Taking Lovenox sucks.  There.  I said it.  However, so far, at least, it’s keeping mah baybee alive, so I lurves it.  Here’s how I inject it, because when I started looking online for Lovenox info everything I found scared the shit out of me.  Believe me, if you’re already at the ‘Lovenox’ stage of infertility, chances are pretty much 100% that you’ve already been through much worse than a slightly uncomfortable nightly injection, yes?  Stop panicking.  Here’s how I do it:

1.  Wash your hands.  (Duh.)  Then unwrap the syringe.  This should be a no-brainer, but in their infinite wisdom, the pharmaceutical co. made the backing on the syringe packaging out of something like onion skin.  It won’t peel off neatly, so you’ll be left picking at it with your fingernails or teeth.  Just open as much as you can, to get the syringe out.

2.  Unbutton your pants/skirt & hitch up your shirt.  Now is a good time to change into pjs, if you’re taking this before bed.  In a few minutes, it will feel good not to have to button up pants right over where you’ve just injected.

The Lovenox website recommends sitting or lying down, but I find that to be quite awkward.  I stand in the bathroom where there’s good light and a countertop to place all the Lovenox goodies.  Do whatever works for you.  If you get lightheaded at needles, then by all means sit or lie down.  You’re (hopefully!) going to be doing these shots for a long time, so find a position that works for you.

I like to have a nice big expanse of skin visible. Fortunately, this is easy for me to manage.  (Thank you, multiple IVFs!)  It allows me to arrange my bruising most artistically.  I’ve thought of doing it like stenciling, but it’s too much trouble to remember where I”m supposed to bruise next…

3.  Clean the general area with alcohol.  Sometimes I forget this, but what the hell, it’s probably important.  Make sure you’re planning on injecting more than 2″ from your bellybutton.  It’s less sensitive out there in the love-handle zone, and you’ll feel it less.  Really.  I understand that in another couple of months – due to the belly-stretching effects of baby Thor – I’ll be moving out into unstabbed territory like my tender virgin thighs.  Just the thought of this creeps me out so I’ll try to update this tutorial when it happens, since I’m sure it can’t be as bad as I’m imagining it.

4.  While the alcohol is drying, move that big air bubble in the syringe to the plunger end – not the needle end.  The medicine moves slowly, like it’s more viscous than I think it really is, so just tipping it the right way takes too long.  I flick the syringe with my fingernail a few times to help it along.

5.  Once the alcohol on your belly has dried, pull the safety cap off the syringe.  This is more difficult than it should be.  That gray cap is slippery because the makers of Lovenox have obviously never given themselves injections, so they don’t understand clammy-hands syndrome.  I tend to hold the syringe needle end down, and try to pull it straight off.  But be warned, I’ve ruined more than a couple of these trying to get the cap off, and once the needle is bent it’s almost impossible to use…

Often, there will be a teensy drop of medicine on the tip of the needle.  Flick it off, because you really don’t want that medicine near your skin.

6.  The needle isn’t as sharp as, say, the insulin needles we’re all used to using in IVF.  Bummer.  They are, however, ground on one side, so if you’re really having a hard time punching through your mighty mighty belly skin, try to position the beveled edge up.  I don’t bother, but some people swear it makes a difference.

7.  Pinch some fat & skin.  Don’t be shy.  We won’t look, I promise.

8.  Jab that dull needle into the middle of that fat fold.  Faster is better, here. Do it quickly.  Sometimes it stings more than others, and stabbing yourself in the middle of an old Lovenox bruise is definitely the hardest, so shift spots from day to day.  I’ve found that there are certain spots on my belly that the needle hurts & others where I don’t even notice it going in.  Experiment.  Even the most tender place really isn’t that bad (and you’ll know better next time.)  Remember – it’s just a needle.

9.  Now here’s the one tip that I cannot emphasize enough.  Depress the plunger s-l-o-w-l-y.  Seriously slowly.  Slowly enough that it might take 45-60 seconds to inject yourself.  Like one millimeter per breath (unless you’re hyperventilating!)  If you start to feel the medicine stinging, then slow down.  This can be hard to do because the plunger is sort of wobbly, and likes to stick (again – who designed these things?) just go as slowly as you can, it does make a difference.

Also, I’ve noticed that because this injection takes so long, I tend to take a death-grip on that poor fingerful of tummy fat.  This is really not necessary.  I try to consciously ease up on that, and I seem to bruise less.  Of course, that could be my imagination, but it gives me something to concentrate on during the looooonng injection time…

10.  When you get near the end, you’ll see that air bubble creeping down toward your tender flesh & if you’re like me, it’ll freak you the hell out.  It even makes a little whistling sound as you inject it.  Do it anyway.  The air bubble keeps the medicine from pooling under your skin, where it will cause – yes! – bruising.  The air bubble is your friend.

11.  Pull that needle straight out.  If a drop of blood or medicine leaks out, you can wipe it away, but DO NOT rub at this area the way you would with PIO.  Rubbing is not going to help and will, in fact, make things worse.  Just let it be.

12.  With the needle pointing away from you, push the plunger HARD, and an automatic needle shield will pop out of nowhere and surround the needle.  Total overkill, here, and startling, besides.  Plus it microdisperses the last drop of medicine all over the place.  Not sure why they assume we’re too dumb or uncoordinated to put a needle cap back on the syringe, but there you are.

13.  Here’s about where I usually start cursing like a sailor, because right about now, my injection site usually starts to feel like I’ve been kicked by a horse.  An angry horse.  It’s the nature of the beast.  Remind yourself that the medicine is in there, thinnin’ yer blood.  I usually go lie down for about 10 minutes while it’s doing its stuff, just because then I can ignore it.  In a few weeks, if you’ve stayed in the same general area for the injections, it seems to hurt a lot less.  But whenever I’ve moved to a new, virgin spot, it hurts like hell again.  So be it.

If you did the injection perfectly, the new bruise will be just a couple of millimeters wide.  If, like me, you were clumsy or shot up too fast, it’ll blossom into a bit of purple loveliness.  The first week or so is usually bruise free and then all of a sudden, you’ll bruise.  You didn’t do anything wrong.  In fact, it’s a sign that your platelet count is finally low enough, which means the Lovenox is doing its stuff.  It’s also a sign that you’re going to have to keep your belly covered for the next many months or resign yourself to long explanations made to horrified friends.

Lovenox is a (literal) pain, but it’s not as bad as the YouTube tutorials I found when I was looking made it sound.  And the longer I’ve been on it, the less it hurts.  Some people go nuts with the icing & the heat, etc., but I don’t tend to bother.  Keep it steady & slow & by all means ice your belly if that works for you, but don’t massage this medicine in!  Personally, I think icing is worse than the pain of the needle, and it doesn’t do much for the pain of the medicine itself, but hey, whatever works for you.

Obviously, I’m not a nurse, or a doctor, or a rep. of any pharmaceutical company.  I’m a patient being treated for Recurrent Pregnancy Loss with Lovenox, in the hopes that it will keep teensy blood clots from killing my baby, Thor.

And with a hoped-for outcome like that?  Lovenox is No.  Big.  Deal.