16 September, 2013

Mirena IUD journal - Sept 12th 2013

The Consultation and Measurements

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So today I took the day off to go to my consultation. I got my prescription for the Mirena, picked it up, and was asked to come in to talk to the Gyno about any concerns I may have and to see if I'm a good candidate.
That kind of scared me because how would they find that out? So My Nurse Practitioner was actually a delivery room doctor, and was teamed up with this gynecologist to be trained on how to put in the IUDs. When I got to the Gyno, she explained that the Nurse would be helping and if I was ok with that. Apparently the parent company of Mirena, Bayer, instituted a training program where they took the doctors who have no mistakes (problems with insertion and issues stemming from poor placement) and teamed them up with other doctors and nurses so they can learn from the best. It’s a really great idea, and not only does it help the doctors, but Bayer comes out on top because if only the best is teaching others, the chances of things that go wrong is less. It’s a win win.

So I get to the office and am not nervous at all. All I know is that I’ll be talking to the doctor, and maybe she’ll go through my history and make sure I'm not a risk. So I fill out all the forms, including when my last period was, typically how long it goes for, the heaviness of the flow etc. It asks if cancers run in my family, or if I have any allergies. The typical health forms.

When the doctor called me in she was very nice; she was younger, very friendly and immediately she put me at ease. She went through all the forms, asked me about my bad pap (which was on the form) and asked if I was in a relationship or not. Apparently, if they feel you have too many partners or are using the Mirena as the only form of birth control it becomes a concern. If you become pregnant on Mirena (the slim chance you can, .1%) this could cause miscarriages, infertility, tearing, or death. So it’s serious.

I explained I wasn’t in a serious relationship (or any) and I didn’t have a steady partner like she asked. She said that was fine as long as I ‘continue’ to use condoms. I say it like that because everyone is dumb sometimes and we don’t. And it’s stupid and a terrible idea we know but we do it anyway.

She went through all the forms, explained that the IUD was 100% reversible. It’s great (and recommended) for mothers who have had children and who don’t want any more right now, or are for women who don’t foresee starting a family. The Mirena is a long term solution (5 years) and stays inside the uterus for 5 years. You don’t take it out, you don’t change it, and you don’t touch it. It literally stays inside you. That can be kind of scary to some people. They have long strings that come out of the uterus into the cervix that can be used to take the device out. As soon as the device is out it will take between 2-3 months to start getting your period back and for the opportunity to conceive. So this is a great method for those who may want (more) children in the future, but know they don’t want any in the foreseeable future. If you change your mind and want kids in 2 years, no problem; it’s reversible. It really is a smart device.

At the end of the consultation she said she needed to take some measurements to see if I was a good candidate physically. Apparently some women have smaller uteruses and they need to be at least 6 inches in length. She was checking due to procedure, but also because I'm a small girl, and she wanted to make sure I wasn’t hurt if they tried to insert it and it wouldn’t fit. If your uterus is not at least 6 inches the chances of your body dispelling it is much higher. It needs space to sit properly and so it is not rejected from the body.
She asked me to lay down and she would do a quick measurement. She said I would feel cramping like I was having my period, and discomfort. Immediately I became very nervous and noticed that she had an actual measuring tape on the counter along with speculum (metal car-jack type thing that holds you open when you go to your pap).

The speculum part was no problem, as I mentioned I have had tons of paps in the past due to my bad cells, and it doesn’t bother me at all. At first she couldn’t find the opening to my Cervix, apparently it’s small so she was concerned she wouldn’t be able to get into it easily. She eventually navigated through that and tried to put the measuring tape through my cervix and into the uterus. She had a problem at first, because my uterus wouldn’t open. She put a little metal tip on the tool she used, which acted like a speculum for the uterus, and held it open. This was extremely uncomfortable. I felt the tool and I felt the tape measure (not inside my uterus but pass through the opening).

Before I went, I asked a few friends and pharmacists about any experiences they had with the IUD. I also looked them up online extensively. 85% of the people said that the insertion was the worst pain they’d ever experienced. I take that with a grain of salt because chances are good these people haven’t had babies, and they may be sensitive to pain. Plus I'm not so I didn’t pay it much mind. However, the rest of the reviews said that it was very uncomfortable and painful in a different way.

I feel like I should preface this next paragraph with this: I have a very, very high pain tolerance. Tattoos, piercings, laser hair removal, falls, epilating (seriously I did this for years, look this up it’s scary), cuts, etc. I can take it very well. I hardly ever flinch and I never say anything or make noise or cry out or any of that. In fact, side bar – my laser hair removal technician told me she has never seen someone with my pain tolerance before, she never have seen anyone not even flinch before (it hurt but not enough for me to flail around). That being said, this uterus excavation was not pain.

Getting hit in the face with a brick is pain (I can imagine). Getting kicked in the gut is pain. Getting needles is even pain for some people. Pinched? That’s pain too. This small tiny measurement up my uterus was not pain. It was a very very uncomfortable feeling. It felt like my whole pelvic region and internal insides instantly cramped up, and not menstrual cramps, but cramps like Charlie Horse cramps (I don’t ever get menstrual cramps, or maybe I do but they don’t hurt so I don’t notice them). I felt the rod and the tape measure and it felt like sharp long sticks in my gut. It wasn’t pain, but a very unsettling sensation. I was very uncomfortable and caught myself twisting my mouth in a weird pursing look. I shocked myself. I expected pain, and this was worse.

She was only up there for less than a minute but the second she pulled all the equipment out I felt myself relax with relief. “Oh shit” I thought to myself. If that was just a tape measure, what will the actual procedure feel like? Can’t turn back now!

To be honest, It lasted 40 seconds and wasn’t THAT bad. If you’re uncomfortable or feel pain during your regular pap smear, this may be a bit much for you. But it took almost no time and she determined I had 7 inches, which was a good candidate for the Mirena.

She said I may spot a bit, and experience moderate cramping for a few hours, which is normal. I actually didn’t spot at all and I had very minimal cramping at most maybe an hour altogether. She made an appointment for me to come back that Monday for the procedure. I had to bring my Mirena I bought with me, and I was told the procedure start to finish would take 10-15 minutes, with 10 being prep work and cleaning the area first.

I was starting to get really exciting but anxious. She gave me a prescription for a few pills to fill and take, which I will explain more in my next post, about the actual insertion.

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