOOOO heinous. I can *hardly* wait to start the fun next week.
Good luck. I hope they get a little more routine.
-AmyY
Posted by: Amy Y at May 21, 2004 1:35:51 PM
I just fainted a little bit. OWWWWWW.
And good luck...gobs of it.
Posted by: amalah at May 21, 2004 2:16:38 PM
Aw hell Julie, I am SO having PIO flashbacks from 10+ years ago....
Why did no one tell me about the fucking hot pack afterwards? It burned like hell. *shudders*
I was walking like you last cycle. So I feel for you. I hope you feel better honey.
Posted by: Cyn at May 21, 2004 2:37:47 PM
Yuck. PIO bites the big one. I've been off them for about 6 weeks now and still have the lumps in my ass. I did them in my thigh regularly, when DH wasn't home.
Even with the pain, I hope you get to do them for a LONG time.
Posted by: Tessa at May 21, 2004 4:48:26 PM
I always figured I would never be able to inject myself with anything unless absolutley necessary like with diabetes or something. I'm not sure what I would do if it came to that point for me. The thought of IVF scares me already because I don't think I could handle super-ovulating. I'm extremely sensitive to the nuances of my cycles as it is. You're an amazing woman. And I imagine you're husband's pretty amazing to go through this with you in relative calm, from what you've described.
Posted by: Carrie Jo at May 21, 2004 6:08:42 PM
Ummmm.....
Ouch! OUCH! My sympathies.
I have the strongest feeling that this cycle is going to result in a baby for you. I am embarrassed to even write this, because it sounds that stupid and fey, but I very rarely get these feelings and... well, I thought I would share it.
I hope you traveled safely and that the cat is gently kneading your sore spots with soft paws as I type this...
Posted by: Julia S at May 21, 2004 11:56:19 PM
Oh, man, PIO sucks no matter which way you "stab" it! Did it for 16 weeks.
I ditto the folks who said to warm up the PIO first, and I would sit on a heating pad for at least half an hour afterwards.
The only good thing about it was that it brought my relationship w/ my husband to a whole new level of trust!!! (I had done all my own injections up to that point- being a big time control freak, this was a big step!)
Wishing you the best. I really enjoy reading your blog. I've been there, and you get it across so well. Thanks.
Posted by: Scarlett at May 22, 2004 12:38:46 AM
I'm a little late here- my internet has been down for a long time- but I had to comment.
I never thought I'd be able to inject myself either, but it's amazing what we'll do, you know? Now, I do the subcu shots, no problem. But the PIO? Uh, no Julie. For me, the shots themselves don't hurt- it's when you've been rotating your ass quadrants for oh, say a month, and you can't find a damn spot to inject yourself in. But listen to THIS: I stopped my PIO shots from my last IVF in March and when I run, which isn't very often, the spots where the shots WERE, still hurt.
Posted by: Janet at May 22, 2004 10:06:30 AM
If you've gotta do the thigh, one piece of advice: get a one-inch needle. Apparently it's still deep enough to do the trick but doesn't hurt anywhere near as much as the inch-and-a-halfers. (Not that I personally am in any danger of having an inch-and-a-halfer go all the way thru my thigh.) I prefer the twisting around solution. I usually do it lying on the bed.
I'm new to your blog and really enjoying it. Wishing you many less painful moments and good luck in the weeks ahead.
Posted by: Deb at May 22, 2004 7:36:09 PM
Oh, Zhules, ouchouchouchouch! My butt and thighs ache in sympathy, but my heart is filled with hope and excitement for you and Paul.
That is probably the only time in my life the mention of McDonald's hasn't made me hungry. I may never supersize again.
Posted by: jc at May 23, 2004 1:19:33 AM
It is just too bad you can't get sauced before you do the shot...heh..
Posted by: Jen at May 24, 2004 7:43:07 AM
Ouch!! My 1st IVF we just followed the nurse's directions, and I STILL have a sore spot from them when I jog down steps or something. Permanent or near permanent scar tissue. But have the nurses ever really gone through IVF themselves? The frozen cycle we did, we followed the directions I got at my Resolve support group instead. I did the whole bit-heat the oil, massage the lump right after, then sit on a heating pad for 10 minutes. I had almost no pain, and very little bruising. I think there's a lesson in there-ask those who have actually gone through IVF. Worked for us anyway. Good luck!!
Posted by: Tuli at May 24, 2004 11:19:19 AM
I know this comment comes a year too late, but in regards to sticking your thigh, I can relate.
Imagine, if you will, a 4 year old girl with some sort of immune issue and the uncanny ability to *just know* that she's gotta go to the doctors to get this monthly shot done (much like a dog can tell he's going to the vet) and crying the entire way to the doctor's, most likely looking like a kidnap victim in the backseat of her mother's car, what with all the screaming and flailing of the limbs and all. Shots that invole a 1.5" 16g needle jabbed in the thigh. (for comparison, your average ear peircing is about a 22g, and most body piercings are done at 14g)
My mother still tells stories of how I had to be the last patient scheduled so that my screams wouldn't scare the other patients.
Posted by: Crystal at Feb 1, 2005 1:25:51 PM
Progesterone in Oil Injection Tips
• Try warming the progesterone in oil vial next to your skin (slipping the vial in your bra is ideal) for half an hour before the injection.
• Change the needle after drawing up the Progesterone to avoid injecting yourself with a dull, oil-covered needle
• To lessen the pain of the progesterone IM injections, place warm compresses on the injection site after the injection is given and rub the area really well so the oil gets disbursed more quickly.
---- >Homeopathic Arnica Gel works well to stop the bruising
Posted by: Subversive Mother at Feb 17, 2006 12:39:44 AM
I'm so pleased that Google found this blog entry of yours for me. My husband is out of town and I'm self-injecting progesterone in the thigh. It genuinely hurt so much that I thought I did it somehow wrong and injured myself. I'm limping around town - I can't contract the muscle in my thigh to bend my knee.
Anyway, good to know that at least one other person out there had the same experience.
Posted by: Cynthia at Oct 21, 2006 10:35:27 PM
does anyone know where I can find progesterone in sesame oil. i have tried several pharmacies and no one has it and I'm supposed to start taking it tomorrow.
help
Posted by: christie at Feb 20, 2007 3:14:36 PM
Bloody hell! I have to learn to inject myself today, so I typed "inject myself" into google, and got this! I was hoping to read that it was painless and easy. Damn, I wish I hadn't read this, I am scared.
Posted by: K at Jun 7, 2007 5:01:28 AM
It is pretty painless unless you're stoopid like I was! Best of luck to you.
Posted by: Julie at Jun 7, 2007 8:27:56 AM
Hello everyone!
I'm in the smae boat with all of you! At first my friend was doing them for me (she is a medical assistant) they didn't hurt at all! but she got sick and had to do tem myself DH won't get near any needles! Let me tell you that I have some hives on my back and bruises on my butt. Nurse said the hives are common. I'm scared now, reading your blog that I might have to do this for 12 weeks or so! I just did my first IVF transfer on Saturday June 06! Good thing my teenage daughter is willing to help me with the shots so I have to start training her with an orange and empty needle! Hopefully she learns fast, because can't take it no more with the torso twisting and spasms!
Good luck everyone!
Posted by: Lucy at Jun 14, 2007 3:44:15 PM
Hi, I posted here a couple of weeks ago, I just came back to say that I've done it now, and it was fine!
Posted by: K at Jun 20, 2007 5:40:18 AM
Holy cow, I'm so glad to have read this. I had to do my own injection in my thigh last night and can barely walk today. They've been going ok with dh doing them in my rear, but this pain in my entire upper leg is completely unexpected. Like someone else said, I googled and found this blog because I thought I must have done something wrong and seriously hurt myself. Thank God I'm home tonight so dh can resume sticking me in the rump. I have about 2 more weeks of this and I will be 12 weeks along!! Yay! Now I know to never again try and do it myself, I'll get the mailman or anyone I can find nearby to do it for me if I have to, lol.
Posted by: Laurie at Jul 8, 2007 8:33:31 PM
I am on PIO right now only day 3 (lucky me) I am not doing the IVF tho i dont make enough on my own to keep a pregnancy and already my thighs are bad looking they also have me on baby asprian for a "clotting issue" so i have HUGE ones the size of a good size orange
Posted by: Jen at Jul 21, 2007 11:40:34 AM
My first injection was done by a nurse and it hurt like crazy. Even 24 hrs after, it still hurts like crazy.
I was stupid enough to give myself a shot in the thigh before and I learned very quickly that the thigh area is not intended for such abuse.
Did anyone read the pamphlet that came with the PIO? It doesn't sound promising...it actually makes me worried about the hazards of taking it on the unborn fetus...ANy comments?
Posted by: Julie B. at Aug 2, 2007 12:41:04 PM
Jen, I just read the pamphlet and thought about the same thing. Especially since it also said that no studies prove that progesterone actually prevents early miscarriages. If one has normal progersterone levels, why is PIO even necessary? Wouldn't suppositories do? I took suppositiories for IUIs and I'd rather do that but my clinics insists on shots.
Posted by: Monika at Aug 2, 2007 1:28:59 PM
I am on week 6 of POI. I have my retired nurse grandmother giving them to me in the buttocks. I've tried heat, warm compresses, deep muscles massages. I have lump the size of tennis alls and as hard as tennis balls. HELP.....it really hurts like hell. Does anyone have a rememdy besides the ones already listed? Doc says 4 more weeks of this. Hell I thought the suppositories would be enough however I'm doing both. Need relief BADLY. Wide open for suggestion.
Posted by: Me at Sep 14, 2007 2:26:20 PM
