Thursday, February 17, 2011

IUD Insertion: My Garbage Nightmare Afternoon

Buckle up kids, this is going to be a long and bumpy ride.

So, without getting into the long and sordid history of my rocky relationship with hormonal birth control, let me just say that I was ready to go in a different direction with my efforts to escape pregnancy. After a lot of research and thought (hard to avoid in my line of work, honestly) I decided to get an IUD.

I wanted to blog this experience so that other women would have an idea of what to expect - even though people are likely to have a variety of different experiences, it can be reassuring to have some warning about what will happen. However, unfortunately because of my fucked up lady parts my experience was not super normal. So...I'm just blogging because I want to. And maybe also so you know how bad it can be.

[Trigger warning for medical procedure description, vaginal discomfort]

I went in a couple weeks ago for a preliminary consultation and a pap test. I tested negative for all the bad stuff, but I did have a case of bacterial vaginosis that went away with a course of antibiotics. No biggie. The pap test was notable because before it started, the doctor asked me if I was uncomfortable having a pap or had ever had any traumatic experiences that would make the pap difficult for me. I thought that was awesome.

In fact, throughout both appointments, the medical staff were all wonderful - totally professional, and really caring and attentive. If you live in Toronto, I highly recommend the Bay Centre for Birth Control.

Anyway. Today I went back to get the IUD inserted. There were two options in copper IUDs, and I chose the one that lasts five years (as opposed to two) even though it is the more difficult of the two to insert. I'm really glad I did, too, because the thought of doing this again in two years makes me want to die.

I had a doctor and a midwifery student, both women. They were both lovely and friendly people. The doc did a quick exam first - lubed finger, speculum, you know how it goes. She was a bit confused because the doctor from the first appointment had determined that my uterus was retroverted, and she felt like it maybe wasn't. After some poking around, the doc and the student came to the conclusion that it was in fact retroverted, but also tilted to a weird angle. So she told me it might be a little difficult to get the IUD in. Ok!

Difficult. Well.

First came the speculum, of course. I generally find it a little uncomfortable but honestly, not too bad. After that came some sort of measuring device that turned everything around it into cramping, like some horrible magic wand of...horror. I could FEEL the cramping moving up my body. It was horrific. I can't really describe the pain of it - it's not sharp or dull or anything I really have words for. It doesn't seem like it should be so bad - after all, in the end it is just cramps - but I found the inability to DO anything was the worst. I couldn't curl into a fetal position or barf or whatever I would do if I had cramps like that and wasn't laying on my back in an examining room.

I wish I could explain how bad it felt, and how low my pain threshold is. It was seriously the worst I have ever physically felt in my admittedly sheltered life.

So they were having some difficulty getting the IUD in, at which point the doctor decided to use some kind of instrument that would keep my cervix out of the way (?). It felt like something was pinching my cervix. I thought that would be horrible, but I was concentrating so much on the never-ending cramps that I could barely even feel it.

It was at this point that I first considered telling them to stop. I thought about just continuing to use condoms, that this could not possibly be worth it. But then the doctor told me that they could try a different (bigger?) speculum. So she took everything out and left to get it.

I could close my legs for a few minutes, and that felt amazing. I was still cramping a lot but the option to move, to sit up, and the absence of the jumble of metal up my vag felt so awesome, I didn't care. I foolishly, optimistically thought that once the bigger speculum went in, it would all be a piece of cake. When the doctor came back, I opened my legs, if cautiously, at least still willingly.

The bigger speculum was certainly less comfortable! And then the horrible magic wand went in again. Thus followed I don't even know how many minutes of poking, prodding, and the worst cramping that could possibly exist. I mean, I know I'm a big wimp, but how was my uterus not exploding? Both the doc and the student were very attentive, but every time they asked how I was doing all I could come up with was a vaguely optimistic groan. Not awesome. I seriously thought, once again, about calling the whole thing off. My legs were shaking so much I was surprised they could even get anything done. I was in shock, but not enough that it didn't hurt like hell.

The problem was not just the tilt of my uterus, but also the fact that I apparently have a long vaginal canal, so my cervix is hard to get to. The one time the doc managed to get the IUD even remotely close to where it was supposed to go, it started sliding out again. Finally, she said "if I don't get it in in the next minute, I will get another doctor."

Oh great!

Once they had determined that it wasn't going in, both of them went to get another doctor. They left the speculum in, on the understanding that if they were going to be gone more than a couple minutes, they would come back and take it out. Honestly it probably wasn't even that long, but lying there alone with the speculum still in, I started to panic. What if they forgot about me? And of course, this entire time I was cramping like crazy. I wished I had asked for my partner to be there with me. I thought it would be unnecessarily difficult to have him there seeing me in pain, but at that moment I wish he had been (in the end, I'm glad he wasn't. It was easier to disassociate myself from the pain without him present).

They didn't forget me. They came back with another doctor, who was chipper and hilarious and a little bit cynical. I liked her a lot. She assessed the situation quickly and determined that I did, in fact, have an anteverted uterus. Aha! I thought. Problem solved! Let's get that thing in there!

So we went to it again. I was struggling to stick with my deep breathing, and at this point my lady parts had taken such a beating it didn't seem to matter that the new doctor was quick but gentle. They just hurt. It hurt more because it was so...inescapable. I had come too far to stop. It would waste everyone's time if I decided, at this point, to bail.

The uterus issue might have been cleared up, but unfortunately the inaccessibility of my cervix was still causing a problem. Once again, the cervix-pinching instrument, then the magic wand of doom. My legs and butt were positively vibrating with shock. I thought I would probably pass out, and I was actually wondering if they would continue if I did. Maybe the student could hold my legs open. Maybe it would be better that way. Every second I didn't think I could endure more pain, but then I did, and then the second after that I did again. It was awful. Seriously, the worst thing I've ever been through. I don't want to scare people, so just bear in mind - my experience was not typical.

At one point the doctor told me to put my bum down, and there would be less pressure. And I did, and she was right - as soon as I relaxed my butt and it touched the paper (I wasn't even aware it was raised), I felt a tiny bit better. But then I would forget and all my muscles would clench and it would start all over again.

Finally, after a million years, it was in. They cut the strings, and removed all their devices, including the big speculum which felt AWFUL coming out. I breathed. I even sat up a little, although I was totally dizzy. The three women were cautiously optimistic, and they told me they needed to do an ultrasound to check and make sure the IUD was sitting properly and wouldn't slide out.

The first doctor went to look into the ultrasound situation, the student went to get me some pain meds and water (I would have pulled out the IUD and stabbed a kitten with it for a glass of water at that point), and the second doctor let me touch the cut-off IUD string (it felt like fishing wire) and explained to me how to check for it in my vagina. I asked her if she could get my partner. She went to get him. I sat up, and I cried and cried.


When my partner came in, and the student brought back the water (OMG it was amazing) and the ibuprofen, I felt better. My legs were shaking and I was pale, and the cramping was still worse than I have ever had during a period, but the ability to close my legs was just about the greatest.

Once I was steady, I went with my partner and the student to the ultrasound room. The ultrasound tech explained the probe to me (it was a transvaginal ultrasound) and asked if I had questions or concerns. I didn't. The ultrasound was not too bad for me - they just put the tip of the probe in, and after everything that already happened, it was the least uncomfortable thing that had happened. Sometimes the tech moved the probe down or to the side and it triggered the cramps, but at least I had a hand to squeeze. My partner and I both commented later on the oddness of the tableau: him holding my hand while I was ultrasounded, as if we were expecting a baby instead of having the anti-baby stuffed INTO my womb. Kind of awesome.

After what seemed like the longest ultrasound ever performed, it was determined that the IUD was in place. Thank goodness, because I don't think I would have wanted them to try again if it wasn't.

After putting my pants back on, and a brief consultation regarding aftercare with the student, we were free to go. We went to get sushi at Aji Sai, and we walked there - the fresh air was really good. All you can eat sushi (and cheese wontons!) was also very good. And I might marry that Diet Coke I drank.

Right now I'm feeling ok - still cramping but ok. I will update again, probably tomorrow, with my thoughts and impressions. All told, my partner estimates that I spent an hour and a half in the exam room before he came in. AN HOUR AND A HALF with a speculum in me - not great, friends. I was kind of expecting about ten minutes. Sad face.

For now, I am doing well and I want to thank my friends for their good wishes and encouragement, and the staff at BCBC for how fucking awesome they are. And especially my loving, supportive partner who took a half day off work, split the cost of the IUD, and most importantly, was totally 100% there for me when I needed him.

More to come.


Anonymous said...

I had a rough experience getting mine in too - my cervix wouldn't dilate and they had to try several times before it finally would! And yes, the tenaculum (cervix pinchy thingy) SUCKS. HARDCORE. I think it's a holdover from medieval torture devices :(

Best of luck for a speedy recovery! IUDs are SO worth it, though :) I love mine!

Anonymous said...

Ike! Getting mine in was unpleasant but no where NEAR that bad. Thumbs up for a "normal" cervix and uterus. Sheesh! You will love it; I love mine to bits!

Anonymous said...

In women who haven't had a vaginal birth, 400mcg of misoprostol two hours ahead of insertion can help a lot. Also, ibuprofen prophylactically an hour beforehand is never a bad idea.

Better living through chemistry!

The Pedgehog said...

Yep! I took both - and I'm glad I did. :)

Jenincanada said...

Dear gods in heaven that sounds like the worst damn day at the gyn's ever. I'm glad you got through it though I have to warn you, even though I know you probably already know this, that IUDs can fail. I nicknamed mine the IUD-idn't. Good luck and here's hoping for a restful night.

Anonymous said...

I just wanted to say that I experienced something very similar...but my medical student passed out during my ordeal (read: hit the floor hard after seeing into my vagina?) so they had to tend to her while I waited with my legs open...and in the end they never got the damn thing in. This was like six months ago and I'm going to try again next month... I'm not entirely sure why other than my disdain for the pill. Thanks for posting this story.

vrock said...

Thank you for sharing your experience. Reading your "worst case scenario" encouraged me to get mine. I've had my IUD for about 2 months, and my insertion was nowhere near what you described. It was the most concentrated and deep cramping I've ever experienced, and my doctor had to try three times to get the IUD in, but I survived, and I'd do it again. Loving it so far!

Anonymous said...

Thanks for sharing! I'm getting my third one inserted next week. I had a Mirena (the hormone one) and I LOVE it. I remember the 'magic wand of horror'. It's so they can measure how high the top of your ute is. I think I'm pretty typical down below, so I'd describe that feeling as...not painful, exactly, but YUCKY. Like a diarrhea cramp. Like gross things are going on in there. They've prescribed me misprostal this time, but I've given birth vaginally twice so I'm not sure I need it. Anyway, that's my version. IUDs are the greatest!

Stay golden said...

Thanks for posting this, as I'm lying here suffering, mostly emotionally, after a very similar experience, I wouldn't dilate, my uterus is curved the other way etc, two doctors, two tries, crying, and literally the worst pain in my life, and I've broken my leg, had serious sprains, been hit by a car and in a car accident so don't dismiss your threshold, you're a badass. I really needed to read other people's accounts, maybe I can stop having nightmares for a whIle :( ❤