Hi everyone!
I am new to the community, but read tons of entries from you all while I was going through this process. I found so much helpful information, but not a lot from 2nd attempt IUD insertion users. I wanted to share my story in case anyone comes here like I did, looking for some advice about 2nd attempts. Sorry it's so long, but I hope more information will be better.
Background:
I was on HBC for 10 years (a variety of pills and the last 5 or 6 years on NuvaRing). I overall tolerated HBC well, no major health issues or history of breast cancer, etc. However, I struggled with lots of other little health issues. Mainly fatigue, slow and steady weight gain even when exercising 3-4 days a week and eating less than 1000 calories (of course when I tell my doctors this, they think I'm lying), no libido, moodiness, breast pain, etc. These were all things I just lived with for many years. This summer though, I was convinced these were due to a thyroid issue after I started having lots of trouble focusing and would sleep for 12 hours and STILL be tired. After normal result after normal result on thyroid testing, I decided to not just accept that "Everything's fine!" and research a lot on my own. Long story short, I fought with several doctors to finally get an integrative medicine consult. Problem was, I had to wait 3 months t get in to see her, but it was well worth the wait. She was AMAZING and pointed out that many (if not all) of my problems were due to some type of hormone imbalance. She wants to test my hormones via saliva, but said she wants to see what my body can do on its own off of the HBC. She recommended that I get put on a Copper IUD. She also sent me for a battery of other blood tests and I found that I have many things going on (candida, low DHEA, low magnesium, etc) but she said many of these problems were likely directly associated with the hormones from the birth control use. She sent me off with some things to do now and said "We WILL fix this!" One of her "things to do" was schedule an appt. with my GP to get a copper IUD. I walked out of her office and immediately scheduled the appointment with my GP's office.
First Attempt:
I had scheduled an appointment with the doctor's office and said specifically that I wanted Paragard. The receptionist didn't give me any prep details, so I sent a message through their messaging system to my doctor directly and asked if there was anything I needed to do and if they could insert it that night along with my pap. The nurse emailed me back and said she was happy I told them, because the order had just said I waned to talk about birth control options and had I just showed up, they would not have been prepared to do the IUD that day. She put in the order to get the Paragard and told me I would need to take a pregnancy test before. She also sent a Rx to my pharmacy for 2 of the 200mcg misoprostol. They told me to take it buccally (in the cheek and let dissolve) 3 hours prior to the appointment and 400-600 mg of ibuprofen an hour before. No mention that I should be on my period (which I was not on during first attempt), and as I researched on here, I wondered if that mattered, but I had read it was fine either way, so I didn't worry about it.
The day of the appointment came and I did everything they told me to. Misoprostol made me nervous because I had read about nausea, diarrhea, etc. but I tolerated it well. It was gross having it dissolve in my mouth, but it was really no big deal. I was confused about how to take it because they said let it dissolve, but it was taking FOREVER to do so. I waited it out but it probably took a good hour to dissolve completely and that was with me sort of pushing it around to get more to dissolve faster. I think this probably made it ineffective and that I should have taken it earlier, but that's just me speculating and I can't find any good research online about this.
I went to the office for an evening appointment (6:40pm, which I didn't even realize they were open so late... later I realized this may have been part of my downfall on 1st attempt, but more on that later). I took the pg test and waited. They called me back shortly after. The nurse took my BP and made mention that "You're here to talk about BC?" I said, "Ummmmmmmm I messaged and the nurse said I was ready for IUD today!?" This nurse said, "Hmm, weird, it doesn't say that in here... but I see they gave you the misoprostol and you took the PG test. Okay let me go get that..." She left and came back with the IUD and tools needed for insertion. Red flag #1--- she examined the box forever and then took out a pamphlet with a checklist for me to fill out that asked about risk factors. She got the tools ready and my said my doctor would be in soon. I could tell she was not used to doing this.
Doctor comes in and says, "Oh, we're doing Paragard today, huh!?" Red flag 2: My doctor seemed to have no idea that was why I was here! She gave me some basic info and had me sign the waiver. I told her I was nervous about pain and she said "Well, I will be gentle!" I was prepped and she got the clamp on my cervix (OWWWW!) and then tried several times to get the sound in, all the while I was reeling and trying not to scream at her. She could not get it past 3cm and said it had to be more like 7 in order to work. After several tries, she finally said it was a no go. All the possibilities I had run through my head and never did I think I would walk out of there with NO IUD! I cried because I was mad and felt like this was my last chance. She had said that only ONE other time that she couldn't get it that the OBGYN could so I felt like my chances were not good. She asked if I wanted an OBGYN consult to try again and at first I said no because, why would I go through all that again and have it fail twice? She clearly felt bad for me and said we could talk about other options. I told her about my visit with the Int. specialist and how I don't want kids and this was really the only option for me. She mentioned essure and tubal ligation, but then said if I didn't want kids, I should definitely try OBGYN and give it one more shot for the IUD. I decided to schedule it and give it a 2nd shot. I went home and cried all night-- probably in part because of PMS (my period was due the next week) but also because I felt like a huge failure and was in a lot of pain for no gain. I also resented my hubby because he has said he will get a vasectomy, but keeps putting it off. I knew my feelings were irrational but I could not stop crying.
On reflection, I think there were some major problems with this attempt: 1: not on period, 2: misporostol in cheek 3 hours before not very effective per the obgyn nurse I later talked to, 3: I had no nurse to hold my hand or help me through it (sounds stupid, but made all the difference on insertion #2) 4: It was late and I am guessing she was in a hurry to get home,so instead of trying other things like lidocaine, she gave up. 5: Miscommunication about why I was there- the nurse I emailed must not have properly relayed why I was there based on the other nurse's reaction and I don't think my doctor knew what was coming until she walked in the room and saw the box sitting on the counter. 6: Though my doctor said she has done lots of these, I don't believe her after going to the 2nd doctor in obgyn.
2nd Attempt:
I scheduled it with an OBGYN MD for the 2nd day of my period based on when my typical withdraw bleed starts from the Nuvaring. This time, I was told to take the miso vaginally the night before (the nurse commented that 3 hours isn't typically enough time). When I asked how many hours, the OBGYN nurse said it didn't really matter, but I opted for about 11 hours because I was afraid that more time than that would make it wear off too soon and too short of a time would make it not work yet. I actually got the first pill in and shoved it as far back as I could, but I DROPPED the second on in the toilet!!! Ahh! I freaked out that now it wasn't going to work at only 200mcg instead of 400. I went to bed and woke with very minor cramping and a little bit of a stomach ache. I didn't experience any diarrhea or anything like that. My period actually started that night (usually starts on a Thursday but didn't start until some time Friday AM in my sleep). I was nervous about this too, because I had JUST started my period and I didn't know if that would impact the ease of insertion. Needless to say, I walked in to the office VERY nervous that this was going to be failure #2 and pain for no gain again, plus taking a day off of work for no reason.
The doctor was awesome! She was funny and joked by saying, "I'm not nervous... it's either going to go in or it won't and then we'll talk about other methods!" Then, she asked why I was opting for the IUD and I told her about not wanting kids and hormone issues and she said, "Oh! Well then you're probably thinking, YOU BETTER GET THIS IN, LADY!!" I laughed and asked, "Is it pretty common for a 1st attempt to fail but a 2nd to work?" She sarcastically said, "Yea...let's go with that......" But then said "We have a lot in our favor with the miso and your period... plus I've done a ton of these." She also told me I can yell at her any time I want during insertion, lol.
She then summoned a nurse and said she would be there to help me through it. The nurse was on her way, but the Dr. started without her. She clamped me (BIG OW again!) and she said, "You're doing great! Relax!" which actually helped because it reminded me to breathe and keep me butt down! Then, she started putting the sound in and I yelled, "DAMNIT!" The nurse walked in as I yelled that, haha and she came and held my hand, told me to breathe, keep my butt down. I apologized for swearing and she laughed and said it was fine. The Dr. said "Oh, this will be easy! It will go in no problem!" based on the sound. Then she said the IUD wasn't going into the straw thingy, which was kind of good because it bought me a few extra seconds to breathe and prepare for the IUD part. When she shoved it in, it hurt just as much, if not more, than the sound and I slid back on the table. The doctor said, "It's in! You're done! 10 years!!!!" I yelled, "WOOHOO!!!!" She cut the strings and removed the clamp, speculum, etc. I commented that it didn't really feel any better after the removal of these things like I expected and she asked if it was just cramping and I told her yes. She was not worried about that and said I could lie there as long as I wanted. She asked if I wanted ibuprofen, but I had already taken 800mg an hour priod to that, so I didn't think taking more was wise. I was so excited it was in that I didn't even care about the pain.
I laid there for about 5 minutes and finally got up to leave. I couldn't walk normally because I was in pain (felt like very bad cramping). The worst part was that I couldn't get comfy... sitting, standing, walking... no matter what was all painful. My hubby drove me home and I sat in bed with a heating pad for about 4 hours. The heating pad helped a little, but it still hurt a lot. I couldn't sleep either. After about 2 hours of very painful cramping and not being able to get comfy no matter what, I made myself a stiff drink and that helped a lot too, haha. By evening, I was able to go out to dinner and felt much better. An occasional pain here and there, and now today (day after insertion) I woke with virtually no pain. The bleeding yesterday was pretty consistent and heavy, but today it's mostly spotting. I felt for the strings and they are there. I'm so happy I could jump up and down!
Was it easy? No. Was it fun? Defintely not. Was it worth it? Absolutely. I know there is a very long road ahead of me with periods, possible expulsion, etc. but so far I will say yes, definitely worth it. :) If you have a failed first attempt, I think it's crucial to make sure you go to a very experienced doctor. I wish I had asked more about this before I went the first time. The second time, the pain was just as bad, but she worked very fast and I think that was another difference. My other doctor was focused too much on being gentle and it made for a lengthly, painful process for nothing. I also think being on my period and taking miso vaginally made the difference for me.
Thanks for listening! I hope my story helps someone else out there like all of your stories have helped me so much. :)