To Inject or not to Inject?

One of the biggest decisions I've had to make thus far in my pregnancy was whether to or not to start taking daily shots of the anticoagulant drug, Lovenox, a form of heparin, used to help thin the blood. A few of the Lupus antibodies I carry, Lupus anticoagulant and antiphospholipid antibody syndrome, tend to make the blood clot, leading to the potential for a miscarriage. Five years ago, I did have a miscarriage at 8 weeks, but it did not appear to be because of a clotting issue. However, because of my previous miscarriage and the fact that I've tested positive for these antibodies in the past, my doctors proposed the option of starting the drug.

I use the word "propose" because of the three doctors I'd seen thus far in my Perinatal practice, two of them felt I should definitely start the drug but the third wasn't sure it was entirely necessary. My rheumatologist thought no, my pulmonologist thought yes, and I was confused. In the end, after much debate and discussion amongst my entire medical team (thank you, team!), the consensus, and our personal decision, was to start the drug and eliminate the possibility of a problem down the road.

Since starting, I've discovered two other girlfriends who were on the drug during their non-Lupus pregnancies, two women from my Lupus group who were on the drug for other reasons, and reassurance from an aunt who is a labor and delivery nurse that it is a very typical drug of choice during high-risk pregnancies. So...I feel very good about my decision, aside from the fact that my insurance is only covering one and 1/2 month's worth of medication, and a monthly dose runs between $900 and $1200 a month.

When Johnny and I discovered the cost of the drug, we tried not to let that influence our decision. We wanted to be smart about our finances, but no amount of money is too much to ensure a safe and healthy pregnancy. Anything for Baby Bun, right? Plus, my doctors have been very encouraging and accommodating in helping me make an appeal to my insurance company. It's possible that the drug may get covered in the end, so cross your fingers. I know Bun's are!

As far as administering the injections go, it's a pretty easy process. My doctor mentioned that by the end of my pregnancy, I was going to look like a bad peach, but I think I'm well on my way. I inject one dose every morning into my upper leg, alternating between the right and left, after using an alcohol swab to clean the skin. I also take an ice cube and numb the skin (and the capillaries on the surface of the skin) for a minute or two prior, ideally reducing the bruising. I got a little fancy recently and tried a few mornings without using the ice (because 3 of my 4 friends who used the drug never opted to ice), but I think I'll stick with the numbing. Why not, you know?


Katie said…
I'm sure the injections aren't fun, but you gotta do what you gotta do, right? Take care of that niece or nephew of mine!
Lynn's Blog said…
Unfractionated heparin is just about as good, except for twice-a-day injections and some extra blood tests - covered by insurance - and an out-of-pocket cost that is much lower than LMWH:
Sara Gorman said…
Lynn's Blog - thanks for weighing in! Heparin IS a lot more cost effective, at least it was when I was pregnant, I agree. But my docs preferred I go with Lovenox - though there was much discussion about the two. Thanks for including the link - GoodRx is the best, right??!!! Take care.

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