XP: Freak out over HGH / IVF baseline today

katib77 · May 2014

My baseline was this morning and I figure "everything is going according to plan" as I stopped suppression meds on Sunday, got AF on Wednesday so today is day three for baseline. But I brought in my HGH (human growth hormone) med because it's the one I've never used in the past and couldn't figure out how I'd inject it. So I thought my nurses could instruct me. I pulled out what the pharmacy had special ordered for me (and apparently my insurance has "accidentally" paid for, they don't cover IF meds but they didn't check as to why I'm on HGH not realizing it's for my IVF cycle. Saving me $600).

They ordered me an "easy click pen" Which is if someone was taking the whole 8.8iu at once as one injection. I'm supposed to be taking it over the course of five days. There is no way to do it with this pen. My nurses were like "see if they can crack the pen open for you" AND the amount of diluent in the pen is not the same amount needed...I need .25cc more. So my nurse said "ask for a 2cc vial of bacro water". I asked "If they don't have it, can I just use the extra diluent I have for menopur?" and she said YES.

I went to the pharmacy and A) they don't have diluent water vials there and

They wouldn't crack the pen open for fear of damaging the vial. Since I work at thatTar.get I went and found a flat head screw driver and cracked it open myself (SCORE!) and came home to dilute it with my stuff. I want to get all three of my injects set to take to work tomorrow (I have to take them at night and I start work at 4pm tomorrow). Only after I did it - the med had white foaming bubbles (I swirled, not shaken the meds per instructions). Then I noticed the diluent for menopur is sodium chloride - and I was like OMG is that the same as the bacro water? Did I just waste a $700 drug?! I've got a call into my nurse waiting on a call back but a quick google search makes it seem like mixing HGH with sodium chloride is common, but no mention of the white foam I'm seeing.

Anyone take HGH and seen foam before?

hmz819 · May 2014

I haven't seen the foam before. Sorry! Hope the nurse calls back soon

katib77 · May 2014

Whew. The nurse called back and said she just wasn't comfortable with the crazy level of foam I described. And as luck would have it she happened to have one in the office that someone donated when their cycle was canceled. She said it was a Godsend because they *never* have donations of this drug. And thankfully I live 10 min from my RE so I just went and picked it up.

But good Lord! I had my baseline appt. at 10:15, went straight from there to the pharmacy, then home to mix it up, and then back to RE. It's now 2pm and I've been dealing with this almost the entire time. There's four hours of my life I wish I could have skipped over. I feel like I aged a year today.

Sha259 · May 2014

I am also very glad you were able to get the donated drug, and not have to use the vial that you had to tamper with.

As much as I love these Nurses, some of the things they suggest to patients makes me (as a drug developer) shudder with fear. I take instructions from my nurse regarding storage and mixing with a grain of salt if it conflicts with what I have learned over my years of developing drug formulations. For this reason I refuse to use multi dose vials (even if there is a preservative) and would prefer a PFS (prefilled syringe) or Lyophilized (Powder cake) drug with proper diluent, giving me confidence in dose as well as safety.

In this case, if those bubbles did not dissipate within say, 30 mins or so, I would not be able to trust that I was getting the correct dose from that solution. Great that you got another one!!

scooteriste · May 2014

Whew! What luck that a generous person donated that drug. I think you deserve a treat tonight after all that stress!

jaztastic · May 2014

Wow you've had a day, but luckily in the end it all worked out for you. What are the odds they'd have just the drug you need. Good for you to have such determination to make it work!

SweetieShellieH · May 2014

I also wouldn't have trusted the foam. I work in a lab and usually when we reconstitute reagents or mix reagents together, they don't normally foam. Maybe some bubbles that would disappear within a few minutes but that's it. It sounds almost like it precipitated. Glad to hear that they had just what you needed!! That's awesome luck!

Lillovebug79 · May 2014

I'm a nurse and anything that's mixed with sodium chloride has a like foaming reaction. However, it should go away fairly quickly. We mix almost everything in sodium chloride as it's compatible with most drugs. A specialty pharmacy should be able to check for sure. But I'm glad that you were able to get new just in case.

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XP: Freak out over HGH / IVF baseline today

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