May 2017 - FET #2, Plaquenil Pills & PIO Reaction

Today is day 17 of the estrogen (aka: Estrace) pills and patches combined with the hydroxychloroquine (aka: Plaquenil) pills, which is our new addition for FET #2 protocol.  The estrogen combo of pills, 3x / day, and patches, whcih change out every 3 days, is pretty easy and routine at this point.  The Plaquenil is a pill 2x per day, and it's not much fun.

First, Plaquenil is meant for treating malaria (irony!!), lupus, rheumatoid arthritis, and other kinds of autoimmune issues.  It has some common immediate side effects, which I can vouch to, including nausea, loss of appetite, exhaustion, and headaches.  The estrogen pills/patches already induce this kind of reaction in me, so the Plaquenil has just upped the ante this time.  It also has some scary longer-term side effects, like "irreversible damage to the retina of your eye."  Yipes.  Thankfully this is typically the case with longer-term use to the tune of years vs. the weeks that I will be on it.

Some mornings I wake up and all I can focus on is whether or not I might vomit.  This lasts sometimes until about lunch time, then often presents itself again around dinner time.  Delightful, right?  It's days like these I am so incredibly thankful to have a job that is flexible and allows me to work from home, in my pjs, mere feet from the bathroom.  It has gotten better over time, but the first ~2 weeks or so was a bit rough.

On day 14, I started progesterone intramuscular shots (this time in ethyl oleate, not sesame oil), and tonight, I added in the blood thinner (Lovenox).  If you've been following along exceptionally closely, and have a memory like a steel trap, you might say, "Wait, why did you switch progesterone oil types?"  Well, let me tell you.  (More likely you didn't notice, but go with it...)

Flashback to FET #1 (queue the harp music):

After about 10 days on the sesame oil version during FET #1, the space between my alternating injection sites developed half a dozen large welts that were like enormous mosquito bites.  This is essentially the centralized area around my upper cheeks and lower back around my waistband.  I asked Michael to look at it, and since they weren't around the injection sites, more in between them, our first thought was that I had somehow gotten bitten by something while sleeping.  A couple of days later, it had only gotten more swollen and itchy, and I called the nurse, who called me in for a quick visit to have a look (at my butt...for the record, minimal modesty remains at this juncture).  She said, "Yep, that's a reaction to the sesame oil...poor thing, let's switch you over to ethyl oleate."  She says that, when injected, the oil spreads with the direction of the muscles in the area, and she's even seen women with these lumps that spread down their cheeks and upper thighs.

Turns out that the progesterone in ethyl oleate needs to be compounded, and there are only a couple pharmacies in the area that do that kind of thing.  This came up once before with the progesterone suppositories (vaginal) during my second pregnancy.  My nurse was able to call it in that morning and it was filled by lunch time, giving me the chance to switch over for the shot due that evening.

Flash forward to today:

It has taken about a month for the itchy lumps to dissipate.  Much longer than I expected, and I was starting the FET #2 round of PIO shots just around the time my backside was returning to normal.  So far, the ethyl oleate PIO hasn't caused that reaction, but since the first reaction didn't start until 10 days in last time, I'm keeping an eye on it...awkward angle though it might be.