*Note* Written post procedure in May, 2018
It could be the pain medication talking, but I really fucking love my uterus. My uterus, and all accompanying nether-parts, have been through so much stress lately I’ve been thinking about getting them their own psychiatrist, or at least a prescription for Valium. Miranda on Sex and the City had a depressed vagina, and she’s supposed to be the relateable one, so you can never be too careful.
This week I took my uterus to the doctor. There wasn’t anything wrong with me, or my uterus, per se, aside from the regular monthly bleeding and the general horror that that tends to cause men. But this story didn’t really start with my most recent OBGYN appointment. I don’t suppose any woman can properly talk about their uterus without going back a few years.
In college I was privileged to have access to health insurance and family that supported my right to accessible birth control options. I chose oral contraceptives thanks to overwhelmingly debilitating cramps and a sneaky suspicion that I would not be interested in getting pregnant before twenty. Despite the thorough lecture our 7th grade health teacher gave us about how pregnancy occurs while we watched a woman give birth on VHS, and the ample questions my mother was willing to answer, I still felt like the danger of pregnancy was out there, looming in the dark corners of a college party.
I didn’t feel like I was protected from pregnancy just by being safe in my committed relationship, or even celibate for that matter. That’s probably a story for another day, but I’ll bet if you have been to a college party, or have seen a college party on tv, or have even just had to walk past a college party to get to your apartment every night after you got off the late shift that you were working to pay your way through school, you’re picking up what I’m putting down. If you’re still unclear… well…I’m talking about sexual assault. Something about the strategically placed blue panic buttons around campus didn’t exactly instill a feeling of security for my uterus and I.
The point is, I chose oral contraceptives as an armor of sorts. A just-in-case against all the things that I couldn’t control. At 17, I was too young to get a concealed carry, and I figured the birth control might help with the cramps.
After almost a decade of taking a pill before bed time, migraines and politics had me questioning if oral contraceptives and the hormones that come with them were the best choice for me. Most doctors gave me a blank stare when I asked about more permanent solutions. One doctor quite literally adjusted his penis as he told a 28 year old me, “You aren’t old enough to make that decision” after I fervently expressed that I did not want children and I wanted to explore non-hormonal possibilities.
This year, I turned 30. I thought maybe the new decade marker on my medical forms would open new possibilities. I asked my new doctor, in my new city, in my new state, if it might be possible to have my tubes tied, or if there were other options to explore.
“You don’t have children yet.” My fully female doctor said flatly, staring at my belly.
“Right…and I want to keep it that way.” I repeated.
I tried to ignore the “yet” that had echoed at the end of her statement. People were always adding the “yet”, as though there were a secret baby lurking in my uterus that I was unaware of, that only those who have had the magical experience of being impregnated can see. I once endured a full hour of a stranger at a bar telling me my best friend would impregnate me one day. He told me he could sense these things, and I just didn’t know… “yet”. Doesn’t matter that my friend and I are not in a relationship. Doesn’t matter that my friend has a husband. Doesn’t matter that I don’t want children. He told me God would find a way.
I was frustrated by my new OBGYN, but she agreed to work with my general practitioner to help me tackle my migraines and so I stuck around. Later that month I was prescribed a medication for said migraines, I just didn’t realize I had to pick the pills up from a pharmacy in the year 1952.
As I stood waiting, the pharmacist leaned heavily on the counter and handed me the prescription. She wiggled a finger at me and clutched the paper bag to her large breasts. “This will make your….” she mouthed the words “birth control” as her eyes darted around the room, “ineffective,” she whispered.
I smiled. “Thanks for letting me know. Are there any other types of contraceptive I can take or use while on this medication?” I asked, not choosing to lower my voice for the 60-something man waiting behind me who surely had heard of condoms before.
The pharmacist winced. “I can write some down for you to discuss with your doctor,” she said, nodding. Then, to be sure I understood, she added in a curt, scratch of a voice, “If you plan to be…” her voice cut out and she mouthed “sexually active” with air quotes around the word as though I might somehow be able to feign sexual activity, “then you’ll need to use alternate protection.” She folded her hands tightly, cheeks pink.
I rolled my eyes and took the bag from her, making a mental note to call my OBGYN as soon as possible.
The receptionist at my OBGYN had a lot of questions about my insurance provider, and very few questions about uterus. I decided that it wasn’t her job to worry about my lady bits, but my concern grew when I arrived at the doctor’s office and was handed three letters describing my financial responsibility, two letters describing the importance of contacting my insurance provider myself, and an actual waiver I had to sign claiming that I understood that the cost was mine, and mine alone to bear.
When Dr. Arnold came in, I was a bit confused, and not because he isn’t my traditional OBGYN. It isn’t surprising to get a parade of strange doctors before my usual doctor because go to a teaching hospital. Honestly, I thought a teaching hospital would be like Grey’s Anatomy and, happily, it is. I was confused because he came bearing even more pamphlets.
Dr. Arnold was lanky, with skinny jeans and a lab coat straight out of Rocky Horror Picture Show. His curly hair was tossed to the side in the way that only years of nervous finger combing could achieve. His thick horned rimmed glasses were the same kind I saw on a bust of a serial killer on Forensic Files and his lisp gave away nothing about his sexual preferences, despite cultural stereotypes. He handed me a bunch of pamphlets using just two fingers to avoid the obvious cooties my female-ness might have. “This one goes in your arm,” he said gesticulating, “and this one… does… not.” He looked down at my crotch, so I would be sure to know that, medically speaking, my vagina was not in my arm.
“I would like as few hormones as possible,” I told him, referencing my migraines. “Does this one here work with my migraine medicine?” I was skeptical given what I had read online.
He peered through the pamphlet. “I don’t see why not. But I’ll ask Dr. Catbasket.” (His attending’s name is clearly not Dr. Catbasket, but it’s really, really close, and I needed a pseudonym so I just can’t help myself.)
After some useless conversation about my menstrual blood, mostly prompted by me once I realized it would make him specifically uncomfortable, he went and retrieved Dr. Catbasket. She hurried in with another resident in tow, and began the process of discussing my options all over again with a new set of serial killer glasses, perched on a new resident’s face (just like Grey’s Anatomy).
After a bit, we had decided on an IUD, specifically because of the low amount of hormones that would be leaking into my body on a regular basis and because I have a strong a history of skin irritations and the arm injection is known to cause rashes.
Though strange skin rashes are, themselves, their own kind of birth control I suppose.
The day of the doctor’s appointment for my IUD insertion, I lay on the table with my feet in stirrups, shivering under my ridiculous excuse for a hospital gown. They had me sign a waiver before beginning, reassuring me as I signed that everything would be okay. I couldn’t help but feel like this was the same scenario for Ariel when Ursula told her “it’s cool, it’s just your voice.”
I laid on the table waiting for the procedure, staring at a table full of instruments. I was immediately struck by how much iodine and gauze they had laid out in preparation. It didn’t look as simple as the pamphlets or the Google search grab of “IUD procedure” would imply (below) with its description of quote “just an easy office visit!”.
My next clue that maybe this wouldn’t end with cupcakes was the doula. She came in like a mouse and stood peacefully in the corner in what looked like a yoga version of parade rest. I would have thought that she was just observing, Grey’s Anatomy style, but then she approached my head and asked if I would like her to help me breathe through “the pain”. My whole body immediately clenched. Turns out I have strong physical reaction to doulas, and it isn’t positive.
She titled her head like Professor Trelawney trying to read Harry Potter’s tea leaves of death, and said soothingly “I am… a doula…it is…my job.” She paused between sentence fragments, I imagine for dramatic effect. I shook my head furiously at her outstretched hands, my doctor already shoving speculums into places I was regretting allowing her access. I already had one lady putting her hands in places, the doula could just keep off.
I won’t go into too much detail about what followed, except to say that getting an IUD involves a lot of things that on their own are painful for many women including but not limited to inserting something into your vagina, opening your cervix, holding your cervix open, and then finally pushing something into your uterus. The end parts were where there was trouble.
The long and the short of it is, that my abdomen and uterus began to seize, very similar to as if I were in labor. I’m still unclear if the seizing caused the difficulties or the difficulties caused the seizing. There was a lot of talking, but I mostly just clenched my jaw and tried not to punch out the doula who was singing a song about breathing.
My doctor continued to work diligently, apologizing, and randomly asking me to cough for her. I did my best, but she was lucky if she could even get me to breathe for her, let alone cough. At one point she grabbed a desk lamp and shined it between my legs for extra visibility. I don’t think I can ever watch “The Brave Little Toaster” with the same innocence ever again.
After about 45 minutes, tears were streaming down my face, and the doula was crumpled in the corner and reeling from my rejection. My doctor began to withdraw the troops.
I sat up as much as my spasming stomach would allow, “What are you doing? Is it over?”
“No, I’m sorry, it’s not. I was unsuccesful.” She sighed, apologizing repeatedly and shaking her head.
The doula adjusted the pillow under my head and told me I was very brave. “You didn’t make a single sound,” she told me as though silence were a badge of bravery. The entire 45 minutes it felt as though someone was using two sharp fingernails to pull a piece of my uterus taught, and then twist it into a knot. Then, after it was as tight as it could possibly go, those same sharp fingernails pinched as hard as they could, stretching it wide from two corners until it felt as though it were about to burst like a balloon filled with too much helium. When I thought that pain was so much it just had to have been the worst of it, the process began again, and again, and again.
We moved to an ultrasound room, where they allowed me to rest for about 20 minutes and wait for an ultrasound tech. I mostly panicked, imagining the torture of having to go through that process again. The plan was to tag team with an ultrasound tech, the tech guiding my OBGYN’s hands using the ultrasound image. I cried, asking to go home without an IUD, and preferably without my spasming uterus if that were an option. They told me to relax and turned the dial up on a speaker in the corner.
The ultrasound room was large, and strangely decorated like a dorm room. There was even an early 2000’s era Dell in the corner, blasting music. The music theme was ominous, mainly orchestral with some percussion. I tried to lie still and relax my abdominal muscles, but they cramped and seized repeatedly almost as often as I sobbed. Eventually the ultrasound tech, doula, and OBGYN all paraded in, laughing cheerfully about the music. I wiped my face quickly and took as many deep breaths as I could, as the ultrasound tech showed me the CD case to the “Lord of the Rings” soundtrack that we were listening to. Makes sense, I guess, “Lord of the Rings” is exactly what people listen to while relaxing… in Hell.
The next phase was quick. Relatively painless. With the ultrasound technician’s help, the IUD was in place within 10 minutes. But within 10 hours I was back on the table, writhing in pain. My doctor wasn’t available to see me, so another doctor asked me a few questions, poking me in the side like spoiled piece of meat. Before I knew what was happening, I was in a wheelchair flying to the other side of the hospital to have my appendix removed.
I clung to the right side of my abdomen as though a doctor might jump out of a ficus and remove my appendix between the hospital lobby and the cardiology unit. I was in a lot of pain, sure, but no one seemed to be listening to me about the IUD, and the uterine spasms, and the fucking doula, and the ultrasound, and the “Lord of the Rings” soundtrack. It seemed as though they were focusing on “the statistically normal causes of abdominal pain”, and ignoring that it might be from the horror I had been through the day before.
Luckily, as it turns out, doctor’s don’t just take out someone’s appendix without some tests, as I had feared during my cross hospital wheelchair ride. After settling in my new hospital room, the new doctor listened intently to my story about the IUD. He nodded nicely, though skeptically. “Miss, I appreciate that this can be scary but I promise appendectomies are nothing to worry about. The worry is not removing them when needed. We’ll check your IUD just to be sure, but, please know that they are very safe, and complications are very rare.”
He reached behind my hospital bed to lean it back. I scrambled my legs around, and spun off the bed. Almost laughing, I looked him dead in the eye and said “If you think you’re…” I pointed at the zipper to my pants, “Well you’re nuts…sir.” He looked exacerbated. I have used that word a thousand times, but until this doctor, in this hospital room, trying to steal my appendix, I never really knew what exacerbation looked like. Half from pain, half from the trauma of being medically assaulted the day before, I demanded we call my doctor, or at the very least a female practitioner. The male doctor complied without complaint, and stood patiently in the hallway. My cheeks turned a dark shade of crimson when it turned out that all he was attempting to do was an external ultrasound.
In the end of this story I got to keep both my appendix and my IUD, though the IUD had been trying to pull an escape from Alcatraz out the side of my uterus.
Due to the spasming of my uterus, the IUD was pushed into the side of my uterine wall, and had begun to perforate the lining. Similar to A1 seen below. My OBGYN made the trip across the hospital for me, and after some crying and flailing, I allowed her to reposition the IUD, which, luckily, had not caused any severe trauma.
Not all women are so lucky.
This is a very long story to tell you that I lived and I’m fine and my uterus doesn’t have a hole in it anymore. But the point of this very long story about how I lived, and I am fine, is to hopefully illustrate just a tiny piece of the struggle I had to go through as a woman seeking a method of birth control.
And this is just one story.
And I am just one woman.