Insertion

It's the big day - my Mirena insertion. I have a 3:15pm appointment, which means I get to sit at work and make myself nervous all day. It's the second day of my period, which is thankfully light, so theoretically the insertion won't be quite as uncomfortable as it would be during any other part of my cycle. I wore a dress today because I figure that I'll want comfortable clothing after the procedure, and nothing is more comfortable to me than a simple dress.

I arrived at my doctor's office just about on time, so of course the doctor is running way behind. When I finally make it into the room - more than an hour and a half after my appointment time - he tells me that he had four surgeries come up. I feel horrible for the women having to endure that! Suddenly my impatience seems pretty petty.

When I walk into the exam room, the nurse tells me to strip from the waste down, have a seat on the reclining chair-table thingy, and put a white sheet over my lap. As I'm getting half-naked I notice a rather large box sitting on the counter. My Mirena! The box was at least a foot long, probably 4-6" wide, and an inch or so deep. I'm horrible at perceiving measurements without a ruler in front of me, so don't take my word for it. I peeked in the box but didn't want to mess anything up, so I really didn't get to check the contents out too well.

My doctor arrived pretty quickly after that. He had me assume the standard feet-in-stirrups position with my booty near the edge of the chair-table. He started walking me through the procedure: he would insert the speculum, apply a little antiseptic to my cervix, use "tweezers" to grab my cervix, use a sound to measure the depth of my uterus, then insert the Mirena. He warned me that the tweezers would feel like a little pinch, the sound would cause a quick cramp, and I would cramp briefly while he actually inserted the Mirena. At this point I start psyching myself out. For whatever reason I always get sick to my stomach at GYN visits. The little scraper thingy they use to collect cells during a Pap smear makes me especially sick. So my anxiety levels started going up immediately.

I laid back and tried to take some deep breaths. He warned me "little pinch" and that's exactly what the tweezers felt like. No biggie! I feel compelled to take this moment to say that I had no idea what a cervix looked like so I was imaging he was tweezing a little flap of flesh that somewhat resembled the tail flap on a raw turkey. If you do a quick internet search you'll learn that the cervix actually looks like a fleshy, gooey donut gem. Fun. So he tweezed the cervix and then warned me "hard cramp" when he went in with the sound. OUCH. Hard cramp was no joke. I don't usually get too many menstrual cramps, so I feel really awful for anyone who has to deal with that on a regular basis. Luckily it was over pretty quickly. He fiddled around for a minute on his work surface, trimming the strings or measuring the Mirena I imagine, then turned back to me. He said, "Okay, now the Mirena. You're going to feel a hard cramp when I stick it in and it will cramp until I pull the inserter out." I KNOW this part took all of a few seconds, but when your poor uterus is being invaded and you are having these hard cramps, it feels like forever. I'll admit it, I yelped a few times. It wasn't a stabby pain but it was definitely uncomfortable. Fortunately, he was out pretty quickly. I believe he reached back in to trim the strings a little further, then he removed the speculum and said he was done.

I took this opportunity to hit my doctor with a final litany of stupid questions. Can I wear tampons soon? I am on my period after all. "No tampons until at least Monday (four days post procedure). No sex either." Bummer. Should I worry about any straining, like the squats they make me do at PT? "No, exercising shouldn't be an issue." What about bowel movements? Would that cause it to come out or dislodge? (I seriously asked this. Pooping is a big deal to me.) "No, bowel movements won't be an issue." Will I be in severe pain? "No, just mild cramping." Well what if I am in severe pain? Should I go to the hospital?! "Just give me a call, but that shouldn't be an issue." My doctor is clearly the patron saint of patient doctors willing to answer stupid questions from nervous women.

After the procedure the doctor asked if I'd taken anything. I said, "No, but I have Ultracet in my car." He had his nurse get me what he called a "fast-acting Aleve" and instructed me to stay on the table for a few minutes. His nurse was so kind to me and said that I should relax as long as needed since my uterus would be angry at me for a little while. I'm stubborn, so of course I was up quickly after that and headed to the cashier. "That was easy," I thought as I strutted out. Well, it didn't take very long - the two minutes it took to get to the cashier, actually - for me to start to feel bad. I think my anxiety got the best of me and I started having cold sweats and feeling a bit light-headed. I sat down, paid my bill, then asked if I could go lay down somewhere. The nurse came back and got me, and let me lay down in an empty exam room. I stayed there for probably half an hour. Honestly, the anxiety was gone almost immediately and I felt better, but I was starting to feel crampy. The nurse and my doctor checked on my repeatedly until they were confident that I looked well enough to leave.

At this point I would have LOVED to go home and sit with a heating pad on my lower abdomen, but unfortunately I had to go to a work function. Sitting around eating free dinner for two hours wasn't so bad!