READERS: This was a gynecological procedure that essentially went awry due to issues with my malformed anatomy. I was a one in a BILLION case, this is VERY unlikely to happen to anyone else. Do not read this and get a negative idea about a procedure that a the gynecological surgeon I nanny for described to me as “so easy a trained monkey could do it in under 15 minutes.” My body has always been a bit weird! Just 2 months ago I had a breast cancer scare because my breasts are made of armpit tissue, so what doctors thought was a lump in my breast was actually a swollen lymph node in the wrong place of my anatomy. It has been a common experience in my life that a doctor says, "Huh, that's interesting..." during an exam. I am literally (<--used the proper way) in medical text books because I am a strange case in different ways. Another reason why my genes need to not be passed on!
In preparation for the Essure procedure, I took 5 days of Letrozole, a drug that inactivates an enzyme called aromatase which would otherwise turn androgens into estrogens- so basically, this drug significantly lowered my body’s levels of estrogen for almost a week. They did this because in order to get me in before the end of the year (read: Before I’d be stuck paying my deductible), I had to have the procedure done mid-cycle, when I’d have a fair amount of uterine lining, thus making it harder for them to see around inside of my uterus. The Letrozole sucked. A LOT. I was exhausted, cranky, nauseated and quick to tears for 5 days. And on top of that, my libido made a brief reappearance while I was taking it and I’d have probably jumped in the sack with anyone- except that sex would have jostled my stomach and unless the person was into Roman Showers, it probably would have ruined the moment.
When they called to ask to which pharmacy I wanted my Rx for Letrozole sent, I asked for another RX of Misoprosol, a cervical dilator. I had an abortion in 1997 (fuck you very much, former Rep. Todd Akin, it was legitimate rape and I got legitimately knocked up from it) and there were issues dilating my cervix because it’s apparently freakishly small. Then again when I had my IUD inserted in 2007, there was a struggle due to size. In fact, I was almost not given one because mine only measured 5cm and the minimum is supposed to be 6cm, but I begged, pleaded and somehow managed to convince the NP to insert it anyway… more on that later. Back to it, the morning of, I inserted 2 tablets of Misoprosol into my vagina and pushed them as close to my cervix as I could so that it would be easier for the doctor to get in there and do her work.
When I arrived at the clinic, I was in a great mood, cracking jokes with the staff and having a great time. I got to pee in a cup and make jokes about how it’s been so long since I’ve had sex, I’d be the mother of a new religion if the test was positive. The doctor ran me through the procedure, for which I'd already watched a video online, so she was excited I knew what to expect. They offered to leave my IUD in place to use it as birth control during the 3 months before the Essure becomes effective, but since I'm not currently sexually active and have no intent to become so anytime soon, I said it would be easier for me if they just took it out now. And I'm glad I did!
They gave me an intramuscular injection of ibuprofen and said most women report that as being the worst part of the whole procedure, then had me swallow a vicodin and an ativan and wait. I’d intended to sit around and read a trashy novel (no sense on trying to read something good if I’m about to be high, right?), but ended up chatting with the office manager about sex-positive messages and then about how awesome dogs are. (I recently signed up to foster a dog and she used to work for a fostering organization.) We chatted right up until I was high on ativan and it was time for me to go into the other room.
Now it should be said that I’m not shy and this is a teaching hospital, in fact, it’s connected with my university (hence why my insurance covers me there), I told everyone from the get-go that if anyone wanted to watch or whatever, they were welcome to do so. I mean, it’s a gynecology office, who cares if they see my vag? That’s their damned job! The Essure rep happend to be in, so I invited her as well. All in all, there were 6 people in the room other than me. The first of many things out of the norm is that my uterus has a severe anterograde tilt, meaning it points at my navel. Theory is that it’s so small, the muscles and other things that would hold a typically-sized uterus into place can’t reach it. So on top of the joys of the speculum, they had to employ the use of a tenaculum to clamp my uterus into place so it wouldn’t run away from them.
Initially, an intern was going to do the procedure (I had approved this), and her first step was to give me a shot of lidocane in my cervix- I didn’t feel it at all. Up next, she was to remove my IUD, who I had named Sparky. She pulled the strings, and I felt a little tug… but nothing happened. She tried again, and the string broke off. They pulled out the ultrasound machine and couldn’t find it in there, no one could figure out why my strings were visible and fine, but my IUD was MIA!
Since they had to put a scope into my uterus anyway, they figured they’d try looking with that. But alas- More problems lie down that road! While the exterior portion of my cervical opening had dilated, the inner bit did not and was guarding the doors like the Swiss Guard! It took over an hour -over a fucking hour- and several dilators of different sizes (they looked kind of like knitting needles) up into my cervical opening. It did not feel good. During this time, the doctor had to step in before my anatomy scared the intern into making a career change. I had all kinds of offers: Did I want to stop? NO! This will happen! Would I like to be sedated? No! Because that implies this isn’t going to be over soon and it IS going to be over soon. I did ask for more ativan and I’m not sure if they ignored me or actually didn’t hear me, to be honest either one was possible. One thing is sure, everyone was really impressed that I was doing so well. I never screamed or cursed, though I did say “OW” more than a few times, I did ask to be warned when they were going to do something new so that I wouldn’t flinch, and I did ask twice for them to give me a minute before continuing. I also made a lot of jokes- mostly about how it’s a good thing they were doing this because if my uterus is this much of a bitch, imagine what kind of demon spawn might come out of it! I made a lot of jokes about how this couldn’t suck as bad as childbirth, until I realized one of the clinicians was pregnant and I didn’t want to scare her.
Eventually, after an hour and 15-20 minutes, they got into my uterus, which meant the speculum could come out- and that helped my pain level more than I can say! This is when they found part of my IUD. I don’t know what happened, but long story short (too late) the body and one arm of my IUD had embedded into the muscle of my cervix with no way of knowing when. It had to be basically dug out- oddly, this didn’t hurt so much as it just wasn’t pleasant. They looked around and couldn’t find the second arm of my IUD, finally I asked if it really mattered, helpfully pointing out that war veterans live with shrapnel in their bodies and what was left of Sparky could be MY shrapnel! Finally, they agreed that it couldn’t hurt me. There was a lot of shock that I never felt it, apparently having an IUD that embedded should have hurt at some point. I had Sparky for 6-1/2 years and during that time, I had bad cramps twice, once about 3 years after insertion and once after my colposcopy, but it’s most likely that this happened early on. It’s also amazing that it worked as birth control at all! Though, in fairness, TheEx would never let me use birth control and he had kids before me and after me, so I might just have a hard time conceiving (High-5, uterus! you’re good for something!) The crazy thing is that my strings never felt different- but again, if this happened early on, I’d have had nothing to really compare it to!
So in with the first coil. I got to watch on the TV screen and want to be the first (I hope) to tell you that uterine lining looks like a cotton candy forest! Mostly because they fill your uterus up with saline to inflate it and get a better view, so maybe it’s more like seaweed? But whatever, I like the imagery of cotton candy and it’s my uterus. Yours can have seaweed if you want. As they were searching out my right fallopian tube, they found the missing arm of my IUD peeking out like a drowning man screaming for help! So they plunged in coil number one- which did come with a sharp, stabbing pain, but keep in mind, my drugs have been wearing off by this point, and then went in to dig out Sparky’s remaining arm, also embedded fairly deep in the muscle.
Then they went back to place coil number 2, which is when we learned that my uterus is bicornuate, or heart-shaped. Seems it’s never shown up that way on an ultrasound because my cervix points the wrong way. This is also likely why I sounded at only 5cm when I got my IUD and possibly why it semi-expelled- I believe that my sheer willpower embedded it, I used to talk to it when it was first inserted and beg it to never leave me. The second coil went in as easily as the first, but maybe hurt a little worse because I was watching it on the screen and saw when the pain was happening- like watching yourself get a shot.
Then it was over. Every clinician in the room congratulated me and told me how impressed they were that I did so well. The doctor was afraid I’d have a vasovagal reaction and pass out, so even though I said I felt find, they made me stay and have something to eat. When she brought me apple juice and crackers, she said she wished she could have made it whiskey because I’d earned it. I had someone hand me my book and I read a chapter while eating, then got dressed and walked out- way sooner than anyone had anticipated. I had some minor cramping, so I asked if I could get an Rx for something and I became the first person to ever leave the office with an Rx for 15 vicodin.
So here’s the thing: Yes, apparently I have the recorded worst incident of Essure insertion as well as having a bad IUD removal at the same time, but would I do it all again knowing how it was going to go down? Yes. My IUD, while it may have been broken apart, embedded and maybe even useless, it made me feel good. I felt like I was a responsible woman taking charge of her sexuality and her reproductive health by providing myself with a good birth control method for my body. I feel the same way about my Essure. So it hurt? I never have to do it again. It’s over now and in 3 months, I’ll go in and get to see proof that the whole thing has worked! I used to be terrified of pregnancy, that fear ruled my life for years. I spent hundreds of dollars on pregnancy tests in my early 20s, I spent hundreds of hours worrying about what I’d do. I haven’t had that fear in almost 7 years and I will never have that fear ever again. So yes, the pain was worth it. And because I have this point of view, I’m glad it was me who went through the shitty procedure because someone else might have been scared away from it all. But me, I feel empowered.