AKA: 5 Days Post-IUD Replacement
Yeah, I've dropped the ball a bit on reporting in, so it's going to be a long one. Let's jump into the wayback machine and hit the button for Monday, shall we?
Monday sucked pretty hard. Had to take the meds to soften(?) the cervix, which did not make the cramping situation any better. I'd had the foresight to take the day off, so at least I was able to suffer without the added excitement of what equates to customer service within the Marine Corps. I did, however, have to take my dog to the vet for routine vaccinations, and then I had my own therapy appointment, and then later on I had to go back to the vet to get meds for our other dog (she's ok, just minor issues associated with getting older), all the while dealing with cramps exacerbated by these meds. Overall, it wasn't catastrophic, but it did suck.
So Tuesday rolls around. It took a little longer to be seen than I expected, but I had some flexibility with when I started work, so no big deal. Weight wasn't nearly as bad as I expected, considering I was in all my clothes, bloated, and full of coffee. Got undressed, sat down, and the doc came in. We talked briefly about how godawful the last 5-6 weeks were with symptoms, and he's shockingly sympathetic. I ask him if we can discuss the hysterectomy while we do the switcheroo, because I absolutely still want it. He agrees, and we discuss.
When the surgery occurs, it will be a Friday. I'll be in the hospital for less than a day, and only because he doesn't have an anaesthesia team that comes into his office. It will be done using the DaVinci robot (a robotic-assisted surgery, which is the COOLEST FUCKING THING), and hopefully the single-site method, where the whole robotic nonsense goes in through the navel. It's absolutely wild. Initial recovery time is like, a day. Since my job equates to sitting in front of a computer and occasionally having to talk on the phone, I will absolutely be able to go back to work on the following Monday, provided there aren't any major complications (read: he discovers something seriously wrong that has somehow been missed on 14 years worth of blood tests, sonograms, ultrasounds, and x-rays). Full healing takes 6-8 weeks, during which time there is to be no sex, and I assume orgasms are also a bad plan. I'll have to revisit that one. He removes the uterus, the cervix, and the fallopian tubes. Now, I was perfectly fine with just yeeting the ute. After all, she's the only one that's been truly problematic. Ok, the cervix is on thin ice, too, but ultimately, I didn't see the need to remove her, and the tubes have been no trouble at all. So I asked why so much was to be removed.
The uterus is the offending organ, so obviously, she's out. Removing the fallopian tubes cuts down on the chance of one type of (extremely aggressive) ovarian cancer (who knew?!), though leaving the ovaries in place will prevent the immediate descent into madne menopause. The cervix could be left in, but removing it will both remove the chance of cervical cancer (and I've already had one abnormal pap, so like...fucking why not?) and will also allow for faster healing. Ergo, it's just standard practice.
Okey dokey, that makes sense. But obviously, you're not just going to leave the vaginal canal open to the body. That would be a terrible idea, at least as far as I can tell. So is there some sort of implant, or do y'all just cinch that shit closed like an old-timey coinpurse?
Yes. That's exactly what you do. You cinch that shit closed like an old-timey coinpurse. This brings up some questions that I think are very important. Other than the aforementioned 6-8 week heal time where there is to be no sex (we had a good laugh about the fact that I have a toy box to help with that), how does this new vaginal shape impact sex? Because frankly, I very much enjoy sex, and I would very much like to continue doing so. And I'm not exactly loaded with space to begin with, so the concept of removing some of that space...well, it gives one pause.
Apparently, in roughly 99% of cases, there is no noticeable change, or there is improvement (because the uterus no longer exists to cause pain/cramping/interruption/pregnancy scares). It is extremely unlikely for intercourse to be negatively impacted by the surgery. The only real possibility is if there's a problem with scarring during healing, and I was led to believe that such a thing could be revised if necessary. And, I mean, vaginoplasty is a thing, and trans women have bottom surgery, so I'm inclined to believe that this is accurate.*
Now, while this conversation is going on, the doc is playing swapskies. At one point, he asks me to "give [him] a big cough". Which is a neat way to distract the brain while he yanks the old IUD out so it hurts far less. Unfortunately, I did feel it (whether because I was well aware of the ruse and my brain refused to be tricked, or because it just hurt that much, I don't know), but it was a brief twinge, akin to lightly stubbing a toe. He told me it was out and asked if I had felt it. I was honest and said I had, but that it wasn't bad. After all, I'd had this done once before without any kind of medication ahead of time, so this was an improvement.
Then came the insertion of the new one. Which sucks, no matter what you do. Because they have to take what amounts to a very fancy straw, ram it through the tiny opening in your cervix, leave it there for long enough to check positioning, and then deploy the new IUD before removing the straw. So yeah, gonna hurt unless you pop some sort of serious anaesthetic, which we didn't do. (It's not common, it's expensive, and honestly, I probably wouldn't take it if it was offered. I'm not a fan of how I feel after such medications, and the immediate pain relief wouldn't be worth the after-effects.) So yeah, that sucked a lot. And I imagine that I flinched, or groaned, or did something, because the doctor, this sweet man, said, "I know, I'm so sorry," while he was working.
I replied, "It's ok, I signed up for this." Because it's 100% true. I signed up for this, having already experienced the initial insertion (which HOLY FUCK was worse, because they have to put a measuring thingie up in there first, and that's just as bad as the deployment straw, and there was no medication to be had for that one) and one swap-out. I was fully aware that it was going to be, at best, very uncomfortable, and that it was far more likely to be at least moderately painful.**
I'm sure I sounded like someone who was trying to sound tough, because I know I was talking through clenched teeth. To his credit, the doc laughed at my response and said, "You know, I like you. You tell it like it is."
He's not wrong.
And that was pretty much it for the appointment. I go back in a month to check and make sure everything is in place as it's supposed to be. There is a minor chance that an IUD can, shall we say, migrate, but that almost always happens within the first month.
Now, I spent most of Tuesday fairly uncomfortable. Cramps, some bleeding (can't use a tampon either, because it's not a period, it's from the beating your cervix takes), still an emotional shitshow. I ate a chicken sandwich, a chili cheese dog, and a chocolate malt for lunch, and still wanted to eat everything in sight. But Wednesday? Wednesday was a different story altogether. I woke up without any pain. Nothing. Not even a twinge. For the first time in quite a while, I had no new breakouts. Obviously, I'm not miraculously free of acne, but nothing new popped up, and that which was already there is healing. And...I wasn't hungry. I didn't want to eat everything. To the extent that at 2pm I realized that my stomach was growling and the only thing I'd eaten all day was a cup of coffee. Oops. Working on not doing that again.
Bleeding stopped by the end of Thursday. Almost all of my symptoms have gone away. There's still a little emotional instability, but I anticipate that taking about a week to regulate, and I'm still having some headaches, but that could also be at least partially weather related. Honestly, the change in how I'm feeling is astounding.
Point of interest: this changes nothing. While I realize that removing the uterus will remove the IUD and thus the constant flow of hormones, I will also not have the organ that causes the pain and nausea and other such nonsense. I'll also be asking the doctor about the possibility of oral hormones for the sake of weaning off rather than cold-turkeying. He may say no, and that's fine. I'll suck it up and deal with it then. Because once my body does get used to dealing with its own hormonal nonsense, and there's no uterus to hurt, everything will improve.
*Anyone who takes issue with trans rights, or believes that trans persons will never be their gender because of their biological sex can fuck right off. Preferably off a very tall bridge and into a sea that's absolutely teeming with sharks, orcas, and/or flesh-eating parasites. And for the purposes of this statement, non-binary, genderqueer, genderfluid, gender non-conforming, and agender are all covered by the same sentiment. Gender is a spectrum and there's science to back it up. Fuck you.
**Something to note: it was painful. I'm not going to sugar coat it. If you're considering getting an IUD, be aware that the insertion is going to hurt. But, at least in my case, that pain still wasn't as bad as my cramps can get, and the pain lasts a couple of days at most, and then I'm done for the better part of 3 years, with only some mild cramping on those rare occasions that I do end up with a period. The tradeoff is definitely worth it.
