IUD Nightmare No More: Special patients deserve special treatment!

I have a long, sordid history of pelvic pain.  I lived with chronic and frequent pain for years, but for a week each month, it became even worse.  My periods were accompanied by vomiting, debilitating cramping, migraines, and very heavy bleeding.  I had tried various birth control pills to control the symptoms, but none improved my situation.  Finally, I decided to take the leap and try an IUD, after reading that they can sometimes stop a woman’s periods entirely.

When I got my first IUD, it was with a rotten doctor and no compassion.

It was December of 2010, I’d just finished my first semester of law school, and my gynecologist told me it was a simple in-office procedure. I picked up my cervix-dilating medicine at the pharmacy and followed the instructions exactly.  I had also asked my doctor about pain meds for the procedure.  She said none were necessary but I could take something of my own if I wanted.  I brought an old bottle of Vicodin.

My amazing now-husband joined me for the procedure.  After my feet were in stirrups, the doctor glowered at my cervix and then at me. She accused me of not taking the cervix-dilating medication.  What possible motivation could I have for not using the drugs that would make it possible to shove a foreign object up my as-yet-unused birth canal?  As she hurled that accusation at me, I’m sure my pelvic floor muscles jumped into my eyeballs.  She said she could insert it anyway and proceeded to do so. 

It was excruciating.  I almost passed out, and my sweet husband (boyfriend of 1 ½ years at that time) had to lean over my face and keep bringing me back from the brink.  The Vicodin that I’d popped in the waiting room didn’t help.  My doctor told me after the procedure that its ineffectiveness didn’t surprise her, as drugs in the Ibuprofen family usually work best.  I spent the next three days in the fetal position from the excruciating cramping and bleeding.  I almost had it removed.  And then, just as I’d done countless times before after my pelvis was traumatized, I recovered.

Tomorrow, things will be different, and I’ll be getting a shiny new IUD.

Things are different now.  I have a kind, compassionate, brilliant doctor.  My IUD “expired” nearly a year ago, and I’ve been having increasingly unpleasant symptoms again.  After my first migraine in years last month, I finally scheduled the replacement procedure.  My doctor has been encouraging me to do so for a year, but I’ve been too scared.  The first IUD procedure was downright traumatizing, and I’ve been dreading the replacement.

My doctor has reassured me that things will be different this time.  And they will be.

First, I’ll be asleep in the morning for the procedure!  He’s booked an OR, and he said I’ll be out for about 5 minutes while he removes my old IUD and inserts a new one.  Does it seem like overkill? No. Not after my history, not after all my suffering, and not after my much-fought-for recovery.  My wellness is something to be protected and guarded, and my doctor is the strongest advocate for that.

Second, his office has been in wonderful communication with me over the past few weeks.  They ran comprehensive bloodwork, he’s called in post-procedure pain medications, and they’ve answered all of my questions.  I don't fear that I'll be left hanging like my first IUD procedure. I have support in every conceivable way.  If I have pain or discomfort, I can reach him for medication support, and I can access my amazing pelvic physical therapist.  I have a team, and they've got my back.  And why shouldn't patients with "special" histories be treated like a "special case?"  I firmly believe they should.

This morning, my husband asked me why I’m nervous today.  “Are you afraid something will go wrong?,” he asked me.  My answer: “Nope, not at all.  I’m nervous because of how horrible it was the first time.”  Wow, what a difference a few years and a wonderful provider can make.  A few weeks ago, I had asked my husband to clear his schedule this afternoon to help distract me from the nerves, and he kindly obliged. 

But this morning I realized that I don’t need much, and I encouraged that reluctant, doting man to go about his normal routine.  Yes, I’m a little jumpy and anxious today.  Tomorrow, I need to be at the hospital at 5:30am for my 7:30am procedure, which will then take about 5 minutes.  The pre-op process, in my past experiences, is the worst part – the hospital gown, the IV, the waiting.  That’s what I’m worried about.

Healing motivation: baby snuggles.

I’ll provide an update when this is in my rearview mirror, but I’m anticipating a pretty smooth day.  And I should be all healed up in time to host my best friend and her little guy, who are visiting me from Colorado next week! Nothing is sweeter than his air kisses or being his "auntie," and nothing is sweeter than uninterrupted time with my best friend.  And unlike past procedures, I've no doubt that I will be well enough to fully enjoy this visit. 


Pre-"op" on Friday!

Pre-"op" on Friday!

Well, I'm the proud owner of a shiny new Mirena IUD!

My procedure on Friday (if you can even call it a "procedure") went as smoothly as possible. I arrived at the hospital early and cruised easily through the 2 hours of prep.  My doctor arrived, IUD in hand, the anesthesiologist put something in my IV to relax me as they rolled me into the OR, and my husband kissed me on the forehead and said he'd see me soon.  I moved myself from the hospital bed to the OR bed, and I don't remember anything after that.  I was out for 10-15 minutes before my doctor was in the waiting room speaking with my husband, telling him everything went as smoothly as possible.  When I was under, they started by administering a nerve block to my uterus, which essentially "turned off" the receptors in my uterus so it didn't notice what was happening.  He quickly removed the old one and inserted the new one, explaining to my husband that it went something like this: cue Indiana Jones video.

ER visit on Saturday

ER visit on Saturday

I had no pain afterwards, and the rest of the day went smoothly.  I rested at home on the sofa.  The blip came when I woke up the next morning and was ridiculously sick.  After vomiting for three hours, I was ghost-white and exhausted. I went to the ER, where I was in a bed and hooked up to an IV receiving fluids within 15 minutes of arrival. They determined that the surge of hormones from the new IUD, paired with the lingering anesthesia and pain meds from the procedure in my system, had made me sick.  They gave me some anti-nausea meds, lots of fluids and electrolytes, and sent me home just two hours later.  I came home and slept, and I'm doing 90% better today.

Was it glitch-free? No. Were the issues I encountered normal? Yes! Apparently, around 11% of women get some vomiting and "morning sickness" / "early pregnancy" symptoms after receiving a new Mirena.  And while the vast majority of women get cramping, I've had none.  I'll spend tomorrow resting and eating bland foods so I can spend time with my sweet friend and splurge on tapas and sangria later this week.

Thanks to everyone who's sent me nice messages and good vibes on Facebook, Twitter, and everywhere else.  I hope sharing this story encourages other women to speak up for "special treatment" if their histories make common and normal procedures a little more difficult for them.  There's no shame in that, so speak up and get the help you need and deserve. :)