You’ll want to read Part 1 if you haven’t already. I’ve had my IUD for just over two weeks now, and so far so good. Depending on your tolerance/interest in these sorts of things, this post might be a little bit too much information. Consider yourself warned. (Alternatively, if this is not enough information – please just ask me and I will be glad to answer your questions.)
On the day of my insertion appointment, I arrived at my doctor’s office complex just over an hour ahead of time to have a pregnancy test – this is required immediately before insertion, as an IUD can cause complications with pregnancy, as you might imagine. Kaiser is amazingly efficient, and I got an email with the test results (not pregnant, duh) about 15 minutes after I peed in the little cup. Right after that I took the misoprostol, which I had to allow to dissolve in my mouth. It is a very small pill, but seemed to take forever to dissolve. Or maybe it was just that I was hungry and really wanted to eat my breakfast, which was sitting right in front of me.
The insertion appointment itself did not take very long. My ob/gyn and a clinical assistant were involved, and it was done in a regular exam room. I was initially a little surprised to be handed a waiver that referred to this as a surgical procedure, but I guess intentional use of a medical device in/on the body is a pretty good definition of the word, so I read the papers and signed away. My doctor and the assistant opened up the packaging and I was given the patient information booklet (which says all over it to read it ahead of time, but it is wrapped in a box that states you shouldn’t open it ahead of time, so go figure) and a wallet card that has the date of insertion and spots for the date of each yearly checkup. They they got a couple of tools set up, and we proceeded.
My doctor was great and did some brief narrative at each step initially – there was some iodine and betadine involved first, and then the my doctor took the wand with the IUD on it and got to work. She wasn’t able to get it in on the first try, but apparently I was being such a trooper that she decided to try again. I had an idea that something was not going quite as planned, because I watched the doc hand the wand back and forth to the assistant a couple of times, in between which they got out something that they hadn’t laid out earlier. But I figured she’d tell me if something was going horribly wrong, and I felt ok. Then she dilated my cervix a little bit. Dudes, that hurts. (Childbearing ladies of the world, I now salute you with some vague understanding of one part of your experience.) But, she was able to get it in, which I was glad for. (And she didn’t tell me that’s what she was doing until afterwards, which I was also glad for.) The last thing she had to do was double-check that it was positioned properly, which involved moving the specula (or whatever that is) around in way that gave me a very “this is not inserted in the way in which it is shaped to be inserted” sort of sensation. Fun.
The interesting thing was when the cramping started, which was during the first try my doctor made at insertion. I felt some sensation that registered in my brain as “ugh, that’s uncomfortable” and made some kind of grunt. And the doctor said “yeah, that’s the cramping starting.” And I said. “Oh, right. It’s been a long time since I’ve had cramps.” And really it has been – I recall some cramping as a teenager, but I don’t think it was ever particularly bad, and I haven’t really had any as an adult. So that was sort of interesting and the cramping over the next couple of days made me wonder if I haven’t been misinterpreting cramping as bloating. Who knows. Anyway, as the cramping got worse I just turned on my yoga breathing to help stay calm. When it started to get painful, I just focused on a little mantra: I hate the pill. Five years of birth control. I hate the pill. Five years of birth control. I hate the pill. . . . I also kept a little side thought about how the pain would be finite, and totally worth the outcome. Long-term thinking, people.
Once we were done, they gave me a few minutes to get myself together before coming back in the room. Normally they just tell you to take some ibuprofen and send you on your merry way, but because they dilated me, the doctor ordered Toradol. This is an NSAID, like ibuprofen. The doctor had another nurse get this and bring it in after I had gotten dressed, and this is when the comic relief of my morning occurred. The nurse walks in while the doctor is putting some things away and the clinical assistant is checking my vitals. She is at the counter next to me with some papers and I glance over and say “oh, it’s a shot?” and she says “Yup.” At this point everyone else has bustled out of the room. I said something like “Oh, ok, I assumed it was a pill.” Nurse: “Yup, it’s a shot. And guess what? It goes in your butt.” I cracked up. We chatted a bit more and she explained what was totally obvious once she said it – that the shot is much faster-acting than a pill in this case, and in addition it can be put in a part of the body near where the pain is coming from. So I presented a cheek and got my shot in the butt. (And a bandaid that later disappeared entirely. I have no idea what happend to it, but it was gone when I was in the shower the next morning, and it wasn’t tangled up in my undies or the bedsheets.)
Overall the procedure itself wasn’t too bad, even with having to get my cervix dilated. As I said, that part was kind of painful. But it was worth it. The cramping lasted a day or two, and the Toradol definitely helped me get through the day at work more comfortably. I made sure to take ibuprofen at the 6 hour mark, when the doctor said the Toradol would be wearing off, and then I took some again before bed. The next day I worked from home and didn’t really need to take any until the afternoon. (Had I not been chowing ibuprofen regularly for the entire week prior to the insertion, I probably would have just taken some in the morning.)
Anyway, I had some spotting that day and a little bit the next, and then by the end of the week I had my period. This was not surprising – I was a couple of weeks away of a period week on my pill cycle. What was surprising was how heavy it was compared to what it’s been like for the last couple of years. I was not really in the mindset of having to deal with a period that wasn’t super light and could practically be ignored, so I had a couple of close calls. The thing here is that it’s been long enough since I’ve had my period every month that I can’t remember if it was a normal old period for me, and I just managed it poorly, or if it was heavier. I guess we’ll find out how things go, but I am hoping that it will eventually stop, or at least go back to being super light. It also occurred to me the other day that I have no idea what my natural cycle is at this point, so I’m not sure when to expect my next period. Sort of an odd problem to have when you have had your period for well over a decade. Two or close to it? I don’t remember how old I was when I got mine.
Once the cramping from the insertion was gone, I have felt absolutely fine, and I think the few minutes of pain in the office, and the couple of days of cramping (and yes, the shot in the butt) are totally worth 5 years of not having to think about my birth control. I have a follow up appointment in a couple of weeks, so if you’re interested in this, look for one more update after that.