PIO tips, Acronyms, Beta Levels & Doubling Chart, & IF info web link here**

[BC-KarenS-MI]

Hello! (PIO tips are first, scroll down for Acronyms, the Beta Chart, compliments of Gwendolyn!!) & last is a link to sight where you can put in your Beta numbers with the dates & it will calculate how quickly the numbers are doubling.

It was suggested to me that we have a post that is pinned about PIO tips! It seems to be a question that is asked weekly! So, please feel free to post your PIO tips here! Please also keep in mind that different RE's will tell you different things when it comes to some of the tips, so if there are conflicting tips here, it's not that they're "wrong", it's just what a specific RE suggests! When faced with something like that, please, consult your RE for his/her best suggestion!!

With that said, here are a few tips from me!

* About 5-10 minutes before your shot, hold the PIO bottle between your legs, under your arm, or put the vial in your bra. This will help to warm up the PIO, & thin it up just a little. This makes it easier to draw it up into the syringe, & easier to inject.

* Use an 18 gauge needle to draw up the PIO, & a 22 gauge needle to inject. (remember, the smaller the number on a needle, the larger it is; the bigger the number, the smaller the needle) The bigger needle makes for easier drawing up , & the smaller needle.......well, you get the idea there!

* Massage the area after the PIO is given, as this will help to disperse the PIO into your body & will help to alleviate some of the lumps that will occur!

* Using a heating pad on the injection site after injection will also help to disperse the meds plus ease some of the discomfort!

* Get a prescription for EMLA cream. This is a cream that will numb the area before getting the shot.

* As for icing the area first....... my RE's have said not to ice the area first, because it makes it harder for the PIO to spread out evenly, plus, it thickens it up quicker too! Think about it......you warm the PIO up to have it go in easier, then you're putting it into an ice cold area. I know some people say to do it. This is one I would check with your RE about.

Those are my tips. If you have any others, please feel free to add them here! I haven't personally used the EMLA cream, but I know lots of women have here. For us, using the specific needles, warming the PIO & having my DH rub the area after worked perfect for us! They weren't the worst thing to have to get, but everyone is different & some will experience more discomfort!!

Oh yeah, I almost forgot! The most important tip!!!!!!! ALWAYS, ALWAYS, when you're getting the PIO shot, picture your little embryo's snuggling in & settling down for the next 9 months! Then, after your beta, you just keep picturing your beautiful little one(s) growing & just keep telling yourself that "this will ALL be worth every single poke in the end!!"

Karen, host of this wonderful IVF board

[AmyLeigh]

COOL KAREN AND THANKS A BUNCH !!!!
XOXOXO
ME

[BC-Tfal]

Thanks Karen. Those are great tips!

Great tips Karen! But I'd have to reccommend a 22 gauge to draw up PIO and a 25 gauge to inject. That's what my re uses and I couldn't imagine having to use such a thick needle (22 gauge) to inject. The 25 is thinner and much easier to take. I agree with you about not icing too. Ihave done both and the heat works much better! Good luck all!

[Tulip]

I do my own IM PIO shots!!!!!! I do not have an option for anyone else to do them for me. My number one suggestion is what's already been said:

GET THE EMLA CREME!!!!
GET THE EMLA CREME.
GET THE EMLA CREME.

So far I've only done this shot in my butt, but am tempted to try my thigh because my hips are getting soooooooo sore!

I put the EMLA on my butt about 1.5 hours before the shot, sometimes a little longer. I use a bandaid to cover the creme.

I heat the PIO so it's REALLY warm.

I use an 18g needle to draw it up, and a 22g to inject.

I sit on the floor & use a floor mirror so I can see what I'm doing.

I have a little floor stool I lean on so I can support myself while I'm twisting around doing the shot.

I cannot possibly "use a dart like motion & thrust the needle in all the way" (per my instructions). That's a joke!!! I position the needle first, then push it in. Because of the EMLA it doesn't hurt, really, it doesn't hurt. I feel it, but it doesn't hurt.

It helps to breathe in, and then let your breath out as you push the needle in.

My hand always trembles when I'm injecting the PIO. Can't help it - that stuff is hard to push out!

I always seem to bleed after I'm done. Sometimes quite a bit, but usually not a whole lot, yet always enough to make a bit of a mess. I rub the spot VERY VERY HARD with an alcohol swab and apply very hard massaging pressure for about 5 minutes. I probably bleed so much because I'm on BA therapy, and no doubt if I progress to heparin I'll start to really bleed!

I sit on a heating pad for several hours after the shot.

Heat & EMLA seem to be the best ways to make this shot easier!

Good luck

[mlb3]

All of your suggestions were great, but my RE warned against putting heating pad on area during 2ww as it endangers overheating the embies. After a neg beta =( he gave me the go-ahead and it really helped a lot.

Best of luck all...those shots are a bear!!

Michele

[babyhopes]

Hi Everyone,

I do my own PIO shots (DH travels for work) and they are a BREEZE! I am so angry at listening to everyone who said I really shouldn't do them myself...that I need a backup, blah blah blah! And I am a HUGE baby so if I can do them - anyone can! Believe me I worked myself up into a frenzy over this - I cried several times thinking I wouldn't be able to do it! I have the EMLA too - but honestly - I don't need it at all. It barely hurts. The Follistim shots hurt TONS more - trust me!

The key is to make sure that the PIO is really warm (I run hot water over the vial for a few minutes - the PIO is in a baggie when I do this so it doesn't get wet. Then I use a 22 gauge to draw up and a 25 gauge to inject. My RE gave me all 22s and said a 25 is too hard to push out but that is nonsense as long as the PIO is warm. And I just find that I barely feel the 25 but the 22 hurts more. Also, when I use the 22 I bleed a TON and with the 25 I don't bleed at all. Yes, it will take about 15 seconds to push it all out, but my follistim (sub q) took almost a minute because it stung so badly!

When I have the shot ready I lay on my bed on my back with my head propped up high on at least 2 pillows. Then, I take one leg and cross it over the other with my knee bent and push my hip up - so I can reach it. Sometimes just so I make sure I hit the right spot I will circle the area first so I don't miss (It looks different when you are twisting than when you are standing!) Anyway, that's it. I just push the needle in (can't really do the dart motion - I pull back - yes you can do this with one hand if you are careful - and my other one doesn't reach anyway - and then inject the PIO. I do this in the AM when I get up so I just jump in the shower afterward and make sure the hot H2O hits my butt....and that's it!!! No bruising (and I am really fair with red hair and i bruised with the lupron and Follistim), no lumps, no pain, no nothing!

Hope this helps any of you who have to go it alone!

Best wishes,
Melissa

[Denise-AZ]

I really appreciated reading about all the tips written on this stream because I am started my injectables on the 30th of this month....I'll ask my RE about the EMLA when I go in for my u/s on the 28th.....
My DH is really scared to poke me and so maybe if he knew that there was something numbing the skin, he would feel less afraid about giving me my shots.....

Thanks again ladies.....

[Hunterswife]

Hi Ladies! I am new to the board (1st post) and have just begun my first IVF/ICSI cycle. I have been FREAKED about the PIO shots b/c I will have to give them myself (dh travels a lot) and and so thankful for all of the great suggestions!

Now I can relax and focus on a positive cycle!

Thanks again!

[jaycee]

I got all worked up about these shots and there is absolutely nothing to it.

I give myself the shots most of the time. My honey travels, so he does them when he is home so he can feel a part of it all. I draw with an 18 and inject with a 22 gauge. I don't use EMLA, a heating pad or warm the oil. I lie on my side and aim for my butt. The needle doesn't hurt going in, and the oil doesn't hurt either. I just inject it slowly. I have never bruised, bled or had any tenderness at all. The progesterone is in sesame oil; I am not sure if this viscosity is any different from other oils.

Fear not, sisters! Good luck!