So as I’ve mentioned in the past, I have a clotting disorder called Antiphospholipid Antibody Syndrome. In really simple terms, it means my body’s immune system “attacks” its own clotting mechanism. It’s exacerbated by pregnancy, so I have to take an anti-coagulant, or blood thinner. When I was first diagnosed, I just assumed the treatment was a daily pill. But those pills cause birth defects, so when I became pregnant I had to start giving myself injections right into my stomach.

Dr. Blood and Dr. Risky decided to put me on a fairly new blood thinner called Arixtra. It works just like heparin or lovenox for all you nerds out there. I am lucky that it comes in boxes of pre-mixed syringes:

my blood thinners waiting to be injected
injection implement

The first time I injected myself, I begged Dr. Risky for a lesson. Dr. Blood’s nurse had walked me through it the day before, but she used a mixing needle to mime the procedure. A mixing needle is literally five inches long. I’m not afraid of needles, but that needle looked long enough to give me an amniocentesis. So I spent the entirety of that lesson trying not to faint. Luckily Dr. Risky’s nurse was willing to walk me through my first injection. She gave me a swab of alcohol to clean my stomach, showed me how to get all the air out of the syringe, and then said, “and then you grab some skin and plunge the needle in!”

I stood there for what felt like an hour trying to get up the nerve to drive a needle into my stomach. I’d spent my whole life saying no to IV drugs (and you know, other drugs), it was hard to go against all those years of anti-drug teachings.

(Mike, it should be noted, stood there the whole time with a big grin on his face saying, “Do it! DO IT! One two THREE!” Bastard.)

Once I finally succeeded in injecting myself, Dr. Risky’s nurse sent me home with a chart to keep track of my injection sites:
Injection suggestions
At first I thought, Oh, how handy! And then I realized that there was no need for it, because my stomach is its own chart. I have needle marks and bruises all across my abdomen. Pretty. As of now, I haven’t been given the go-ahead to move the shots to my legs.

The needle is very thin and sharp, and is about as long as a dime’s diameter.
needle, dime

Sometimes it hurts, sometimes it doesn’t. There are two kinds of hurt. The first is the pain of the injection. Often, the needle slides in like butter, but other times there is some resistance and that’s…not awesome. The other kind of hurt is the burning sensation that can come with the liquid being injected. But really, I am using the terms “pain” and “hurt” loosely because really it’s just minor discomfort for a couple minutes. Nothing any of us couldn’t deal with. Nothing any of us wouldn’t do for the health of our babies.

I’m pretty used to injecting myself now. For the first week I had some misfires where I’d start to stick the needle into my stomach, only to chicken out and barely pierce the skin. I’ve hit a couple spots that bled. Once time blood literally shot out of the injection site. It was unpleasant.

So far the shots have succeeded in preventing any clots in my uterus or inside the amniotic sac with Binky. With Madeline, there were two large clots present at my seven week sonogram. My weekly ultrasound checks for clots like that, and also for any separations that may have started. Blood thinners increase the risk of placental abruption, so Dr. Risky is constantly on the lookout for signs that the placenta may have started to pull away.

It is comforting to be so closely monitored, but after every appointment I cry about what could have – should have – been for Madeline. I wish I’d had such attentive doctors when I was pregnant with her. How I wish I’d been tested for APS once my clots were discovered. I would have gladly given myself shots or ANYTHING if it would have given Maddie more time in the womb. I try not to get caught up in what-ifs, but every day when I jab the needle into my skin I can’t help but think of how things could have – should have – been different.