Wednesday, March 24, 2010

IUD, WTF, OMG

I thought I was so brilliant for choosing an IUD. Unfortunately, most of the medical professionals I spoke to in my quest for long-term, hassle-free, non-hormonal, effective birth control were not easily convinced of my brilliance.

I repeatedly explained that I was in a long-distance relationship, but that my dude-person and I were getting married in six five four months. I explained that I did not want to use barrier methods, and that I didn't feel comfortable with the idea of artificial hormones. That my future husband and I were both healthy and infection-free and that we wanted children someday just not right away and I've done my research and know that insertion is going to hurt and I can deal with it so will you please, please put a copper-wrapped plastic T in my uterus so I can have consequence-free sex with my husband?

Because I was 22 and had never had the kind of sex that can get you pregnant a child, most of the health care providers I spoke with refused my request. One woman, after examining me and ostensibly listening to my history and list of birth control "wants" and "do not wants" suggested, "Have you thought about using condoms?" As though I'd never heard of them. (Never mind that condoms fall into the already-rejected "barrier method" category.)

It took some serious doctor-shopping and several very uncomfortable women's-clinic visits, but I was finally able to find a doctor who was willing to trick out my uterus with a shiny new ParaGard IUD. My new OB-Gyn BFF was also willing to really listen, and he somehow managed not to talk down to me despite my being a college student and his being a doctor. Amazing! (If I could have taken him to Seattle with me when I moved so he could be my doctor forever and ever, I totally would have.) Thank you, Dr. Patton. You rock.

The IUD made my periods heavier. I knew that this could happen, especially with the ParaGard, but I'd been suspicious. Why? My periods have always been very heavy, and I guess I thought there had to be some sort of limit. No one makes a "super plus plus" tampon. But it turns out that IUD-plus-me results in periods of WTF-proportions.

So I had semi-hassle-free birth control. Whatever. And, as promised, the IUD was super-effective at preventing pregnancy.

It's no secret what happened when I had the IUD removed just to "see what would happen." I had one (alarmingly late) IUD-less period before Westley was conceived.

"What are you planning to do about birth control after the baby is born?" my midwife asked during one of my final clinic visits.

When I mentioned thinking about having a new ParaGard put in at the earliest opportunity, she was very enthusiastic: "Do it!" Hippie-dippy, crunchy-granola Seattle midwives are passionate about IUDs, it would seem.

With my midwife's blessing upon me, I went in for IUD-insertion numero dos when Westley was two months old. It was a breeze. I left Planned Parenthood feeling very pleased with myself for being so responsible.

A year later, I was sitting in the doctor's office, filling out paperwork, trying to cram my symptoms onto the three lines available under "Please describe below." Persistent, debilitating low back pain. Fatigue. Pelvic pain. Periods lasting 9 or 10 days.

The fatigue was more or less resolved with diet and exercise. The low back pain didn't respond to physical therapy, and the effect of acupuncture was minimal. And my periods were getting worse: 14 days of bleeding and pain so bad that walking was a challenge.

Finally, this past Monday, I had a pelvic ultrasound. I was expecting them to find something growing on the back of my uterus, pressing into my back. Possibly a fibroid, since they seem to be an issue for the women in my family. Of course, it could be something else. A tumor. Rob and my mother both suspect endometriosis, but that's hard to check for. And then it's possible that it's "nothing."

I lay on my back, staring at the wall-mounted TV screen, wishing the ultrasound technician would tell me what was going on but feeling too nervous to say anything. Instead, I told her a little about Westley and the cute things he says. I mentally flip-flopped between hoping the technician would find something and hoping she would find nothing.

When I scheduled the appointment, I forgot to ask if the ultrasound would be transabdominal or transvaginal. It turned out to be first one, and then the other. The abdominal ultrasound was easy, though I felt lost at sea, watching the black and gray swirls on the screen. When the technician got to the transvaginal part of the exam, she was very quiet.

I'm daydreaming, trying to relax and ignore the probing of the camera-wand, when she asks, "Have you ever had this done before? What I'm doing now?"

"No." My First Vaginal Ultrasound, by Mattel.

More silence. Black and gray blobs on the screen. Something looks vaguely circular, but as soon as I decide it's there, it disappears. I stop looking for shapes.

"Has anyone ever commented on the shape of your uterus?"

What a strange thing to ask. "No. Just that it's over to the right side."

After another minute or two, she leaves to get the doctor. After a minute, the ultrasound technician comes back into the room alone to take a few more pictures. I try not to feel the magic-camera-wand. "Where is the doctor?" she wonders out loud to herself. She doesn't sound relaxed. I make the scared part of myself to calm down.

Finally, the doctor arrives. She's very pleasant. Kind of jolly and maternal. She takes over with the magic-camera-dildo-wand and tells me to rest my knee on her side. It's nice to have some human contact; everything is momentarily less scary and clinical. As I move my leg slightly, I'm suddenly aware of how tense and cold my feet are.

The doctor looks at the screen, and then at me. She's still very pleasant. Cheerful, even. "It looks like you have a duplicated uterus."

The words echo in my head.

"Okay," I say, like this makes sense to me. I can feel my mind trying to process. Duplicated uterus. That must mean--

"What that means is you have one uterus...with two separate cavities."

"Okay." Oh, God.

"Your IUD is in the right cavity."

"Uh-huh." I don't like where this is going. I really don't like where this is going.

"Your left cavity is...unprotected."

Just like that, my 99.9% effective birth control is more like 50-50. But I can't focus on my coin-flip fertility for long. My head is spinning. I'm not pregnant now, am I? Is that what they're going to tell me next?

No, no. Not pregnant. The doctor is saying something about my possibly having two cervices also. Though she says "cervixes." "I think you do." But I'd need an exam to confirm that. The doctor finishes up with, "So we'll fax this report over to your doctor, and be sure to use an alternate method of birth control. An IUD might not be the best choice for you."

"Right." I try to laugh.

Duplicated uterus. My mind is repeating it, so I don't forget. "A duplicated uterus? Is that what it's called?" That sounded like my voice, asking for clarification.

"Yes," the doctor says, and quickly offers a slightly more in-depth explanation, throwing in the words bicollis and didelphys (which I will be surprised to realize I remember a few hours later).

The doctor leaves, the technician leaves. I get dressed in the dark, feeling disoriented, and hollow.

Usually when I have two of something that I'm only supposed to have one of, it's desserts. Or glasses of wine. Or Aleve tablets for my excruciating back pain (which, come to think of it, having a duplicated uterus doesn't really explain). Rob and Westley are waiting for me in the lobby, and I can't decide what I'll say when I see them. I wish I had a picture of it. All I can think about is circus sideshows.

At least it's not bad news. But it's not exactly good news, either.

Waiting for the elevator, listening to Rob narrate the saga of Westley-and-Rob-wait-for-Mommy. I still haven't told Rob anything other than, "I have something to tell you. It's nothing bad." I'm not even sure if it's nothing bad. The doctor sure made it sound all normal-variation-y and not freaky-scary-dangerous.

I notice that the woman waiting next to us is holding a little ultrasound photo. She's smiling quietly at the shiny black and gray blobs. Her midsection looks soft and round.

I suddenly feel incredibly freakish and alone.

.....................................

7 comments:

Allison the Meep said...

a) holy shit. whoa. holy shit. that's crazy.
b) i absolutely hate transvaginal ultrasounds, aka the rape wand.
c) kind of funny that in a post about having a duplicated uterus, the last mirror image picture you posted somehow has created a small vagina on your neck. not in the old lady vagina-neck kind of way though.

Amber, The Unlikely Mama said...

Holy crap! So does this have anything to do with the pain?

Baby in Broad said...

Amber, I have no idea if this has anything to do with the pain. It definitely raises more questions than it answers, I think.

Anonymous said...

I'm just a random lurker, but since you said you felt alone...there's at least one other blog I read written by a woman with two uteri. She had a too early delivery with her first, but just recently carried her second child to term. This post of hers mentions a yahoo group for women with uterine abnormalities. You're not alone.
http://www.followingelias.com/2008/06/mullerian-anomolies-and-me.html

-Emily

MOMSICLE VIBE said...

WOW. Amazing. So, this extra uterus has been there all along, right? So, this doesn't explain your pain? I'm sorry you are in pain and I'm sorry you felt alone. I hope you don't anymore.

I HATE ultrasound dildo - boo! I have also had tense moments with u/s techs and I know how scary it can be when your trying to decide if you should be scared.

Feel better!

Thomasin said...

I'd say this was fascinating, but that probably makes you feel worse so instead I'll say: isn't the human body amazing? There are so many variations, all part of being normal. Because, honestly, I don't think this sounds abnormal, just not so typical. I hope your follow-up appointments are conducted in a considerate way by your providers and that you receive some reassurance. And that they figure out your pains and can help you feel better.

~Thomasin

Anonymous said...

Ultrasound Technician use diagnostic imaging through sound waves to create an internal picture of a patient's body. Unlike most diagnostic testing, ultrasound is not computer operated, and actually guided by the sonographer's ability to get clear, accurate pictures. In this field it is required to work closely with a radiologist and communicate what images they need to get a proper study.