Day 20: The Large Needle

Truth be told, I love giving Leah her daily injections.

For a few summers in elementary school, my parents enrolled me in a summer camp at the local university. I loved being in chemistry class with a bunch of other youngsters, moving fluids between vials and seeing what would happen. The same fascination carried over into chemistry classes in high school, when combinations of liquids would precipitate down in tiny nuggets we were not allowed to touch.

I enjoyed building things as a child, as well. My room was full of G.I. Joe paraphernalia the assembly which was required I performed myself, rather inexpertly. It was a dark day in my adolescence when my brothers--ten years my junior--stopped asking for toys that came delivered in boxes filled with plastic frames that needed to be carefully separated and put together.

Giving Leah her injections gives me that same feeling. There is only one pre-filled syringe. The menopur comes in an astounding four glass vials with little plastic caps that are surprisingly tight. The menupur also comes with a Q-cap for help in combining the drugs and filling the syringe. When it's time for Leah's injections, I lay everything out on the bathroom counter: the 3ml syringe, the 30g needle, the Q-cap, the two vials of powdered menopur, the vial of sterile saline, the Follistim pen, the small needle for the Follistim. This is Leah's gear. The Follistim even comes with its own carrying case. Some assembly required.

After the egg retrieval, Leah's medication changed. She started taking 50 mg of progesterone twice daily. The progesterone is different from the other medicines. It comes in a large ampoule holding 500 mg. The progesterone is also oil-based. It is more viscous in the vial. It is also delivered intramusuclarly.

There is only the syringe and the needle when I draw out the progesterone. I draw in 1 cc of air before inserting the needle into the progesterone. The nurse never explained why this is necessary, but I imagine it's to equalize any pressure beneath the sealed cap of the ampoule. I push the air into the vial and it bubbles slowly in. I lift the vial upside down and draw in a little more than 1 cc of the medicine.

The menopur dissolves quickly in the saline, but the progesterone is thick. There are small bubbles that come into the syringe with the medicine, and they effervesce like champagne. If those bubbles make it into Leah, she could die.

After I draw the medication out, I switch needles. The delivery needle is 25-gauge and an inch and a half long. I am not a person that's afraid of needles; I love to give blood and do so without fear. But this needle terrifies me. It is long and wide.

When I clear the syringe of air, the fluid does not squirt into the air. It spills over the edge of the needle and beads down the side. It is dark like maple syrup.

I don't want Leah to see the needle. Not even to tease her about her being afraid of something so small and harmless. The other injections were subcutaneous. They went through the skin into the layer of fat beneath. The progesterone is intramuscular. When Leah has covered he face with a pillow and rolled onto her stomach, I pull the needle out from behind my back. I clean a large area on the upper, outside quadrant of her bottom with an alcohol swab. As the alcohol dries, I check her hip to make sure I don't hit the bone.

The needle seems to go in forever. Deep. You can feel the needle moving through the skin, and then you can feel the needle moving through the layer of fat. Finally the needle breaks through and the plastic base is resting against her skin. I press the plunger as hard as I can while keeping the syringe still so she doesn't bruise. The plunger moves slowly and drives the medicine deep into my wife.

When the syringe is empty, I draw out the needle. I am supposed to massage the medicine into the muscle so it doesn't pool. I re-use the alcohol swab, because a few drops of medicine follows the needle out. Leah clutches the pillow to her face until it stops hurting, and then asks if I can stop massaging yet.

When she's ready, I take the needle and replace the cap. I twist the needle off the syringe and toss them both into empty bottle of Listerine we've now half-filled with the medical waste of the process.