I sent my uterus, Augustine, away at 25 years old. She was a terrible houseguest, left a mess, and raised hell most days, and she just couldn’t stay here anymore. This is the next part of the saga, but if you haven’t read parts one, two, or three yet, I suggest you read those first. Like the Harry Potter series, you can start the story wherever you like, but you’ll miss a lot if you don’t start at the beginning.
Dr. W. was a godsend because he promised he would help me, no matter what, when the other gynecologists I saw admitted they had no clue how to help me and would not take my case. Dr. W actually had ideas. Unfortunately, some of those ideas were not as helpful in practice as in theory. Case in point, the IUD.
There is a mostly plastic interuterine device on the market called Mirena, which is highly effective as a contraceptive but is also built to release a teeny dose of synthetic progesterone at a constant rate. Dr. W. suggested I try the Mirena IUD because a very common side effect of the implant is a much lighter period. For a significant number of women, menstruation stops entirely after a few months. No period? Yes, please!
Our hope was that the IUD would subdue my uterus enough that I could step away from the anti-inflammatories for the most part. After years of needing them on a regular basis, I was becoming really concerned about the long-term impact of filtering all that medication on my kidneys and my liver. Mirena represented a chance for relief that no one but Dr. W. had been able to provide. It was also the first major monetary expense of this process, since I had 80% drug coverage for everything else that refused to cover the Mirena. My momma gave me the almost $400 to pay for it because I was still a student and didn’t have room in my budget for a very expensive little plastic T.
Before the IUD “placement,” Dr. W. told me to take a dose of my pain prescription because it might be a little bit uncomfortable. Those who’ve spent time in specialist’s offices (or dentist’s offices, for that matter) know that “uncomfortable” means agonizing. I took my drug as instructed, figured whatever they did to me on that table would be a means to an end, and went on in to see Dr. W.
IUD insertion is generally timed for a point in the woman’s cycle when the cervix is slightly open due to ovulation. We did our best to schedule things, but I was taking The Pill at that point, and therefore not ovulating, so Dr. W. just had to (literally) take a stab at it. There is a strange vulnerability that occurs in a gynecologist’s office, a vulnerability that is heightened dramatically when the doctor plans to shove a device into the uterus and leave it there.
Dr. W. explained that easing the IUD through my cervix was going to suck. He said it would be a big pinch, but that if I could breathe through the pinchy part, it would be easy from there. As stoically as possible, I braced myself for the cervix part while Dr. W. did the work he had to do, including disinfecting my cervix (a highly strange procedure) and arranging my $400 gamble on the giant plunger dealie that would stick it where it needed to be. I was more than a little unsettled that the strings of the thing were a foot long during the set up process. I should have just kept my eyes shut.
When an IUD is placed, it’s sent through the cervix, and continues on until it gently touches the top of the uterus. This part allows the physician to see how tall the inside of the uterus is and to determine how far to bring it back toward the outside world so it’s centered neatly inside the uterus. The whole works is encased in a very long tube with a plunger at the outside end, and the doctor presses the plunger when s/he has the IUD in the correct position.
Dr. W. started the whole awkward process, and before I was really ready, he told me, “Here’s the pinch,” after which there was a small bit of pressure and then a sharp tweak. I let out all my breath, and began to comment on how mild the pinch was, when I suddenly started seeing all the colours I knew and wailing in pain. Dr. W. seemed agitated and cried, “Wiggle your toes! Wiggle your toes!” I couldn’t find my toes because of the agony in my uterus, but I tried. The pain continued, and Dr. W. frantically tried to finish with the IUD.
When the process was over, Dr. W. tried to explain what had happened while I curled up like a jumbo shrimp, sobbing on the exam table and holding my belly. He said that the cervix cooperated nicely, but that as soon as the IUD brushed the top of the uterus, Augustine, had an absolute and total freakout. We’re talking a full on, buy me that toy in Wal-Mart temper tantrum. Dr. W. said he’d never seen a uterus react so violently. Apparently, Augustine was not happy about having her space invaded and her reign of terror threatened by the Mirena, so she contracted furiously to try to force it back out. Because I’ve never had children, my uterus was a very small space, so she squeezed the IUD to get rid of it, but that meant she was crushing her very soft uterine innards onto a foreign body. It was ugly, and it was blindingly painful.
The pain softened a little bit, enough that I could hobble out to the car, but stayed intense for a number of days. I could not function, even with maximum safe doses of my pain prescriptions, so I went to my family doctor’s practice and I saw one of her colleagues because she wasn’t available. He was concerned that my pain was still so strong and noted that I had a slight fever, indicating that the IUD had possibly punctured my uterus, which can cause a life-threatening infection. I was starting to curse Dr. W. and during this time had the first and only panic attack of my life one evening, which was almost as scary as the IUD placement itself. I felt truly wretched.
An ultrasound confirmed that my IUD was placed perfectly, and no damage was done to my uterus, and the pain slowly subsided over the next few weeks. Apparently, Augustine was just a bitch. I had placed all my eggs in the Mirena basket, and I was counting on the stupid thing to call off my periods and solve some of the problems. Unfortunately, the pain never improved beyond a point that was actually worse than before I got the IUD, my periods did not get lighter, and I continued to cramp dramatically about 26 days out of every month. I didn’t have it removed because I clung to the hope that it would eventually make things better, and I also kept it in there because I was terrified of having a repeat of the pain I experienced when it was inserted.
I waited for the better part of a year for the IUD to improve my symptoms, then I finally began to campaign in earnest for a hysterectomy. More about that very difficult battle another day. Thanks for reading.
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