Monday, June 16, 2014

Situations to learn about someone

Having a conversation with your date certainly helps you learn more about them, but there are certain situations that can help reveal qualities that do not show during a conversation.

1.  Driving 
This has nothing to do with driving skill.  It is a matter of seeing how his personality manifests in driving and his car.
-  How well maintained does his car look?  It could be a new car but poorly cared for.  It could be old but well taken care of.  
-  Does your gentlemen friend open the car door for you? 
-  How messy or smelly is his car?
-  Is he an aggressive or passive/overly cautious driver?  This can reveal how his personality generally is.
-  Does he speed and consistently weave in and out of lanes just to make the trip slightly faster?  He is risking his (and your) life just to save a few minutes.
-  Does he let other cars (who signal) into your lane?
-  When there is a long exit ramp packed with cars, does he drive to the front of the line and muscle his way into the lane?  Unless the driver has a very good reason (e.g., they are in a hurry because they have to rush to the hospital), I generally think such people are narcissistic or selfish - what makes them more important than everyone else??
-  Does he let pedestrians cross?
-  When it's late at night, I think it's an extra bonus when he waits after he drops you off to see that you safely go inside your home before driving off.

2.  Eating
Having a meal together can reveal their manners and how considerate they are.  Please see my post on Proper dinner date etiquette.

3.  How he treats children, the elderly, the handicap, and animals
These are "vulnerable" populations so you can see how your significant other treats those they think may be "weaker" than them.  Are they playful with children and animals, and respectful towards the elderly and handicap?

4.  Playing a game or sport in a team
-  How competitive is your partner?
-  Is your partner a good team player?
-  What is their sportsmanship?
-  Do they cheat to advance?
-  Do they boast after winning?  Or are they a sore loser if they don't win?

5.  Taking a short trip together
This gives you a preview of whether your personalities and lifestyles get along.
-  Are you able to stand the other person after being with them for hours or after sharing a room?
-  If you share a room, are your routines, lifestyles, and preferences compatible?
-  Do you want to do the same activities, go to the same places, or eat at the same time/restaurant?  If not, how well do you two compromise?
-  How considerate is the other person of your feelings, personal space, and preferences?
-  How well do you converse with them over the course of an entire day?  Do you run out of conversation?
-  Who pays for the travel, hotel, food, activities, etc?
-  If by the end of the trip, you wish you had more time with them, then that is a good sign.

6.  Stressful situation
Inhibitions are let down under stressful situations.  How do they handle a challenge?  People are not usually as nice as they typically are, and their true colors may show.  

Sunday, May 25, 2014

Being Childfree

Being childfree is different from being childless.  Being childfree is the conscious decision to not have children, whereas being childless is not having any children despite the desire to do so.  

My recent egg freezing had me rethink about whether I want to be a single parent.  If those two weeks alone were difficult, I cannot imagine how it would be raising a child alone.  If I don't find a partner, will I be able to give the amount of time and attention that I want my child to have since I will need to work full-time to support us?  There are so many important decisions to make and innumerable things involved in raising a child.  It would certainly be easier with a partner.  Without one, it is doable but suboptimal, and depends on various factors (such as having family/friends to help and/or the financial means).  The choice to be a single parent is individual and what is right for her.  So I certainly commend single parents.

Isn't it interesting that there aren't single men who hire an egg donor and surrogate to raise a child on his own?  (I am not referring to homosexual gay couples.)  There certainly could be single men who do that, but it is rather uncommon.  On the other hand, most women have the strong tendency to be maternal (more than men's tendency to be paternal), which may be partly due to biology and our society or culture.  However, the trend has been that women are having children later in life, or not having children at all (currently 20% of American women, compared to 10% in 1970s).  This is largely in part due to education and career.  At least half of the student population in colleges and graduate schools is now female.

It is important to understand the reason(s) for wanting children and be sure that it is a good one.  Unlike a purchase, you cannot return or exchange the child once you have one.  Some reasons I have heard for wanting children include: 
-  A natural urge to care for a "little someone"
-  Falling in love with someone and wanting that "love" to grow and expand into a family
-  Being told by society/culture that this is want we should be doing as an adult
-  Being lonely
-  We want someone to look up to us, or someone to need/depend on us
-  The significant other wants children
-  It is a way to save a failing relationship
-  To raise someone the way we wanted ourselves to be raised as a child (in essence, raising "ourselves")
-  To fulfill the dreams we wanted for ourselves but did not
-  Someone to dress up in cute clothes and braid their hair

On an ethical level, having a child is a big responsibility - your child's whole world is you.  He or she will depend on you for everything (at least at the beginning).  You will deeply impact their life and determine whether it turns out well or not.  On a personal level, raising a child will consume a substantial portion of your time and money which potentially prevents you from enjoying or being dedicated to other things and not developing a full life.  And on an environmental level, every life will use a lot of resources (water, food, products) and contribute to pollution/waste over the course of their lifetime.

I think for me, if I find someone to share my life with, then I would have a child.  But if I do not find that special someone, I don't know if I will.  But at least I have my frozen eggs as insurance if I decide I do.

Sunday, March 16, 2014

Proper dinner date etiquette

Having proper dinner etiquette on a date is important, as it is a form of nonverbal communication and contributes to the overall impression you give.  Some of the following tips seem obvious, but apparently may not be, since a few of my dates did not know them.  Other tips may be a little too formal for the setting so may not have to be followed (decide for yourself).

Before you meet your date
-  Generally, it is the guy who chooses the restaurant.  Ask your date if she has any food allergies or preferences, so you can factor this when picking the restaurant.  This shows you are considerate and a thoughtful planner.
-  Do not choose a very cheap restaurant such as McDonald's.
-  Make dinner reservations and confirm 1-2 days before the date.
-  Check out the menu in advance.  You can look up foods you are not familiar with, and/or their proper pronunciations.  This makes you appear more intelligent during the date.
Dress properly for the restaurant.  Do not wear sneakers to a nice restaurant (although you should not be wearing sneakers on a first date anyway - unless there is a sporting event or activity involved).
-  Bring cash in case the restaurant does not accept credit cards.  Make sure your credit card works (e.g., you paid the bill so it will not be declined).
-  Be on time.  Contact your date if you will be late, if even by 5-10 minutes.

At the restaurant, before the meal arrives
-  Gentlemen, try to pull out your date's chair and take her coat, if possible.
-  Turn off your cell phone, or at least set it to vibrate or silent.  If you are expecting a call, let your date know in advance.  (This may be useful if you want a rescue call from a friend in case the date does not go well and you need an early escape.)  But if you take the call, excuse yourself and step out of the restaurant to talk.
-  After sitting down at the table, unfold the napkin and place it on your lap.  Do not use it to clean the utensils or plates/dishes, wipe your face, or blow your nose.  If you need to leave the table, loosely fold the napkin and place it on the side of the plate (not on the chair). 
-  Do not position the menu such that your face hides behind it.
-  Do not complain about how expensive the food is. 
-  Do not order an overly excessive amount of food.
-  Do not order food that is sloppy (such as spaghetti where the sauce may fly), requires hands to eat (such as crab legs that require cracking), or easily gets stuck in teeth (such as spinach).
-  Do not order for your date unless they request.
-  Close your menu if you are ready to order (so the wait staff knows).  Do not place the menu on your plate.
-  Be courteous to the wait staff (say "please" and "thank you").   Do not snap your fingers to get their attention.  Instead, try to make eye contact or raise your hand slightly when the wait staff is close by.

During the meal
-  Do not eat until both parties have their food served.
-  If there is more than one set of utensils, start with the outer ones (those furthest away from the plate), and use the inner utensils for later courses. 
-  If you ordered individual entrĂ©es, offer to share your food before you eat or use your utensils.  Give your date a sample so they do not have to reach over to your plate. 
-  If there is a common dish you are sharing, serve your date first using serving utensils, not your personal utensils.
-  Do not make faces or sounds at food you do not like.
-  Do not drink to the point where you get drunk.
-  Place your drink to your right.
-  Do not play with your food or utensils.
-  Do not wave or point with your utensils.
-  Once you use the utensil, rest it on the side of the plate or in a bowl when not in use.  Do not put it back on the table. 
-  Do not put elbows on the table.
-  Do not chew or speak with your mouth open.
-  Do not slurp soup.
-  If you burp, excuse yourself.
-  Do not pass gas.  Excuse yourself to the bathroom first. 
-  Do not double dip.  Instead, break the bread or food in half so you can dip each half.  Or transfer some of the spread/sauce/oil/dip to your own plate to use before spreading/dipping and eating.
-  If you suspect there is food in between your teeth, do not pick it out with a toothpick or your finger in front of your date.  Instead, place the napkin in front of your mouth as if you are wiping it, then use your tongue to remove the bit of food that is stuck.  Excuse yourself to the bathroom if it is difficult to remove.
-  Spit food inconspicuously into your napkin if you do not want to swallow it.
-  If you cough or sneeze, turn away from the table and food, and cover your mouth.  Do not blow your nose at the table.
-  Pace your eating to your date's so you are not waiting for a long time after you finish while your date is still eating.  They may feel rushed since you are done.
-  When you are finished with your meal, placing utensils at 4 o'clock on your plate signifies to the wait staff that you are done.  Placing utensils at 4 and 8 o'clock signifies you are still working on the meal.

After the meal
-  Generally, the guy pays for the meal.  I think it is nice if the woman offers to pay her half.  In this case, gentlemen - nicely decline her offer and pay anyway.  Ladies - bring money just in case the guy does allow you to pay.
-  Do not skimp on tipping or use a coupon.  This will make you seem cheap.
-  Tip in cash (generally 15-20%).  This is something I prefer regardless of whether I am on a date.  When the tip is placed on a credit card, the wait staff is penalized a small percentage.
-  Gentlemen, it is a bonus point if you also tip her valet.  Same if there is a coat check.

For more suggestions on a first date, please see:
Advice for first dates
What to wear on a first date
Questions to ask on first date
What impresses women and men
What men and women dislike
The first date kiss

Monday, February 17, 2014

Cheating

Why do people cheat?
It is difficult to get accurate statistics about the prevalence of cheating since people may not admit to it, even under anonymity.  However, it is estimated that at least half of all people have been in a relationship where their partner has cheated in the past, or were cheating in their current relationship.  People who cheat typically do not start out intending to do so.  It is not usually about sex.  Instead, it often starts off as filling a void in the current relationship.  But then it inadvertently or unintentionally progresses to something deeper.

What is considered cheating?
Once you have established that you are in a mutually exclusively relationship, most people would consider intimate physical contact with someone else, such as petting or intercourse, cheating.  But there are many gray zones:
-  having romantic feelings or sexual thoughts about someone else
-  fantasizing about someone while being intimate with you or masturbating
-  hanging out with someone they are attracted towards (either regularly, or on a date-like event such as dinner and dancing)
-  kissed someone they are attracted towards, either on the cheek or lips (but only once)
-  (body) massage - giving or receiving
-  romantic gestures such as sending flowers or giving frequent gifts/one expensive gift
-  saying sweet things repeatedly to the same person
-  constant flirting (in person, online or sexting)
-  staring at someone attractive walking down the street
-  looking at porn
-  being obsessed with a celebrity and asking your partner to dress up and act like them
-  visiting a strip club and/or getting a lap dance (from the same dancer on multiple occasions)
-  having a threesome with your partner
-  being intimate with someone of the same gender (some guys may actually prefer or not mind if their girlfriends/wives were intimate with another female, especially if they could watch or be an active third party participant)
-  Would it matter if your partner knew or was present during any of the above acts?
-  Does it matter if the other person was an ex?
-  Does it make a difference if you committed the above acts under the influence of alcohol or drugs, when your judgement was poor and you did not have full control of your actions?

Some may not consider the above acts cheating, especially if there is no intention to pursue the romantic feelings or establish a romantic relationship.  However, the acts can be considered at least risky behavior or inappropriate in a relationship.  It is important to discuss with your partner what is considered inappropriate/cheating.  Your partner may have different standards from you.  If you and your partner do not establish boundaries, then it is easier for one of you to (inadvertently) cross the "cheating boundary line."

Two questions to help you decide whether an act is inappropriate:
1) Would you still do it if your partner was present or will find out about what you are doing?
2) Would you be fine if your partner did the same thing?


Prevent cheating
There is a difference between finding someone attractive and being attracted towards them.  You can find someone attractive but not be attracted towards them.  It is natural to think someone is attractive.  We cannot help that.  But trouble can occur when we are attracted towards someone and want to be with them. 

The best way to stop cheating is to prevent it from happening in the first place.  Be aware of your feelings.  If you find yourself attracted towards someone else, do not put yourself in a situation in which something could happen.  Do not be in a place alone with them.  Limit contact with them.  Spend more time with your partner and reconnect with them.  Think about why you initially fell for your partner and capitalize on that.  Think about the weaknesses in your relationship and work on them.

Think about whether it is better to tell your partner about the feelings you have for someone else.  Think about their personality and tendencies.  Will your partner appreciate your honesty and trust you more?  Or will it only hurt the relationship because they will become jealous, upset, angry, insecure or unforgiving?

What to do if your partner is cheating 
First, deal with your emotions - shock, anger, sadness, scared, betrayed, resentment, and perhaps even jealousy.  After you calm down and have a clearer head, decide whether you want to stay in the relationship.  No matter which you decide, you will need to confront your partner.  If you pretend nothing is wrong in hopes that everything will just work out, you have not changed anything so you will just fester and become more angry and resentful, which will only manifest later.

If you want to stay in the relationship, you will have to re-establish trust... which will be extremely difficult but not impossible.  You and your partner have to be completely honest with each other in order to move forward.  Your partner has to acknowledge wrongdoing on their part, accept responsibility for what happened, and make efforts to reconnect with you (including cutting contact from the person they were with).  You both need to try to understand the reasons your partner strayed as well as the weaknesses in your relationship, so that you both can fix them.  Seek counseling, as an objective third party who is experienced in dealing with this area can be a mediator and help you both realize issues and create solutions that you cannot on your own. 

Wednesday, February 5, 2014

Freezing my eggs: Round 2

January 7, 2014
My menses came today.  Coincidentally, I had an appointment to see the doctor at The Center for Human Reproduction to discuss doing a second round of egg freezing.  My first round was 12 months ago and I had harvested 18 eggs.  I was concerned that the number of eggs would significantly decrease over the course of a year since I am in my mid-30s.  My doctor said that Asians tend to have fewer eggs compared to age-matched Caucasians.  I guess that explains why a few of my Asian girlfriends in their late 30s only had 4-5 eggs retrieved per cycle.  However, my doctor said that she was actually excited that I was doing another egg retrieval because I had such good success last round, and thinks I would likely be productive again.  She was correct - she performed a transvaginal ultrasound which revealed 17 egg follicles!  She also drew blood and did a pap smear today.

Generally, doctors prefer to start hormone injections during the first few days of a menstrual cycle to start the process of egg freezing.  The injections last about 10 days (depending on how the egg follicles are maturing) and the retrieval occurs 36 hours after the last injection.  If I started the hormone injections this week, the retrieval date would occur around Jan 24, a day on which I had an unbreakable commitment.  Therefore, the doctor decided to start me on birth control pills (Apri) to better control my menstrual cycle and timing of when I will start hormone injections, and therefore, the retrieval date.

I also discussed with my doctor the possibility of fertilizing the eggs with donor sperm.  She said that the chances of egg survival are significantly better if the eggs are fertilized prior to freezing.  However, I needed to decide soon since there is the process of choosing the donor sperm, testing and preparing the sperm, transporting it from the sperm bank, etc.  In the end, I decided not to fertilize the eggs. 

Medications
The doctor ordered the following medications from a specialty pharmacy for my egg freezing:
-  Apri (bill control pills): controls my menstrual cycle
-  Menopur injection: stimulates growth of ovarian follicles
-  Bravelle injection: stimulates growth of ovarian follicles
-  Ganirelix injection: prevents ovulation
-  Lupron injection: stimulates ovulation and decreases estrogen levels
-  Doxycycline pills: antibiotics post-retrieval to prevent infection

 Financial costs 
My insurance does not cover this procedure since it is elective (there is nothing medically wrong with me, per se) so everything will be out-of-pocket.

-  Egg freezing (includes medical visits, ultrasounds, labs, retrieval and freezing) = $6000
-  Hospital facility fee for operating room and recovery room = $600
-  Anesthesia = $500
-  Storage of eggs = $830/year
-  Medications = $1800 (I had some medications left over from the first round, so I did not need to purchase as many this time.  Otherwise, it would have been $3000.)
-  If I decide to obtain sperm to fertilize the retrieved eggs, then there would be an additional $4500, and $830/year for storage of the embryos (which is separate from storage of the unfertilized eggs).

The total cost is approximately $11,000 (if I did not have last year's medication) to freeze my eggs, or $16,000 if I fertilize the eggs.  In addition, I would have to pay $830 annually to store the eggs, or $1660 annually to store both the unfertilized eggs and embryos.

January 7-19, 2014
I took the birth control pills at 9 pm every night with food since nausea is a relatively common side effect.  However, there were times when I did not take the pill with food, and I was not nauseous.  I had more severe menstrual cramps and lower back discomfort than usual.  Ironically, taking birth control pills should decrease severity of these symptoms.  Fortunately, the cramps and lower back discomfort resolved when my menses finished.  My boobs got a little bigger on the birth control pills.


January 22, 2014
Three days after stopping the birth control pills, I got another period which was shorter in duration.

January 23, 2014
I had labs and an ultrasound.  I found out my pap smear was normal so the injections could begin.

January 24, 2014 (day #1 of injection)
This was the first night of hormone injections which consisted of 1 Menopur and 2 Bravelle's.  (See below for schedule of daily medications and detailed instructions for administration.)  I was nervous since it has been a year since my last injection, and I needed someone to be with me for moral support.  It took about 20 minutes to prepare the injection and administer it, including 5 minutes to mentally prepare for the actual injection.  Shortly after the injection, I felt a twinge under the injection site.

January 25, 2014 (day #2 of injection)
I gave myself the Menopur and Bravelle injection tonight without anyone there.  It was fine.  The first time is the hardest.  Afterwards, you know what to expect which makes it easier.  I started to "feel" the presence of my ovaries and uterus.  I guess the hormone injections are working!

January 26, 2014 (day #3 of injection)
I went for labs and ultrasound - still 17 follicles (10 in one ovary, 7 in the other)!  I was in a hurry that night to give the hormone injection since I got home late, and I needed to give myself the injection before 10 pm.  I was in such a time constraint that I did not even have time to be nervous about giving myself the injection - I just prepared the syringe and injected! 


January 27, 2014 (day #4)
In addition to the evening Menopur and Bravelle, the doctor said I needed to start Ganirelix each morning to prevent premature ovulation since my estrogen levels were very high.  My estrogen level was higher than expected even for the hormone injections, and also higher than last year's level when I had hyperstimulation syndrome.  After the labs and ultrasound, I gave myself an injection of Ganirelix in the exam room.  My head felt very heavy intermittently throughout the day.  I did not have a headache, per se.  And I felt bloated.

January 28, 2014 (day #5)
The ultrasound showed that a few of egg follicles were 10-12 mm big, but most were 8-10 mm.  The doctor said that they prefer the follicles to be 18-20 mm at the time of retrieval.  Because my estrogen level was very high, I had another Ganirelix in the morning, and the doctors decreased my hormone injections at night to 1 Menopur and 1 Bravelle.  Now it takes about 7 minutes to prepare and administer the injection.

January 29, 2014 (day #6)
My arm is starting to get bruised from the daily blood draws.  The phlebotomists have been drawing from the same vein each day.  I am impressed that they could reuse the same vein even though it has been used so often and the area is bruised.  The nurse recommended putting pressure on the area for two minutes after the blood draw and to put warm compresses on the area at night.  I have a little trouble getting up and bending down due to bloating. 

January 30, 2014 (day #7)
I continued the regimen of Ganirelix in the morning, and 1 Menopur and 1 Bravelle at night.  It takes 4 minutes to prepare and administer the injection now.  My boobs are still slightly bigger but starting to feel tender.

January 31, 2014 (day #8)
The doctor showed me a list of my follicles and their sizes.  Most of them are between 10-14 mm.  Three were 7-9 mm.  The doctor thinks the bigger ones will be usable but is unsure about the three smaller ones. 

February 1, 2014 (day #9)
Looking at the ultrasound, the doctor predicts 14 follicles will be usable by retrieval.  The follicles are now 13-17 mm in size.  The remaining 3 follicles are smaller and will likely not be big enough by retrieval to be used.  I feel a little bummed that I cannot maximize the use of all the follicles, but at least 14 eggs is still above average for what women my age harvest (which is about 10 eggs).

February 2, 2014 (day #10)
My estrogen level is high enough such that the doctor wants to retrieve my eggs soon.  I gave myself a Ganirelix in the morning, and Lupron at 9 pm so that I would be harvesting 36 hours later.  No Menopur or Bravelle needed.

February 3, 2014 (day before retrieval)
My bloating is more severe.  I feel the presence of my uterus and ovaries.  I can physically feel a bulge on my left side which corresponds to my ovary.  Each egg follicle is slightly smaller than an inch, and the left ovary has 10 follicles, so my ovary is very big.  I was instructed to take doxycycline (an antibiotic) with dinner, and not to eat or drink anything after midnight.  The clinic also recommended that I not wear jewelry (except a wedding band) or contacts (wear glasses instead) to the retrieval.  Someone also needs to accompany me to the appointment and take care of me on the day of retrieval.

February 4, 2014 (retrieval day)
Today is the big day!  I had my egg retrieval in the morning.  I was scheduled for 8 am and asked to arrive an hour early.  However, I allotted even more time to get to the clinic in case the roads were bad (from the snowstorm the night before) or there may be an unforeseen accident (my car windshield actually got shattered by snow/ice that fell onto it on the way home -- after the procedure, thank goodness!).  I arrived to the clinic at 6:30 am.  Once I arrived, the doctor performed an ultrasound to re-examine the follicles one last time before the procedure.  I was then taken to the pre-procedure room where I changed into a gown and met the anesthesiologist.  In the operating room, I had leads and blood pressure cuff placed for monitoring, and an IV inserted for IV fluid, doxycycline and propofol.  I got woozy after getting the anesthesia and quickly fell asleep.  No breathing tube was used.

I awoke in the recovery room and my abdomen felt very uncomfortable.  The doctor retrieved 17 eggs but I would only know the next day how many are usable, but he estimated 15.  I had 18 eggs retrieved last year, and all 18 were good. 

Post-discharge instructions
Day of retrieval
-  no shower/bath
-  no tampons (use maxi pads instead for staining)
-  do not go back to work, drive, or drink alcohol
-  take doxycycline with dinner 
-  Tylenol as needed for cramping (but I did not require it).  My lower abdomen was sore, and it was difficult getting up and down.  It was also uncomfortable when there was increased intra-abdominal pressure during sneezing or coughing.  But overall, it was much better than last year.  Fortunately, I took today and tomorrow off from work.

Day after retrieval 
-  can shower/bathe
-  can return to work and resume normal activities
-  take doxycycline with meals in the morning and night

Days after retrieval
-  continue doxycycline with meals in the morning and night until finish bottle (which is 3 more days)
-  follow-up appointment with doctor 3 days after retrieval

February 5, 2014 (day after retrieval)
I feel much better physically but am still very bloated.  The nurse called and said that 12 of the 17 eggs retrieved were usable.  I was a little disappointed and may consider a third round of egg freezing.  Twenty eggs results in 1-3 live births and I want to have two children, so I would prefer to have 40 eggs. 

However, these two weeks have been taxing, both mentally and physically.  Not only does it require getting up earlier each day (including weekends) to get labs and a transvaginal ultrasound before work, but I also had twice daily injections on most days.  My friends were there for me during this time, but I still felt somewhat alone and stressed going through this process.  I cannot imagine going through IVF, pregnancy and raising a child by myself.  I really commend single parents.

Medication schedule
                                                                Ganirelix     # of Menopur     # of Bravelle            Other         
January 7-19 (pre-injection)                        No                    0                        0           birth control pills
January 24-26 (days #1-3 of injection)      No                    1                        2
January 27 (day #4)                                     Yes                    1                        2
January 28-31 (days #5-8)                         Yes                    1                        1
February 1 (day #9)                                      Yes                    1                        0
February 2 (day #10)                                    Yes                    0                        0                  Lupron
February 3-8 (post-injection/retrieval)        No                    0                        0               Doxycycline

Medication preparation for Menopur and Bravelle
1.  Wash your hands and clean the space you will use.
2.  Lay out supplies on the table:
     - vial(s) of hormone
     - one vial of sodium chloride
     - sterile syringe and needle (I used a 3 ml syringe with 22 gauge 1.5" needle) or Q-cap
     - smaller needle for injection (27 gauge 0.75" needle)
     - rubbing alcohol
     - gauze
     - sharps container
3.  Remove vial caps (flick cap upwards with thumb).  Wipe vial tops with alcohol.
4.  Open syringe package.  If using the needle on the syringe, pull back to 1 ml line and uncap the needle.  If using Q-cap, twist off capped needle and dispose into sharps container, then twist Q-cap onto syringe and pull back to 1 ml line.

5.  Insert the uncapped needle or spiked end of Q-cap into vial of sodium chloride.  Push plunger all the way down to transfer air from syringe into vial.
6.  Turn vial of sodium chloride and needle/Q-cap upside down and withdraw 1 ml of sodium chloride into the syringe.  Remove needle/Q-cap from vial.  Flick the syringe or gently tap syringe against a surface to get rid of air bubbles.
7.  Insert the needle/Q-cap into vial of hormone.  Push plunger all the way down to transfer 1 ml of sodium chloride (and any air) into vial.
8.  Gently swirl the vial to mix the sodium chloride with the powdered hormone until the hormone completely dissolves into the clear solution.
9.  Turn vial and syringe upside down (or at an incline) and withdraw all the solution (which is still 1 ml) into the syringe.
10.  Repeat steps #7-9 for each hormone vial you need to administer.
11.  Twist off the needle/Q-cap, and dispose.  Open wrapper of smaller needle.  Twist smaller needle onto syringe.

Medication injection
1.  The injections should be given between 5-10 pm.  I try to administer it within the same hour every night.
2.  I prefer to use a scrunchie to tie my hair (since my long hair may partly obstruct my view when I look down) and another scrunchie to tie the back of my shirt to hold it up.
3.  Clean the injection site with alcohol and allow time to dry.  The injection site is the lower abdomen, at the level of the belly button, two inches away from the belly button on either side.  I alternate between sides from one injection to the next.
4.  Hold syringe with needle pointing towards the ceiling.  Withdraw (pull plunger back) slightly and tap syringe so air bubbles rise to the top.  Slowly push the plunger up so all air bubbles are pushed out of the syringe and a small drop of solution forms on the needle tip.
5.  Hold syringe in one hand.  (I prefer putting my index finger on the plunger so I have good control when pushing the plunger down.)  Use your thumb and index finger of the other hand to grasp and pull up the skin of the injection site.
6.  Hold syringe at a right angle to the skin.  (I prefer to take a big breath here.)  Insert needle all the way into the skin.  Steadily push in all 1 ml of hormone solution.  There is pressure as the hormone is being injected, and it can burn a little.  (I exhale slowly here and take deep breaths while solution is being injected.) 
7.  Release skin and withdraw needle straight out.  Place gauze over injection site and gently rub.  You did it! 
8.  Recap needle and dispose syringe/needle into sharps container.  Discard used vials.
 
Ganirelix is given in the morning.  It is already prepared in the syringe but administered the same way.  There is less pressure as the solution is injected but the injection site hurts slightly more afterwards and for a slightly longer time.

Sunday, January 5, 2014

Attracting Mr. Wrong

One of my friends asked me to write about how to stop attracting the wrong type of guy.  There are a few aspects to consider...

Do you know what type of guy you want?
The first step is to know what type of man you want.  Some women have trouble with this.  Or they think they know, but really do not.  They may date different types of men.  Or if they date only one type of guy, that type may not actually be a good fit for them.  For example, a woman who likes to date "bad boys" may be disappointed or frustrated that he does not pay her enough attention, does not treat her well, or is not willing to commit.  It is important to differentiate between what you want and what you need.

Some women do not know what type of man they want because they may not know what they want in general.  Without knowing who they really are themselves, what they want for themselves, or what their life goals are, it is difficult to know what they want/need in a partner.  Therefore, it is important to focus on you and your goals first.  Your goals will depend on your age, stage of life, interests, values, personality, job/financial status, religion, whether you want children, where you want to live, etc.  Your partner should be able to fit into your goals.  And since your goals may change over time, the type of man you seek may also change as you get older.

Are you doing something to keep attracting Mr. Wrong?
Think about the impression you give.  For example:

How do you dress?
If you frequently wear short, tight clothes, do not wonder why sleazy men ask you out.

Where do you hang out?
If you keep spending time at the library, you may only be meeting bookworms.

Are you portraying yourself accurately (either in person or on online dating profiles)?  
If you say you like sports, do not be surprised that you attract athletic men or guys who like to talk/watch/play sports with you. 

Do you flirt with men who are not your type?  
If so, Mr. Wrong may think he's your Mr. Right.

If Mr. Wrong asks you out, do you say "yes" anyway?
You may do your best not to attract Mr. Wrong, but he may find you appealing regardless.  However, you can always stop yourself from dating him.  Please see my post on How to reject someone.


Penelope (a black cat with a white stripe) running away from Pepe Le Pew's (a skunk) romantic intentions

Time will tell
Very few people instantly know when they have met Mr. Right.  The vast majority of the time, we date someone who has some potential to be Mr. Right.  Sometimes the guy may even say/do things to give you the impression that they are more perfect than they really are, especially at the beginning of a relationship during the "good behavior" or "honeymoon" phase.  Time will reveal whether he is truly Mr. Right or Mr. Wrong - sometimes in a matter of a few dates, and sometimes in a few years.  Pay close attention to the things he says and does - Are they consistent over time?  Do his words and actions match the type of guy you want?  Dating means taking a gamble, and investing time and emotion to form and cultivate a relationship in order to learn whether you and your partner are compatible.  But once you know that he is not right for you (and you have unsuccessfully tried to work it out), respect both his and your time by letting him go.