Cycle Day 14

Today's symptoms: headache is gone finally, huge gross bloated stomach is even bigger, tired due to lack of sleep, emotional and weight gain has lowered to +7lbs.

Today is the day before the ER and I feel like it is the calm before the anxiety storm.  At this point I have done so much but starting tomorrow it will be all out of my hands.  I will be glued by the phone waiting for daily updates.  It will last 6 - 7 until we get our final numbers.

Yesterday my E was 2900.  This means by the time of my ER I will again be 4000+.  That makes the day of and day after critical to how quickly I recover from all this.  Here is my prep for the ER.

Today

• Remove nail polish.
• Take a shower tonight.  Wash hair and dry natural, no products (not the best look for me).
• Wash whole body and face with antibacterial soap, no lotions or products afterwards.
• Eats lots and lots of watermelon from 10pm - 11pm.
• Take a stool softener.
• No eating or drinking after midnight.

Tomorrow:

• Take a shower and wash with antibacterial soap.
• Check in for ER at 8:30am.
• Take my antibiotic.
• Procedure starts at 9:30am.
• Eat salty food.
• Drink coconut water.
• If I need it I have tylenol with codeine.  I didn't take anything last time because I knew I was going to be doing back to back cycles and I didn't want anything to delay the process.  This time I have a month or two before the transfer so it is ok to take something if needed.

Kite ceiling tile from the exam room

At our last check we still had 16 follicles.  The picture to the right is the ceiling tile in the exam room.  We are keeping our fingers crossed that they can retrieve all 16 and that each has an egg.  It is not uncommon for the doctor to not get all the follicles, but usually you get 90% or more of your count going in.  It is also not uncommon to not have an egg in each follicle.  I'll post updates as soon as I can,  Thanks for all the love and support during our stims.  

Thanks for reading,

HEATHER

Cycle Day 13

Today's symptoms: headache again,huge gross bloated stomach, tired, emotional and weight gain has moved to +8lbs.

With my nurse Kristen

We had an 8am appointment this morning for another US/BW check.  I still have 16 follicles in the running which is very exciting. The most we have ever had before is 15.  The smallest was 13mm and the largest was 23mm.  Still waiting on the final E numbers.  No matter what they are though, we got the go ahead to trigger tonight for an ER sometime Wednesday morning.  

Kristen (left) is one of two nurses that I see at all my appointments.  She walked in when we were taking our daily blog pick and I asked her to jump in.  She has been so great and so supportive.  It really is nice to have a sweet and caring nurse that I trust.

When it occurred to me that this morning was my last stim shot ever, I wept.  This was my 7th time using injectable meds (3 IUIs and 4 IVFs.  No matter what happens next, there won't be stims involved.  If our embryos come back normal, then we move to FET and the only shot for that is PIO.  If we don't get any normals back we will move on to DE/DS and I wouldn't be the one doing the stims.  Either way we are stim free.  Hallelujah!!!!

Thanks for reading,

HEATHER

Cycle Day 12

This is Heather's husband Ryan. Heather asked me to write today's blog entry and discuss the male perspective on infertility. I thought it would be helpful to talk about the clinical and social aspects of dealing with this condition.

Me reading our follicle count

As you know from reading Heather's blog, we are diagnosed with both unexplained infertility however while we are cycling most of the attention is focused on Heather. I do get to take large quantities of vitamins (a photo of which appeared on an earlier post) but like most things fertility related, what I ingest is relatively small compared with what Heather has. My responsibilities going through an IVF cycle typically consist of administering the shots and providing as much support to Heather as I can. Going through an IVF cycle can be very frustrating as a male. As you know from reading Heather's post, the shots and side effects of the medication can be very painful and it is tough watching her go through it. If I could take the shots for her I would but sadly I do not believe it would be as effective. At this stage of the cycle her discomfort and emotions are all running to the max and I am doing my best to be as emotionally supportive as I can (I still manage to occasionally frustrate her at times though :). To provide support, I try to keep as calm an exterior as I possibly can, however on the inside I feel extremely angry and frustrated. Like others in our situation I am just mad that we have to go through this.

Socially, dealing with infertility on the male side is very isolating. My friends do not really understand the issues that we are facing and it is tough to constantly address why we do not have kids. To further complicate the issue we are at the age where all of our friends are having/had kids and it is hard to see them all moving on while we are still stuck going through this. At times it is all very overwhelming to deal with infertility, provide as much support to Heather as I can, as well as dealing with stress at work. Fortunately for me, I told my boss and he is understanding of me leaving work to go to our numerous appointments. We have met many people going through this journey who do not have the support from their superiors at work and I don't know how they manage. Sometimes the stress from everything: job, family, infertility is just so much I can feel myself shutting down. As a coping mechanism I have generally withdrawn from my social circles which is fairly common according to many other men I have talked with who are also dealing with infertility. I know the isolation is not healthy and I am trying to step back out into the world but it is hard, especially when you see everyone around you getting pregnant. Fortunately Heather runs a support group here in San Diego and there is a strong male presence at the meetings. It is tough for me to discuss my feelings in public but just knowing the other guys in the meeting can relate to what I am going through makes even the standard male conversations about work and sports very therapeutic. Also hearing them discuss their own issues reminds me I am not alone.

Hope this provides everyone with a small glimpse of the male side. To update everyone on our cycle: today was a good day for us though as the news from the doctor was very positive: we have 16 follicles and it looks like they are all progressing very well! There is a light at the end of the tunnel and I am counting the days until our retrieval!

Thanks for reading,
Ryan

Cycle Day 11

Today's symptoms: headache still, a very bloated stomach that is starting to get very uncomfortable, tired, emotional (I'm still crying about 5 times a day now) and weight gain has moved to +7lbs and bring on the acne that comes with all the hormones.

Today we have the day off from doctors visits.  Tomorrow we start going every day until they determine that we are ready to go.  They are looking for the smaller follicles to get to 14mm and the bigger follicles to not get larger than 30mm.  This is the reason for the ultrasounds.  We do the bloodwork to make sure that my estradiol doesn't get too high.  If it does get too high you run the risk of OHSS and of all the things that could go wrong, this is one of the worst and most painful.  My E usually ends up between 3500 and 5000 which is actually pretty high.  Most people get up around 2000.  Its a fine line with your E levels.  You want it to increase because that means you body is producing hormones and your follicles are growing.  You want it to not get too big because of the OHSS risk.

Today we are 'enjoying' our last day off (it's hard to enjoy a day like today when I am just so uncomfortable).  That means its time to prep for the upcoming ER week.  I am doing a freeze all so I don't need to get ready for a FET, I just need to get through the ER.  Here is my shopping list:

• Watermelon - I usually have a hard time with the IV, its tough for them to find the vein. The anesthesiologist told me an old wives tale of eating watermelon the night before helps to keep the veins bigger.  I googled this and got a bunch of results from bodybuilder sites stating that bodybuilders use watermelon before a show in order to make their veins 'pop'.  I swear it works!  Ever since, I eat watermelon about an hour before the cutoff of when you can't eat anymore and since then they have always got the IV going on the first try.  
• Coconut Water - It is imperative to to drink electrolytes after the retrieval.  If you only drink water, the bloating will remain for a few days.  If you drink electrolytes, the bloating goes down so much quicker.  Gatorade is another option, I just personally don't like the taste.
• Soup - They recommend eating foods high in sodium.  I just eat a bunch of soup over the next few days.
• Food for the husband - I don't like to have to worry about him or deal with too much the day of ER or even the day after.  So I usually cook a casserole for him to eat.  This time around it is costco chicken courtesy of my parents.
• Restock ginger chews.  I have gone through 3 bags already.  I always make sure that I have at least a whole bag on hand.

My brother, Parker and I

Usually I lean on my acupuncturist for help in relieving my pain but once I get this close to the end, I can't have acupuncture anymore so I suffer alone in my discomfort.  All that I can do is wear my IVF pjs and relax, watch a lot of tv, do some crosswords, and take naps.  Luckily I have a very sweet brother who came to pay me a visit today.

Thanks for reading,
HEATHER

Cycle Day 10

Today's symptoms: headache again, bloated stomach, tired, emotional (I'm crying about 5 times a day now) and weight gain has moved to +6lbs.

Today started off with the usual 5:45am wake up call for my Bravelle shot.  Then off to the doctor at 7:30 for my us/bw monitoring appointment.  They call with updates once the labs come back and the doctors have a chance to review the numbers.  So far my FC is still looking good they are all between 8 - 16mm.  The earliest I will trigger will be Sunday night for a Tuesday ER.  Since this will be my last cycle I don't mind stimming a few extra days now in the hopes that the smaller ones have time to grow and will be big enough to retrieve.  The rule of thumb with this clinic is that they need to be over 14mm for there to be a likely chance of getting an egg.

Today's picture was unknowingly taken by Ryan right after I had my blood draw.  As I mentioned in an earlier post, I am horrible with needles and blood.  After fainting so many times, finally a nurse asked "have you ever tried lying down?'.  It sounds like such a logical solution and I feel stupid for never thinking of it.  Ever since then, I get my blood taken laying down.  I cover my eyes and try and block out all noise.  She lets me know when she is down and then she leaves the room.  I wait a minute or two before sitting up.  I also make sure that I drink at least 1 glass of water before I go and I eat at least a cracker or something small.  Since I've done this, I've never fainted.  If you are a fainter too, I highly recommend this.

Thanks for reading,
HEATHER

Cycle Day 9

Today's symptoms: headache again, very bloated stomach (started wearing my IVF pants), very very tired, emotional and weight gain has moved to +5lbs.

During my very first IVF cycle, my doctor warned that most people get a very bloated stomach and he recommended having a pair of pants that are one size bigger than normal on hand.  I didn't think I needed that and ignored his advice.  By Day 14 of stims I was miserable and regretted not having bigger pants.  I ended up wearing pjs to that ER.  Since then I have purchased a pair of jeans, a pair of pajamas and a pair of yoga pants all one size bigger and it makes it so much easier.  Not only is your stomach bigger and bloated, but it is full of bruises and it is rock hard.  The thought of wearing tight pants is horrifying.  Today I officially switched to my IVF pants and as I type this I am wearing my big yoga pants.

another bloodwork/us appt.

Last night we started Ganerelix.  This is officially the start of the end of the cycle so we were so excited to get the good news.  At yesterday's check up they are still counting 16 follicles plus a few too small to count. The most we have ever had is 15 at the day of retrieval. They are 9 - 14mm each.  I have found out through switching clinics that not all clinics measure the same way.  SDFC measures the longest side of the follicle.  RPMG takes an average of two measurements.  Therefore my 14mm follicle at SDFC is much larger than what it would measure at RPMG.  Just because we have 16+ follicles doesn't mean that we will get 16+ eggs, not every follicle has an egg.  My bloodwork came back and my E was 642 which is a little low for me.  They are guessing I will stim 14 days which would take us to Tuesday and ER on Thursday.  We are going back tomorrow to get a more accurate calendar of the next few days.

Today I sat home and waited for my next set of meds to be delivered.  After my first cycle, I've never ordered all the meds at once.  That cycle was almost cancelled halfway through.  Now I order enough meds to make it to the second monitoring appointment.  Once I get the OK that the cycle is doing well and that I'm progressing, I order the rest of the meds.  I use MDR pharmacy and they ship overnight for free as long as you spend $500 and we all know that is nowhere near a problem.  Now I have enough meds to make it to Day 12.  If I go over I order one day at a time.  The last thing I want is leftover meds.

This was my ceiling view from the exam room yesterday.  Each room has a different picture.











Thanks for reading,
HEATHER

Cycle Day 8

Today's symptoms: headache is still there ugh!, slightly nauseous, bloated stomach, tired, emotional and the weight gain has started +4lbs.  

Yesterday was great.  I felt a million times better after acupuncture. After being sick for so many days in a row, it was so nice to be able to eat lunch again.  The worst symptom I have is a headache that just won't quit, but I always get a headache so it wasn't a shock. 

Last night we went to hear Meb Keflezighi speak.  He is the 2014 winner of the Boston Marathon.  He has written a book called Meb for Mortals.  His book is about setting goals and preparation and hard work.  He was a great speaker, very funny and has an amazing story to tell.  The hard part was hearing that if you set goals and do everything you can, thats how you can make your goals become reality.  And yes, I understand that he meant physical goals but all I kept thinking was that I have done literally all that I can do.  Where is my payoff?  

The hard part over the next several days will be dealing with the emotions that are bubbling over the surface.  While the drugs do make me a bit crazy and heighten all the emotions, the emotions are there and would be there, with or without drugs.  It's really hard being stuck in this situation and feeling that I am doing all that I can and I am not getting results that I want from all this effort.  Then you turn on the tv and watch the news and it is filled with all these horrible stories with horrible people and they all have kids.  It's so unfair.  It feels so unfair.  We all say that it is unfair, but that doesn't change the situation.  Children are everywhere and all I can think is 'why not me?', 'why not us'?  And to add salt to the wound, Mother's Day is coming up and it is a stab to the heart reminder that I'm not one.  I keep getting emails about Mother's Day brunch and hurry and buy Mother's day gifts.  The advertisers just won't quit.  So yesterday I cried about 5 or 6 times over various things.  
Having a great support systems is really helpful during times like this.  I have friends I've met online, my support group here, my acupuncturist, my friends outside of the infertility community, my dog, my family and most of all my husband.  It takes all these shoulders for me to lean on to get through the next week or two.

Thanks for reading,
HEATHER

Cycle Day 7

Today's symptoms: headache in the am, nauseous until acupuncture, stomach slightly bloated and very very tired.  

Great news, the new protocol worked!  I didn't get sick once last night.  We did two vials of Bravelle this morning and will do the rest tonight.  So hopefully we reached the halfway mark, but one never knows how long they will stim for. You have to keep setting goals and celebrating the small accomplishments.  It's the only way to survive this whole thing.

Today was a great day for one reason, ACUPUNCTURE.  Acupuncture is the most amazing thing and I was counting down the minutes until I walked in for my appointment.  It took my headache away and drastically reduced my nausea almost instantly.  Acupuncture is such a personal thing that you really need to find someone you like and trust.  I loved the place I went to in Los Angeles and was lucky to find an equally amazing woman here in San Diego (details for both are below in case you live in either area).

I have been going to acupuncture for a long time now.  I used to go for pain in my leg and then switched over to fertility focused practices.  I often laugh at the comic situations I find myself in.  I faint immediately at the sight of blood and needles, no joke, so many times I have lost track.  Now I go to acupuncture and get needles stuck in me on a weekly basis, I get blood taken every other day and Ryan gives me shots morning and night.  The irony of it all!  Anyways, because of my aversion to needles, I was very apprehensive over treatments.  First off, there is absolutely no pain from these needles, you hardly even feel them.  Secondly, I always tell them that I can't see anything and they put an eye mask on and I drift away to relaxation city.  When they come back in, they remove all the needles and then the eye mask.  I have yet to see one needle.  Oh and I get about 10 - 20 needles all over each treatment.  It is nothing like what Charlotte got on Sex & the City and none are in my face.

Fingers crossed my shots go well tonight and the worst is behind me :) 

Los Angeles acupuncture -  Denise Wiesner, L.Ac., FABORM
San Diego acupuncture - Jeneanne Paden, L.Ac

Thanks for reading,
HEATHER

Cycle Day 6

Today's symptoms: headache (not as bad as yesterday), only threw up once, nauseous only in the morning, stomach starting to get slightly bloated, emotions are starting to accelerate too, crying over TV and movies has commenced (and not even necessarily sad things), started to get really tired

Today's progress : FC 16 - 20 they are still a bit too small to count accurately.  They are 3 - 8 mm.  Estrogen is 252.

We went to the doctors at 7:30am.  We like the first appointment because we get it over with and they are usually right on time.  I mean, how far behind can you be with your first patient?  (don't answer that RPMG!)

Night time is the worst time.  Within 30 min of the shots, I get sick and I stay feeling sick all night long and into the morning.  I wake up feeling much better and then the countdown begins until the next dreaded shot.  I spoke to the doctor about this and he changed my protocol.  Tonight we are going to break it up and do 2 vials of Bravelle in the am and 3 vials of Bravelle and 1 vial of Menopure and the HGH at night.  Hopefully this will make me feel much better.  In all my cycles, I have never been this sick before.

So I gave my allotment of blood and stayed by the phone waiting for the results.  I am so excited over today's FC and Estrogen levels!  Last cycle we only had 7 follicles, so we are doing much better this time around.  I am progressing at a slightly slower speed so we are probably looking at a 12 - 14 day stim cycle.  The average stim cycle is 9 - 11 days, lucky us, we are above average :(  So far we have stimmed 14 days every cycle except for the last one which was 12 days.  This is not good on so many levels, not only do I feel crappy longer, but every shot is hundreds and hundreds of dollars so it is painful on a financial level too.  



I am still super happy over my levels and knowing that I am about 1/2 way to being done.  Trying to focus on the bright side.  The picture to the right is the ceiling tile photo that I look at when getting examined.  It's a lot better than staring at the dots on the ceiling.   


Thanks for reading,
HEATHER

Cycle Day 5

Today's symptoms: horrible headache still and spent last night throwing up again

Around midnight last night we called and left a message for the nurse.  I have been sick before but nothing like this.  We received a call this morning and they basically told me that throwing up this much is really out of the ordinary and that I probably have the flu.  That is not the case.  I don't have a fever or any other flu symptoms.  Within 30 min of the shots I'm sick and it lasts several hours, but by morning I'm feeling better and it stays that way until the next round of shots.  This is so frustrating.  I have an appointment with the doctor first thing in the morning. This is the first time I have taken this amount of Bravelle all at once.  I take 5 vials at the same time.  I think they are just being lazy on a Sunday.  Frustration level is skyhigh!

Today's agenda - take a bath, change into new pajamas, watch movies on the couch with Parker.  So far I have achieved everything on the list :) 

Thanks for reading,
HEATHER

Cycle Day 4

Today's symptoms: horrible headache since yesterday afternoon, spent last night throwing up several times, uncontrollable night sweats and nauseous.  

Basically I feel like I have the flu.  It is to be expected because I always Feel this way at some point.  This cycle it came a few days earlier than usual.

The answer to surviving the next few weeks is ginger, lots and lots of ginger.  I have tried everything and heard everything to try and I always come back to ginger.  It really helps and its natural to boot, so no additional pills to take, YEAH!  There are all kinds of ways to enjoy ginger.  Below are my favorite ways that seem to help take the nausea away the most.  A helpful trick is to buy a bunch of ginger, peel it, cut it into chunks and store it in the freezer (you can't store it in the fridge, it will turn color and once it does it becomes toxic and inedible).  Then when you need it, it just takes a minute.




Ginger Water - Ryan bought me this pitcher for Christmas and I have used it ever since.  When I am not cycling and I feel fine, the recipes are endless of what you could put in it.  When I feel the way I feel today, I fill the whole fruit compartment with ginger.  Sometimes I add lemon too.  I sit it out and drink it all day.  Once the ginger is in the water, you don't need to keep it refrigerated.  It is much better on your digestion to drink room temp water anyways.  I do stick the pitcher back in the fridge at night and take it back out in the morning.  I keep adding new water to it.  I only replenish the ginger once it starts to look more spongy than like ginger.  This happens around day 4 - 5.



Ginger Tea - I take a few pieces of the frozen or fresh ginger and add boiling water.  I used to add honey to it, but now I am on a low sugar diet so I skip the honey.  Today I tried a regular bag of chamomile tea and added the pieces on ginger to that and it tasted really good.  The ginger pieces can break apart so if you have a loose tea strainer, I would suggest using that.




Ginger chews - Gin Gins are ginger candy.  I can not recommend these enough.  It is delicious and really helps and it helps quickly.  The real major downside is there cane sugar in them so it does not follow my low sugar plan. They are vegan and gluten free though. But when you are feeling this crappy, a little sugar won't kill me or kill my diet.  At this point, anything that takes away the nausea and throwing up takes priority.  I purchase them at Cost Plus World Market because they always have every flavor.  You can also find them at Whole Foods and on Amazon and probably other places, but those are the ones I know for sure.

Thanks for reading,
HEATHER

Cycle Day 3

Today's symptoms: headache (not as bad as yesterday's), very nauseous, loss of appetite

I probably should have mentioned before that every time I cycle I suffer a huge amount of side effects.  They are not uncommon or rare side effects, but not everyone suffers the same amount or as many of them.  If you are about to cycle for the first time, do not let this scare you, look at it as just a warning of what may happen.

It's not all bad though.  Since this cycle I am going with Ganerelix instead of Lupron, I have 0 weight gain!  YES!!!!  That is pretty exciting.  Usually at this point I have packed on the usual 10 lbs that Lupron is so happy to provide.  Lupron, you are a mean jerk!

Since I shared my vitamin list yesterday, today I thought I would share Ryan's.  Since we have unexplained infertility, we both take everything we possibly can in the hopes that something may help.  There is no data that proves that these will help, but they won't hurt our fertility chances.  

Every night when we sit down for dinner, Ryan grabs this bowl with all his pills. He has been doing this about 6 months now.  He seems to have less allergies and less rashes since he started so I think something is working in the right direction.

Zinc - 60mg - 1xday
Selenium - 200mcg - 1xday
Arginine - 2 - 3xday
Folic Acid - 400 mcg - 1xday
Vitamin C - 200-1000mq - 1xday
Vitamin E - 600mg - 1xday
L-carnitine- 1g three 1xday
CoQ10 - 30-100mg - 1xday
Maca Root - 1.5g 3xday
Astragalus - 1500mg - 3xday

PQQ - 10mg - 1xday

Thanks for reading,

HEATHER

Cycle Day 2

Today's symptoms - Massive horrible headache.  I always get them when I'm on Menopur.  Let me know if you have found any cures because I sure haven't.

Today I woke up with the above mentioned headache which was there when I went to sleep.  Nothing else really exciting to report on Day 2 so I thought I would walk through the hideous amount of vitamins and supplements I take.  Most of these are fertility related but some are from being a vegetarian and some are because I was recently diagnosed with candida.  I was also diagnosed anemia awhile back but that seems to be back to normal levels.

I don't take any vitamins or supplements that contains any ingredient derived from animals.  This can prove to be very challenging.  Finding meds without gelatin is the hardest.  If you too are a vegetarian or vegan, don't hesitate to ask for specific brand names.

First thing in the morning with a glass a water.  No eating or drinking anything else for an hour.
L-Thyroxine (only thyroid medication a vegetarian can take) - 75mg - 1xday

Next up - sometime in the am
Inositol - 4.1g - 2xday

During the rest of the day
Probiotic - with each meal
Digestive enzymes - with each meal

Probiophage DF - 1xday
PharmaGABA - 100mg - 1xday
Milk Thistle drops - 1 ml - 1xday
Chromium - 1 mg  - 2xday
Calcium - 500mg - 1xday
Algae Omega - 625mg - 1xday
Prenatal - 1xday
PQQ - 10mg - 1xday
Aspirin - 81mg - 1xday
B-12 - 2500mcg - 1xday
5 Hydroxy-tryptophan - 100mg - 1xday
L-Arginine - 1g - 1xday
5 MTHF - 1mg - 1xday
CoQ10 - 500mg - 1xday
Basic Nutrients 2/day - 1xday
Bromelain - 1000gdu - 1xday
DHEA - 25mg - 3xday
Vitamin D - 1000iu - 2xday
Oil of Oregano - 460 mg - 1xday
Paleo Greens - 1 scoop - 1xday
Daily C powder - 1 scoop - 1day
Allicin - 5000 mcg - 1day

After dinner
Vitamin E - 400iu - 1xday
Iron - 150mg - 1xday
Vitamin C - 500mg - 1xday
HCL - 400mg - 1xday

Before bed
Melatonin - 1mg - 1xday

Thanks for reading,
HEATHER

Cycle Day 1

So today is officially the start of my next IVF cycle.   Leading up to today I did 5 weeks of BCPs.  This cycle I chose to do DHEA instead of testosterone gel during priming.  I have a lot of apprehension and not a lot of hope.  Having the last 4 failed, its hard to get excited.  In all likelihood this will be our last cycle so there is a lot riding on this one.  So here goes.....

When I woke up I found a very sweet card from my husband.  It was so nice of him to think of me and realize how nervous I am about the whole thing.

For those not in the know,  before you can start the stims, you must first visit the doctor and get the OK.  You have to do ultrasound and blood work.  The ultrasound is to check for cysts and leading follicles.  The blood work is to check that you don't have elevated estrogen.  So off to the doctors we went.


Next stop was acupuncture.  During cycling, I go to acupuncture once a week.  I get so much out of it.  It feels great, it relaxes me and I really love my acupuncturist.





Results came back and I am good to go.  My AFC was 15.  This was great news.  last cycle my AFC was only 7.  This cycle our protocol is 375 Bravelle with 75 Menopur and HGH.  At this point we are super pros at this.  The drill is, he prepares the shots and I ice my belly.  Once the shots are ready, we put the heated neck pillow in the microwave for 5 min.  We go upstairs, do the injections, comeback down to an aroma pillow that relaxes my tensed neck.  Here are the first 7 days of meds not including what is refrigerated.

Today was an easy day with no side effects yet :)

Thanks for reading,
HEATHER