Thursday, June 28, 2012

The Paragard Insertion Procedure and Aftermath

My appointment to get the Paragard IUD inserted was at 11:30am on Thursday, June 28, 2012. My gynecologist is female, older, and has been my doctor for five years now.

Like most visits to the gynecologist, they took my vital stats and then had me go into an exam room and put on a hospital robe. The nurse came in and set everything up on the counter - the Paragard device, as well as all the tools they needed. My doctor then came in and talked with me again about my medical history and about the common side effects of the Paragard (cramping, heavy periods, long periods, etc.). She told me she would be using Novocaine (local anesthesia) on my cervix because she's had IUDs before and knows how much pain they can cause. I asked her to talk me through the procedure, because I was curious, and she also promised to warn me before she did anything that would cause pain.Then she had me lie back and the procedure began.

The first thing I have to say before I describe the whole thing is that it wasn't as bad as I had planned for. About an hour before my appointment, I took 800mg of Ibuprofen as well as a tablet of .5mg of Ativan (Lorazepam, a common sedative) which I have in case of emergencies. I was also on my period, which is the recommended time to have the procedure, as your cervix is already dilated a little. Various stories on the internet convinced me that the pain was going to be the worst thing I had ever felt and that I might pass out from it. Although the pain was pretty intense, I'd have to guess that the total duration of it was roughly 20-30 seconds. Then again, I had the Novocaine, so I can't speak for women whose doctors don't use that.

The first thing the doctor did was insert a giant speculum (bigger than the usual one for pap smears) into me. After that, she inserted the Novocaine, which was an injection that was supposed to pinch, but I really hardly felt anything at all. After that, she cleansed the inside of my vagina and cervix with betadine, which is an antiseptic. I didn't feel that part at all.

And then came the first of the two "waves" of pain. It was time to get the tube holding the Paragard device through my cervix and into my uterus. As she slid it up, I had about 10-15 seconds of extremely intense cramping. It was very, very bad, but also very, very brief. I got shaky and sweaty, but once it was up there, the cramping passed and I had a moment of rest while the doctor prepared the next step.

The next step, which brought the second "wave" of pain, was raising the "arms" of the IUD to lock it into place. This was another 10-15 seconds of terrible, sharp cramping just like the previous wave, but it was also brief. After it was in place, she pulled out the tube, the cramping subsided, and the doctor said it had gone in perfectly. Because I was on my period and because the procedure aggravated my uterus, the doctor took a moment to wipe a bunch of the blood away and (I think) apply more antiseptic.

The whole procedure is fairly uncomfortable throughout, with the speculum in place and someone rooting around in your vagina and all, but my pain was brief and bearable.  I think I was probably in the exam room for a total of 30 minutes?

Once she was completely done, she gave me a bunch of literature to read about the Paragard and answered my questions. She told me to keep taking Ibuprofen for a while, to avoid tampons just for this one cycle of my period, and to use my best judgement about having sex, but she said she would at least give it a few days. I felt a little dizzy, so I laid back while we talked. By the time we were done, the dizziness had passed. I felt mostly fine as I got dressed and made my follow-up appointment for a month later, mostly just a little shaken by the whole procedure still.

I got home with no issues. I didn't feel anymore dizziness or nausea for the rest of the afternoon or evening. I kept taking 400mg of Ibuprofen every 4-6 hours or so that day and had mild-to-moderate cramping. It was noticeable, like a bad period, and although I did stay in bed with a heating pad for the afternoon, I think I could've pretty easily gone to work or done errands. I also did some stuff around the house that evening with no issues.

Overall, I have to say that while the procedure isn't a walk in the park, it wasn't as bad as the internet horror stories had led me to believe.

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