I took 800mg of ibuprofen right before the appointment and I went to my local Planned Parenthood for the insertion. I'm a poor student and living in California, so with their FPACT program everything was 100% covered today -- no fees for anything. Sweeeeet. I was not so thrilled about them not allowing my boyfriend to come in the back with me. I understand that they're just looking out for their patients, but I knew IUD insertions can be anywhere from mild cramping to pain so severe you pass out, so I wanted him with me. Being told he couldn't come in spiked my blood pressure to 146 in the systolic reading and they weren't going to insert it if it didn't go down! Eep! She had to read my BP twice more before it went down to an acceptable number. The nurse told me that if I wanted some support a nurse could stay with me but I just grumbled "I don't think that would be very helpful." If I couldn't have the boyfriend I would rather just do it on my own.
The nurse gave me a urine pregnancy test (negative! w00t!) and checked my hemoglobin with a fingerprick after asking me a lot of history questions. She then set me up in a room and showed me the bigass box the Mirena comes in, a box the size of my arm even though the actual device is less than a fingerlength. I got undressed from the waist down, put a paper sheet over me, and waited for the doctor to come in. Luckily the Ring has made my periods pretty light so I wasn't gushing blood everywhere.
The doctor came in and told me of some of the potential side effects of the Mirena; she did mention that it can have the same side effects as hormonal birth control, which I thought was nice. I know some people have been told the hormone dose is too low to cause side effects and then they got unpleasant surprises when they got mood swings or whatever.
She palpated my uterus vaginally first, which was a bit uncomfortable as she just plowed right in, and told me I had a very tiny uterus. I crossed my fingers and hoped it would be enough to fit the Mirena.
First she used a speculum on me, which I hadn't had done in a while and so it felt like a great big crank was being inserted into me. That wasn't too bad; burny and uncomfortably full, but not too much cramping. She swabbed the cervix with Betadine and I barely felt that. The sounding to measure the depth of the uterus was pretty uncomfortable, but I knew it would be from reading about it; it felt like one huge, long-lasting, deep cramp that totally covered my entire abdomen. It was a definitely a bigger cramp than periods have ever given me. I breathed out deeply through my nose and clenched my hands together, pursing my lips, and felt like I was about to start sweating from how uncomfortable it was. My legs felt it, too, feeling weak and achy in the stirrups. But I didn't say anything and she actually looked up and asked if I felt it/if there was cramping; I think she was wondering if she was fully in since I wasn't acting bothered by it. :-P I kept telling myself that if I'm going to be doing artificial insemination on cows and going through their cervix (I'm in vet school), that I should be able to handle something going through mine, as well!
My tiny uterus turned out to be 8cm, big enough for the Mirena, yay! She pulled out the sounding device and took a few minutes getting the Mirena ready, which gave time for the big cramp to fade away, thankfully. I wasn't sure if I could've stood if it she had inserted it while that huge deep cramp was pulling on me. By the time she was ready to insert the IUD the cramp was pretty much gone. The IUD insertion wasn't too bad; there was more cramping, but I just kept breathing and it was fine, better than the sounding. Again I didn't say anything and again she had to ask if I felt it.
It was a relief to have the speculum pulled out, though the second uterine palpation wasn't exactly thrilling, lol. But once that was done I sat up and there was only moderate cramping, nothing that a little deep breathing couldn't handle. Their policy is to come in for a 6-week checkup and string trim, which is going to be awkward since that's right in the middle of three two-week sets of being hundreds of miles from the area, but maybe I can go into a different location for it. She also recommended using condoms until I have the appointment to make sure things are A-OK, and considering I am fairly paranoid about expulsion, I think I'll stick to it, much as I hate condoms.
My boyfriend and I stopped for some of those disposable heating pads on the way back. Since then I've been wearing one, drinking tea, eating comfort food and snuggling. I've also been keeping up on 800mg ibuprofen every 3-4 hours as advised. Cramping hasn't been bad at all; about the same as my normal period cramps, just more frequent. Overally, on a pain scale of 1 to 10, the whole day has been about a 4 or 5. Totally bearable.
I do have a few questions though.
1. Is it normal for my strings to be so long? When I go to the bathroom I can feel them tickling the entrance of my vagina. The doctor specifically said she had left them long and would trim them at a 6-week checkup, but I really don't fancy getting poked when I'm peeing for the next several weeks, either. I can't feel any plastic bit coming out of the cervix, and I do imagine my cervix will go back to being nice and high once my period's over, but I'd just like some assurance that a) it's normal for the strings to be that long if they aren't trimmed at insertion (and if the cervix is low at that point) and b) that they really will start to curl around the cervix at some point.
2. About how long does the string curling/softening process take?
3. My biggest fear is that it will partially expel and I won't realize it. I'm pretty sure I'd notice if the whole unit came out, but I'm aware that it can hang out partially in the cervix and become ineffective without fully expelling. Has anyone had this happen to them? How long did it take you to find out? Did you become pregnant as a result?
4. For those of you experienced side effects from the Mirena, be it unusual/lightened bleeding, mood swings, other hormonally-driven side effects, how long did those take to start up? I'm guessing if I'm going to get them it will be in a few days, like it was when I was on the Ring and before that the Patch, but I'd just like to hear about it.