On July 13, 2009 I had an IUD inserted.
I had done my research and after years of being on the Pill decided it was time for me to be free of daily pills and the accompanying hormones. I had made the appointment at Planned Parenthood Golden Gate over a month before. I had gone to San Francisco City Clinic to pick up my medical records. I was prepared.
I arrived early for my 10:30am appointment. There was a single protester in front of the building in which Planned Parenthood Golden Gate is housed. She carried a sign and pamphlets and very meekly asked me if I wanted information about abortions. I let her know that I was pretty good on abortion facts and entered the building.
After taking an elevator to a vestibule, a sign instructed me to pick up the phone which was next to a door. The voice on the other end of the phone asked if I had an appointment and then I was buzzed in to another vestibule. This second vestibule faced a typical doctor’s office reception area, except there was very noticeable bullet-proof glass between me and the staff. I was told, through the bullet-proof glass, to sign in.
Signing in consisted of writing my name, date of birth, and reason for my visit on a 2″x3″ pre-printed form and sliding it through the tray under the bullet-proof glass. I was then buzzed into the waiting room where I joined about a dozen other people, including one man and at least one same-sex female couple. There was a sign in the waiting room that indicated patients’ accompaniment must provide identification.
Eventually I was given paperwork to fill out, and finally, 45 minutes after my appointment time, I was told to provide a urine sample. Then I waited in another waiting room. I was glad I had brought my iPod and a couple of magazines, and had no other plans for the day.
One of the reasons I had no other plans for the day was because friend had told me that when she had her IUD inserted she wished she had taken the day off work since the cramping she felt after it was put in was quite uncomfortable. I was prepared for some pain, but as I’d never had cramps that were more than slightly unpleasant I wasn’t expecting things to be too bad.
After sitting in the the second waiting room I was finally called into a counseling room, a full hour after my appointment time. A clinician told me the risks associated with having an IUD implanted, and made clear my choice between hormonal and non-hormonal IUDs. Based on her characterization of the non-hormonal IUD as tending to cause heavier periods and more severe cramps, I opted for the hormonal IUD that was likely to make my periods lighter and possibly end altogether.
I signed some paperwork, the clinician told me that they did a pregnancy test on my urine and only because I was not pregnant were we even continuing the appointment, as IUDs are not implanted into pregnant uteri. She asked to see my medical records, and then informed me that what I had gotten from San Francisco City Clinic were not medical records at all. Crap. I assured her that I had never had an irregular Pap smear and I was STI-free.
Thankfully, having gotten the wrong paperwork from the clinic did not prevent the continuation of my appointment. I imagine if I seemed like I didn’t have my shit together or was cagey in some way they would have told me to return with my actual medical records in hand before I was permitted to have an IUD implanted.
Instead, my clinician told me what to expect once I was in the exam room. She told me they would give me Chlamydia and gonorrhea tests because risk of infection and pelvic inflammatory disease is higher with an IUD in place. The clinician told me to finish my current pack of birth control pills since I had less than a week’s worth left and the hormones in the IUD don’t kick in for two to three days.
And then she asked me if I wanted to take some ibuprofen to help deal with the upcoming pain. Hmm, sure, but I was a little worried. Was it really supposed to hurt that much? I was slightly comforted that they weren’t offering me Vicodin, but I definitely would have appreciated it more. The clinician sent in a nurse, who administered the ibuprofen and water.
While waiting for the ibuprofen to kick in the clinician told me that for the first few months the IUD was in I would have to check to make sure it was properly in place. I would be required to reach into my vagina and feel for the filament strings which would be hanging a few centimeters outside my cervix. As far as I was concerned I wouldn’t be able to reach my cervix. I certainly had never tried to do so before, and all the times it had been hit during sex were during particularly vigorous fuck sessions. But I tacitly agreed to be diligent about checking for the first few months the IUD was in place as she instructed.
She told me feeling the strings was good, but that feeling what felt like the end of a pen was bad. Very bad. It was also bad if I felt pain beyond usual menstrual cramps or had excessive bleeding. All of these things should cause me concern and to make an appointment to have the IUD checked.
Finally I was led into the exam room where my clinician told me to take off everything from the waist down and sit on the exam table with the paper drape over my lap. For those of you who have never had a gynecological exam, this is the standard, but at an annual exam that also includes a breast exam, one must get fully nude. However, socks can be left on, which is helpful because the stirrups are often cold.
The doctor came in and told me what she would be doing. First, she took a sample of my cervical cells and went to look at them under a microscope. I was left there with my feet in the stirrups. There was a lovely poster of an underwater scene on the ceiling so the time went by quickly.
The doctor returned and told me there was no evidence of infection. If I had had an infection she would not have inserted the IUD on that day because putting in the IUD could spread the infection to the uterus, which could cause PID. Next, she explained what she was doing as she inserted a sterile speculum into my vagina and then soaped up my cervix. I had no clue there was such thing as cervix soap, but it’s nice to learn new things.
Then the pain began. Yes, it hurt, a lot. And I’m a wimp. By this time I could hear what was supposed to be soothing, New Age, nature sounds, but they were annoying me because I was in pain. That poster of the underwater scene on the ceiling became very ugly when twisted up with the pain I was experiencing.
The doctor continued to explain what she was doing and said nice things like, “This may hurt” and, “Almost done.” First she had to measure my uterus to make sure it was appropriately sized for an IUD. This required dilation of my cervix, which didn’t maybe hurt it fucking hurt (and makes sense considering it’s the dilation of the cervix that causes menstrual cramps).
My uterus is apparently average(ly sized) so the doctor then put the sterile IUD in. This also hurt. Finally–and not being able to see what the doctor was doing in my uterus through my vagina and cervix I’m not positive about this–she tied the filament string onto the loop on the end of the device. I am convinced the looping of the string and the tying of the knot was the most painful part of the procedure. The string has to be tied in place after the IUD is in the uterus because the distance between the loop at the bottom of the device and just outside the cervix, where the strings end, is different on every woman.
The doctor then said, “You are now the proud owner of an IUD.” While my feet were still in the stirrups she asked if I wanted to feel the filament strings (on a spool, not the ones in me by that point) so that I would know what to feel for in my vagina. She reached up, I reached down, and roughly between my knees I felt the filament strings that felt kind of like fishing line.
I was still in pain. The doctor packed up including turning off the damn “music” thankfully. I got dressed and went to get my blood taken, as the doctor suggested I get an HIV test while I was there. The doctor gave me a flexible plastic credit-card sized reminder card that indicated I was to have the IUD removed by July 12, 2016, which seems like a time so far in the future, but is only seven years away. It has to be removed by then because the hormones contained in the device will have been depleted due to constant release over seven years.
Then the doctor gave me a clip board with a form on it and a pen. The form had questions about domestic abuse. I was to mark next to any of the questions to which I had an affirmative answer. Quite a few of the questions concerned my living situation; whether I felt safe in my home. Uh, yeah, I live alone. My dog and cat love me, and any abuse they heap on me is of the pay-attention-to-me-now variety. I did not mark any of the questions. I didn’t ask if the form was standard for all patients. The timing was odd since I had filled out all the other forms when I first arrived. This was the only form I received after the implanting of the device, which may be because I had a large dark bruise on my upper left thigh.
A few nights before, the guy I’ve dubbed Alex Semi-Nutty (story on him definitely coming soon) came over. He and I have great sex that tends to get a little rough. He is a biter. During our tryst he bit my thigh, hard. He did not break the skin, but the bruise developed into a nice dark purple number by the time I went in for my appointment. When the doctor first saw it I assured her it was received consensually, but I guess she had to make sure by giving me the form.
When I left the building the protester was no longer there. I took the bus home, still in pain. It felt like cramps. The pain lessened over the next few days. I don’t know if it was the pain or the fact that they were caused by the thing in me, but the cramps kind of turned me on.
I checked if I could feel the filament strings. After washing my hands I poked around and felt nothing but soft, squishy pussy. Hmmm. I reached in with a couple of fingers to see if I just wasn’t reaching deep enough. I was getting a tad worried and wanted to kick myself for not asking exactly how I should do this when I was at Planned Parenthood. Then I poked all around and THERE! Apparently my cervix is much further forward than I thought. (Actually, I had not thought about the location of my cervix other than at the end of my vaginal canal, ever.) So now that I know where to feel for the strings I’m to do so once a month (after my period) for a few months.
I have an appointment in August when the doctor will check that the device is properly in place. I will bring them the correct medical records then.
A couple of days after having it inserted, my IUD was christened by a hot new fuck.
I swear. True story.
I woke up on Thursday with a sore throat and a headache. The pain lasted through the day despite my concerted effort to take it easy so I would feel better in time for my date that night. I took some ibuprofen and really did feel better. However, by the time the ibuprofen was doing me any good I had already postponed my date to next week. I want to be at my best when I see this particular person.
