Follistim: A Photo Essay

In the evenings we do Lupron, which we already covered, and Follistim.  Follistim comes in a handy-dandy pen gizmo and is way more convenient than any of the other drugs.  It's also wildly expensive.  Here's the kit:

The blue case holds the injection pen; the cardboard box holds a cartridge of drug and some disposable needles for the pen.  When we open the case, the pen kit looks like this:

So you've got the pen, you've got some needles (in the little pink things), you've got a place to carry some sterile wipes --- all in a nice zip-up case.  How convenient!  Er, except that once the pen is loaded with drug, the whole shooting match has to be stored in a refrigerator.  Which makes it significantly less convenient, and sort of defies the whole point of the snazzy carrying-case.  Well, whatever. 

The pen itself is a lot like an ink pen with a reloadable cartridge:

So the piece at left is just a cap, liek the cap on any pen.  At top is the bottom of the pen; you stick the catridge in from right to left, then screw on the bit with the plunger.  The cartridge itself is the glass thing at bottom.  Close-up, it looks like this:

It's small.  Here it is loaded in the pen and held in my hand.  The cartridge is about the length of the last two digits of my pinky finger, and much, much narrower; it's maybe 5mm in diameter.  The list price for this 600 unit cartridge is more than $500.  The good news is, they do usually have some extra medicine in them; we got >700 units out of the first "600 unit" cartridge.

Once the cartridge is loaded in the pen, you need to put a needle on it.  The needles come in these little containers that look like miniature versions of the creamer containers at Denny's:

You take the paper top off (again, it's like a creamer container) and just screw the whole thing on the end of the pen:

Then pull off the creamer-container and an internal needle cover to expose the needle.  It's very small; this is not only a sub-q shot, it's one I haven't kludged together from old IM needles.

With the needle on, it's dial-a-dose: you turn the know on the end of the pen until the desired dose appears in the window.  We started out with a 125 unit dose; now we're up to 150.

Ready to go, the pen looks like this:

To use it, I stick it in Sarah's belly and push the plunger down with my thumb.  The dose injected is determined in advance by the dial-a-dose thingy, so it's stress-free (for me).  In the event that the cartridge runs out in the middle of an injection, it's no big deal; you just note on the dial how much drug was left to be injected, reload a new cartridge and needle, and finish the injection.  Of course, this means another stick, which Sarah doesn't care for.  But them's the breaks; given the expense of this stuff, you really really want to use every bit of it.