Friday, January 21, 2011

My Mirena Story (A Cautionary Tale)

DISCLAIMER: I really don't like talking about this (I'm a really personal person), but I feel it is good to get my story out there, especially if it might help someone else to make a better and more informed decision about this type of birth control!

Okay so story start just before my son Cyrus was born, a little over two years ago. At what ended up being my last regular doctor visit before he was born my Midwife asked what we planned to do for birth control after the little guy came. I had honestly never given it a second of thought. I guess I just always thought I would go back on the pill like I was before we started trying to have a little one. She told me I essentially had four options: The shot (which I was very much against due to large amout of hormones and some friends terrible experiences), the progesterone only pill, an IUD, or nothing (including barrier methods, and natural family planning). Well we knew that we were going to want to wait a while and she knew we were planning on breastfeeding so she strongly recommended the IUD. Now I was so very out of the loop on birth control methods, as I had been so very far from needing them for most of my life, that I had never heard of the IUD. SO she gave us some info to mull over. It turns out there are two kind currently on the market, a copper coil 10 yr one (Paraguard) and an all plastic hormone releasing 5 yr one (The Mirena). Despite misgivings about the safety of the devices from my parents (I honestly didn't have anytime to ask anyone else before I made a decision, oh MOPs friends if only I had known you then!) my midwife convinced me the Mirena was my absolute safest and very best option! And me, the self diagnosing, Web-MD, internet junkie that I am, I did NO FURTHER RESEARCH on the matter. WHAT WAS I THINKING?? So in a disturbing turn of events we were informed by our insurance that they would not cover the procedure if my Midwife did it (which she thought, as we did, was ludicrous) so I was sent to a brand new Dr. I had never before met. She entered the room like a bumble bee, dressed in what my husband deemed a most inappropriate manner (really stilettos and a mini dress to work?) she talked to us for no more then five minutes, took a painful measurement of my uterus, replied that she must have measured wrong and took a second measurement, loaded the Mirena and inserted it. I experienced sudden excruciating pain! Seriously similar to child birth pain! This was the "slight pinching" I had been warned about?? I couldn't stand up straight it hurt so badly! Hubby asked "Is this much pain normal?" scantly clad Dr said it was and recommended some Advil. Hubby basically carried me to the car were I sat in a ball trying to think past the terrible cramping I was feeling. We got home and I discovered that not only was aI cramping but also bleeding very heavily, like post baby heavily. The cramps lasted all day and into the night, and the bleeding lasted almost two weeks. I have since found out that while it is common to have some cramping and bleeding, what I experienced is not common and... well I'll explain...
A month later I go in to have the device checked by the same Dr. She tries twice to find the strings, while telling me that it is common to not be able to find them (I have never been able to feel them) as she has cut them very short. On her third try she claims success and tells me the device is where it should be! I tell her that I don't really like it, and ask when the spotting will spot, She tells me "Oh soon, soon" and to give it more time... so I do. At my 6 month postpartum checkup I tell my midwife that I am unsure about the Mirena, and worried that I can't feel the strings, she tells me not to worry and to give it more time. Hubby gets a job at UNMH and we switch to LoboCare Blue Cross Blue Shield. (The aforementioned Dr, Midwife, and insertion all happened be at the Lovelace Woman's hospital) by this time I am VERY unsure about this Mirena, as I began to wean Cyrus my cycle started back like normal, not lighter (or not at all) like was promised of the Mirena, I m also feeling some strange side effects including depression, some more personal symptoms, and more troublesome increased anxiety. On my new patient visit to my PCP I tell my new Dr that I am still not sure about the Mirena and could it be causing the symptoms? She thinks this is very unlikely since the hormones it releases are very localized, and tells me for the third time (from the third Dr) to give it some more time. Flash forward one year, I am having serious doubts about the Mirena, mostly due to SEVERE panic attacks, that seem to come from nowhere (serious it feels like I am going CRAZY) and some extremely disturbing dreams about miscarrying because of the Mirena or about it falling out and not noticing. I have now gone online and read horror story after horror story about Mirena side effects. Most of all I learn I am not alone. Hubby and I talk about it A LOT. He is very concerned about the panic attacks (after all he spend night after night working with psych patients), after sitting next to me in bed while I experience one we decided together, it is time to get this thing OUT!
Just about two years to the day of getting it in, I go to my Dr (a new one, my first PCP has finished her residency and we have a brand new baby resident). I tell her the symptoms and she LISTENS and AGREES that it is time to get it out! She goes and gets her supervising and they come into remove it right then! I'm loving her so much for finally listening to me, yet at the back of my mind there is a voice telling me (and I honestly believe this was the Lord preparing me) "It's not there. They aren't going to find it. But don't worry it will be okay." And shocker, they can't find it! But they tell me not to worry, this happens all the time. They ask when was the last time I felt the strings, and I tell them that I have never been able to, and that the Dr who inserted it told me she cut them very short and I probably wouldn't be able to. They let out big sighs and say, "Oh that is good news, I'm sure that is is just short strings" they send me to UNM's elite IUD removal team at the Center for Reproductive Health. Our first appointment the resident reassures us, this happens all the time. He looks for it and can't find it. He goes to get the ultrasound again I heard the voice "It's not there, he won't find it. But don't worry" and after an extremely embarrassing internal ultrasound (much sympathy to all of my gal pals who have ever had to endure this) they again CAN'T find it!! So now the Attending comes in. The esteemed Dr. Singh, the IUD expert. She tells me there are three possibilities. The most likely, it fell out and I didn't notice (to me this seems unlikely as I am pretty sure I WOULD have noticed), the next more likely but rare, it is embedded in the lining of my uterus (I find out this is more common when used while breastfeeding, and when device is inserted within the first 6 month postpartum, mine was inserted at 8 weeks postpartum) , and the last most unlikely, it has perforated my uterus entirely and is free floating in my abdomen. So they send me out for x-rays. I know in my head and in my heart that it is still in my body. SO when the resident calls to tell me that they have located it on the x-rays I am not surprise. He tells me not to worry and that by the location they are assuming that it is embedded (completely encased) in the wall of my uterus, so they send me to ultrasound, where I undergo an abdominal ultrasound and another terribly fun internal ultrasound. Again the voice in my head says "It's not there, they won't find it. Don't worry." And I call tell by the look on the tech's face as she goes around and around that she can't find anything. So even before the Dr calls I already know... it perforated my uterus. The clinic calls with the news, and as they ask me questions about me insertion, they are sure, and I am sure that it has never really been in the right place. In fact they hypothesis that she either partially perforated my uterus at insertion and the contraction of my uterus due to breast feeding pushed it the rest of the way out, or she completely perforated at insertion and was not honest about feeling the strings at my followup. Only the Lord really knows for sure what happened! SO they send me for a CT to triangulate to exact position (adjacent to my uterus next to my right ovary) and I go back in the clinic where they explain how they will remove it by laparoscopic outpatient surgery, which they schedule me for.
Yesterday I checked in for surgery at 9:45am and we were done by 3:30pm. Every single person that helped me yesterday was absolutely amazing! And I felt the prayers of all my friends and family! I know the Lord was with me, just as he has been all along. I didn't choke the night before and need to drink water (the ladies in my small group know I was very worried about this!! lol) and Todd was able to sit with me the whole time in preop which made the time go by so much faster! (And poor guy, he was so tired as he had just got off from a 12 hr shift and hadn't gotten a lunch break) I was in surgery for 45 mins and the amazing Dr Singh (I truly believe, being led by our amazing Lord) found it without incident and GOT IT OUT!! And today, after more then two years, I am MIRENA FREE! Praise the Lord. (Insert two gross pictures! The first is the pictures from the surgery of them grabbing the Mirena and then of my guts Mirena free! The Second is my dyed belly with my 5 mil incisions)

So here is why I am writing about this. First: for anyone considering an IUD I want to encourage you to do your research, and to REALLY pray about it!Which is something I am ashamed to say I never did (well beforehand, I have spent many hours praying about it since then!). Spend some SERIOUS time prayerfully considering this option and do LOTS and LOTS of research! Ask lots of questions! Read every message board you can find! Ask all of your friends, boy, I wish I had!
Second: If you do decided this is the right thing for you, be VERY VERY careful where you go to get it in! If your insurance covers it I really would recommend going to Dr Singh or one of the other Drs at the Center for Reproductive Health. Because they are careful, and they they know what they are doing and they listen to your concerns. And while I won't ever be getting another one, if I was I would go to Dr. Singh. Make sure you ask your Dr about their experience, and ask around (even look it up online). I'm much to trusting and through this I have learned not all Drs are created equal. And listen to me sisters with free (government health care) just because it is free doesn't mean you don't deserve to be treated well, and listened to!
Lastly I have a more universal point... God is always with us! I learn this more everyday and in every way! He was with me when I had it put in (even though I never bothered to include Him in the decision), He was there with me through all my misgivings, and I truly believe He was there keeping me from getting pregnant all these months while it was where it was not supposed to be, and He was there giving me crazy bizarre dreams and promptings to get it looked at! And He was with me through all my panic attacks, and He was there with me when the fourth Dr FINALLY listened to me! And He was with me in the CT tube, and ALL day yesterday! And He worked through all of my dear friends' and family's prayers. And I was calm and not fretful for the whole procedure! As my dear friend Michele (who can speak so much to this in her own life recently) just said on Tuesday as she talked about her call rolling over 5 times on Paseo. God wasn't just there as her car rolled over and He saved her life and kept her precious girls from even getting a scratch, but He was there with her everyday that she was at home with four girls feeling overwhelmed and lonely. It is so easy to see Him is though or scary times, but He is always with us! Even in the still and quiet and mundane things! AMEN! That is something I needed to be reminded of! God is good! All things work to His glory!