Statistically screwed

If there is a side effect to a medication, a tiny little inconsequential "this never happens but you should know that it could" disclaimer in a patient information insert, an odd "check out this patient's story" in a medical journal, odds are good that it will happen to me. I'm the person who gets weird reactions to just about everything, from Amoxicillan to Sudafed.

You'd think that, knowing this about myself, I would have put more thought into the potential ramifications of my choice of birth control when I selected the Mirena IUD. Hell, I even signed a patient consent form acknowledging that I was aware of all the things that can go wrong with the Mirena. That silly form should have stopped me dead in my tracks, but I couldn't see past "worry-free birth control for 5 years."

Worry-free, my ass.

I had problems from the beginning with my Mirena. Days after it was inserted, I started cramping excessively. I knew this could be common, but decided to check to see that the strings were in place just to confirm that everything was where it should be. Couldn't find the suckers anywhere. After several consultations with a friend who has a Mirena and several more attempts to locate them, I called the OB who had inserted my IUD. She agreed that things didn't sound quite right and very sweetly met me at her office after-hours on a Friday evening to see what was up. I knew the news wasn't good when I saw her face during the exam. My Mirena was nowhere to be found and she couldn't say for sure where in my body it might be.

I had a series of ultrasounds over the ensuing weeks and my Mirena was eventually located in my uterus, just slightly off of where it should be, with the strings up and inside. I was still having extensive cramping, and the obvious solution was to remove the device. But without strings to pull, there was no easy way to get it out of me. My doctor attempted to retrieve it with a "string catcher" device, a terribly uncomfortable procedure which involved a needle-in-a-haystack search through my uterus with a long metal rod. It didn't work. My only option, my doctor regretfully told me, was surgery.

I was still breastfeeding Evan, who was 5 months old at the time, and he wasn't great about taking a bottle. I would need to pump and dump for 24-48 hours after anesthesia, and even if I could get him to take a bottle, I had very little milk in my freezer (why bother to pump if he wouldn't drink expressed milk?). Julia had never tasted a drop of formula and I hated the idea of not being able to say the same for Evan. I was also terrified of anesthesia, which I've never had, and of the potential side effects I might encounter there. What would happen if I left the IUD in place, I asked my doctor. She saw no reason why it couldn't remain, and even be used as birth control, if I could handle the discomfort. I opted to give it a whirl.

Over the next several months, I reached a truce with my Mirena. The initial pain subsided and while I would occasionally feel it shift inside of me and have several days of pain, it was nothing I couldn't live with. I loved the freedom from thinking about birth control and eventually decided that despite my lousy start, I loved my IUD as well. Then I started to bleed.

Over the past several months, I've bled at least 3 weeks out of every month. After years of anovulation, followed by nearly continual pregnancy and breastfeeding, I actually think I've bled more in the past 5 months than the past 5 years. My doctors office assured me when I called that bleeding was normal up to a year after insertion (see the small print on the patient release form?), but I was concerned that since I couldn't check the strings, I had no way of knowing if the sucker had moved. So they scheduled me to come in.

After discussing the situation, my doctor and I agreed that between the bleeding and the cramping, this Mirena clearly just isn't working for me. So she tried again to get it out. No dice. I came back again today and another doctor in the practice tried again while the original OB worked an ultrasound on my abdomen so that they knew where to guide the string catcher. It was agreed that I endured a metal rod poking through my cervix and fishing around my uterus like a champ. But again, the attempt failed. They now suspect that the IUD is actually embedded in the muscle of my uterus, which I suspect can't be good news, though no one in my doctor's office will come right out and say that.

I'm out of options and after months of telling me there was no reason to get this thing out of me any time soon, everybody now seems to be in quite a rush to remove it. So on Monday morning, I'm going in for a D&C. I'm terrified -- of the surgery, the anesthesia, the side effects I might endure and most importantly, of what they're going to find when they get in there and what it might mean for my future fertility.

I'm 95% certain that I'm through having babies. But I want to reserve the right to change my mind later on, which is why the Mirena seemed to be such a good choice for me in the first place. I'm not sure how I'm going to feel if I find out I lost that ability when I chose to get a Mirena. But before I can even worry about that, I have to worry about Monday's procedure. I know that statistically, there's nothing to worry about, that these things happen every day and are handled routinely. But statistics and I, we don't have a very good track record. I signed the Mirena patient agreement without thinking twice about it, and look where that got me. I don't mind telling you, I'm a little terrified of signing that surgery release form on Monday morning. I can just cross my fingers and hope that statistically, I have to get lucky some time.