Thursday, January 31, 2013

Tenaculum - Useful Instrument or Torture Device?

It has been just shy of one year since I touched my blog.  Plenty of interesting, exciting, heartwarming, and heartbreaking things have happened in that year.  I mentally began outlining at least two dozen blog posts in this last year, but nothing could prompt me to put pen to paper (or fingers to keyboard) until now. 

What is so important to write down for the readership - all that might be left after a one-year absence?!  Is it the Benghazi assassinations, the exploitation of Sandy Hook to push a political agenda, or the hot mess and herp-a-derp that was my Facebook feed during the entire election season?  Is it the milestones reached by my sweet baby and my preschooler?  Is it a helpful post detailing normal behavior of a breastfed newborn, infant, and toddler?  Is it a PSA about how to properly adjust side-mirrors on a vehicle?  What could possibly awake my writing spirit from such a deep slumber?  My vagina, of course!

Are you new here?  If so, consider this a fair warning:  I get very graphic and descriptive and this is a post about menstruation and female genitalia.  That sounds really nice, but it's too polite and some of you might not understand. . .I'm going to talk about how it feels to have a faucet of blood running from between your legs and what I'm trying in order to not be held hostage by my bleeding snatch for two days out of every twenty.

Anyone left?  Let's proceed!

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Though I am still breastfeeding my 13-month old, my period resumed in mid-September.  I could tell it was coming because I had some weird cramping and backaches for a couple of weeks leading up to it.  It was, predictably, quite heavy and I chalked it up to my uterus making up for lost time. 

By the new year, I had experienced seven periods.  I can handle heavy and, since having 20- to 22-day cycles (or shorter!) for so long, I can also handle frequency.  It's the volume that I can't handle. 

How heavy is heavy?  So heavy that I have to use pads I'd purchased to be used immediately postpartum, but never needed since the lochia wasn't nearly that bad.  So heavy that I couldn't get my menstrual cup (it was the Diva, though I bought a Keeper to try and couldn't bring myself to deal with it) to actually form a seal.  So heavy that I would experience a laundry problem no matter what I was using to try to manage my menses.  So heavy that I was unable to leave my house and unable to do more than sit on the toilet or lie down during those days.  So heavy that I would soak a pad (couldn't use tampons) within minutes.  Blood would gush out with such force that it made me feel weak when it happened.

I finally had enough when I realized that I was planning my entire life around my period and when I figured I'd be experiencing menstrual flooding.  The OB/Gyn nurse I spoke with was alarmed and asked why I had never gone to the ER.  Call me silly, but it seems a bit ridiculous to show up to the ER and announce that you're there because you're bleeding to death. . .out of your vadge.  She disagreed and said that losing that volume of blood in such a short period (hah!) could be dangerous and that they'd want to evaluate me the next time it happened.  I agreed to go to the ER the next time, but I ended up getting my next period ten days late.  This is distressing enough, but it was even more distressing that my period started two hours before my gynecologist appointment.  Crap! 

As it turns out, that actually wasn't such a bad thing.  Yes, I know, no one wants to be in stirrups when they are bleeding.  Heck, I don't want to be in stirrups period! 

My gynecologist agreed that it was utter bullshit that I was being held hostage by my menstrual cycle.  I just love my doctor and respect that he's not an arrogant douche, but I was still expecting to have to argue my case that this period was not normal and that living like this wasn't acceptable.  I almost wanted to cry when he empathized and said that it sounds awful and that he was glad I was seeking help.

Of the options presented, inserting a hormone-infused IUD (Mirena) was the least invasive so that's what I decided to try first.  Friends and family are aware that my husband had a vasectomy less than a month ago.  And I just had an IUD inserted.  Yeah, I think my hubs is just totally thrilled with the way I chose to handle my problem.  The timing, it boggles.

I've never had an IUD before and it sounded just horrible to me.  A device that stays in your body - in your uterus! - for years at a time?!  No thanks, that sounds horrible. 

After inspecting one and having a lengthy discussion about what hormone is released by Mirena (and which are not), I agreed to go ahead and do it right then.  I know some of you are like, "WTF?  ON YOUR PERIOD??  ZOMG!!!"  Please realize that I wasn't thrilled at the prospect either.  I'm apparently not the only one who likes my doctor and his schedule is pretty full so I didn't want to wait for another cycle or two before coming back.  Also, he indicated that it was pretty well as good a time as it gets to insert an IUD based on the position of my cervix during menses.  My husband wasn't there to give his opinion (odd since he usually attends all appointments with me - I have issues with doctors), but I made a spur of the moment decision to just do it.

He talked to me through the entire procedure and always let me know what he was going to do before moving ahead.  My old friend, the plastic speculum, was surprisingly comfortable.  I'm usually squeezed up tighter than a virgin at a whore convention so that it's almost impossible to get it in and hurts like a mofo to click-click-click that bad boy open.  He said he was going to swabbed the interior of my ladyparts with iodine.  I half-way sat up, "Inside?!"  Yes, inside.  No, freezing cold iodine up your cooch doesn't feel good at all.  Not even on a hot day.

Whatever, my vagina and my cervix was swabbed with iodine.  It's not the worst thing I've had up in there.  It wasn't that bad and I figured that would probably be the worst of the whole procedure.  My naivete. . .it is so precious.

"I'm going to clip your cervix up and this will feel like a hard pinching pressure.  One, two, three. . ."

OH. MY. CERVIX!!! 

HOLY CRAPOLA!!

Immediate thought:  MUST.  NOT.  KILL.  HIM!!!

I couldn't breathe for a moment or two and I immediately broke out in sweat.  "Fuck, Doc, that really hurts," is all that I could push out between my clenched teeth.  Yes, I cursed in front of my doctor and his nurse.  No, I don't care and I don't think they did either.

"I know.  We're almost done.  I'm going to measure now.  This might feel uncomfortable"  Actually, I was so hyper-aware that MY CERVIX HAD A FREAKING CLAMP ON IT that I hardly noticed this measuring.  If anything, it reminded me of getting a pap smear and was the least painful part of the entire procedure.

At some point, his nurse grabbed my hand and murmured that it was almost over.  I was covered in a thin film of sweat and trying like crazy to breathe and not freak out because THERE WAS A CLAMP ON MY FREAKING CERVIX! 

The IUD was inserted.  Again, not all that painful because all I could feel or think about was my cervix.  I know it was only a few minutes at the most because there was a clock on the wall, but it felt like eternity before my cervix was released from such torment.

I was lying on the table and slowly became aware that it was over.  I propped up on my elbows, feeling like I'd just been thrown for a loop.  He helped me out of the stirrups and told me to relax for a minute before getting up.  We all discussed when to schedule my re-check and then he helped pull me up to a sitting position.  I still felt weird, but wanted to get the heck out of there at that point.

While I was getting dressed, I was very aware that I didn't feel right.  There was something inside of me and it felt wrong.  My cervix was smarting something fierce and I felt almost lightheaded from the whole experience.  My world was rocked and not in a good way.

Why did this hurt so much?  I don't know.  Perhaps my cervix is just particularly sensitive.  My cervix has never dilated by itself.  It has been manually dilated twice and I was under general anaesthesia both times.  Now I recognize the odd ache that I felt after both procedure.

I went home and was unable to walk upright within a couple of hours.  I couldn't pick up my baby.  I couldn't get in the shower.  I couldn't do much of anything except lie down and curl up in the fetal position. 

I was tempted to use the pain meds I'd been given after my last c-section, but didn't want to be out of it when baby woke for middle of the night nursing sessions.  I stopped taking prescription pain meds within two weeks of that surgery, but my cervix hurt bad enough after inserting the IUD that I wanted that level of pain relief.  I was also experiencing horrible cramping.  I ended up taking Tylenol to manage the pain.  In retrospect, I should have taken something stronger because no one gets a shiny gold star for being a pain martyr. 

The pain finally began to subside 36-hours after insertion.  I am still very aware that there is something inside of me, but I'm hopeful that this sensation will diminish over time.  I'm still getting the odd twinge of a cramp, but nowhere near as bad as it was yesterday.

I have heard from many women who have had an IUD and it's a pretty even split.  The ones who love it LOOOOOVE it and the ones who hate it HAAAAATE it.  None of them indicated that they experienced anywhere near the level of pain that I have experienced.  Only time will tell if the IUD works in the way I hope it will and I will be ecstatic if I can reclaim my life.

Have you had an IUD?  Did you have a painful insertion?  Was it horribly painful after insertion?  Did you have any positive or negative side effects?  Comment anonymously if you'd like and share your experience.

***

Oh, yes, the title of this post may seem odd.  The instrument that was used to hold my cervix is called a tenaculum.  While it is certainly a useful instrument, it is also most definitely a torture device.  Do a GIS and be prepared to see the stuff of my nightmares.