The short version is that it went really well, and I will enthusiastically attest to the "reduced pain and recovery time" claims made about it. A step-by-step of what happened:
The Night Before:
I inserted my first misoprostol pill a little while before bedtime. I'm sure it started to work relatively quickly (within about 30 minutes) because I had some Fun Time Cervical Cramping going on for a good chunk of the night. They subsided by morning but started up again shortly after I inserted my second pill. I don't know how common a reaction this is (though it would make sense, on account of the aim was to soften my cervix), but I'd say that my misoprostol-induced cramping rivals my cramping directly from the Essure.
I got to the office about an hour before the actual procedure was supposed to start. I met with my gynecologist, who confirmed the plan for the day and gave me a chance to ask questions. Then the nurse for the anesthesiologist checked my blood pressure and pulse, confirmed that I'd been fasting for the past 6 hours, and had me pee in a cup. (Surprise, surprise: I am not pregnant.)
Next, the nurse had me undress from the waist down, after which she went over what-all would be going into my IV. In addition to the anesthesia (administered later in the procedure room), there was a steroid, an NSAID, and an anti-nausea medication. The nurse double-checked my health history and explained possible side effects of the twilight sedation (I may or may not by conscious or with-it during the procedure; I may or may not experience amnesia afterward; I may or may not feel lightheaded or nauseated for the several hours afterward). We went through my medical history to make sure I had no issues that might make twilight sedation skeevy; then the anesthesiologist came in, double-confirmed all that, and gave me a chance to ask questions.
Finally, the nurse administered the non-sedating stuff into my IV, and we headed off to the procedure room.
The patient table for hysteroscopic stuffs looks largely like a standard gyno table in the US. Except where there would normally be stirrups, there are sort of plastic leg braces to support the patients' lower legs and to keep them from falling in or out while the patient is not-so-conscious. I couldn't see the whole hysteroscope, but I did see the wand (thin and long, closer to a long chopstick or a short TV/radio antenna than a vibrator) and the screen (a fairly large LCD computer-type screen). The screen was turned to give the doctor the correct viewing angle, so while I could see it when sitting up, I couldn't while lying down. I won't lie: I'm a teeny bit bummed about that, but I understand that it's way more important that the doctor be able to see in order to safely and accurately place coils of metal into my insides than it is for me to have a good spectator view of the same.
Once I was settled on the table, my gynecologist came in and once again and confirmed that we were ready to start. I said yes, and the anesthesiologist started up with the sedation.
This is where things start to get fuzzy. ;)
I was actually conscious through the whole procedure, but it was like... really drunk conscious. There were a bunch of people in the room -- the gynecologist, the anesthesiologist, a nurse, a technician, and another doctor who was observing the procedure -- and so while I could see and hear what was going on, it was hard for me to follow and process individual voices. If just one person was talking, it was fine, but if there were separate conversations going on, my sedated brain got a little confuzzled. As a result, I can clearly remember bits and pieces of what was said, but not everything. I do know that everyone's voices stayed calm and pleasant, though, so I never did have a reason to become super aware.
Pain-wise, it was really pretty similar to my IUD insertions. The IUD pain was maybe actually a bit more intense, but the Essure procedure lasted longer. But it was the same sorts of low pelvic cramping and then subsiding -- and I definitely felt 3 distinct cramps. My guess is that the first one, which was lower and centered and the most similar to IUD insertion, was the scope going into my cervix. The other two happened one on each side and a little higher in my pelvis, so I'd guess this is when the coils were actually being placed into my fallopian tubes.
I also remember my gynecologist saying, "Well, that was easy," and someone else saying that the septum (in my uterus) was not an issue. After that, most of the medical folks packed up and cleared out. The anesthesiologist stayed with me while I was coming out of sedation.
And I have to say, the sedation was by far the worst part for me. I felt lightheaded and dizzy, and it took me a little while (I could not say how long, on account of feeling woozy) to feel:
- like I could sit up.
- like I could get up and walk to the recovery room.
That said, when I did feel like I could get up, I did it independently. I did need someone to keep me from getting tangled in my IV, but I didn't lurch or stagger or need someone to help balance me between the procedure room and the recovery room.
The recovery room had an awesome easy chair. I hung out there for a little while, on top of a sheet (I was bleeding a little) and with a blanket on top of me (air conditioning + largely naked me = COLD!). A GYN nurse brought me a cup of water. (Fasting in the desert = dry Tori.)
Again, there was a certain chunk of time where: a) my sense of time was a little fucked, and b) sitting still was all I really wanted to do. That passed relatively quickly, though, with me feeling... maybe not 100% but no more out of it than if I'd taken my allergy medication.
By the time the nurse came back to check on me, I was ready to get dressed. After she removed my IV, I proceeded to do that, then waited for the gynecologist to come back in. While I was waiting, I snuck a peek at my chart and texted my partner, who was in the waiting room. For anyone who's curious about the time line:
- 11:52am -- I entered the procedure room.
- 11:55am -- Anesthesiologist began administering twilight sedation.
- 12:00pm -- Gynecologist began Essure
- 12:12pm -- Essure complete.
- 12:15pm -- Sedation fully stopped.
- 12:20pm -- I moved from the procedure room to the recovery room.
When my gynecologist came back in, she confirmed that the procedure had been successful and that both inserts had been placed very easily. Additionally -- the uterine septum about which my previous doc had made such a big deal? She did not think it was an issue. I am almost certainly a candidate for ThermaChoice without excision and may even be a candidate for in-office NovaSure, though we need to wait 3 months for my HSG before deciding any of that.
Finally, the doctor gave me emergency numbers to call (one for anesthesia-related issues, one for gynecological issues) if I needed them, a prescription for pain relievers, and a prescription for birth control pills. I thanked everyone profusely on my way out, any my boyfriend and I went to lunch.
I'm taking it easy this afternoon, and I definitely Would. Not. have enjoyed needing to resume my regular work and activities that same day. But honestly? If push came to shove, I probably could have done it. I'm still not 100%, but I've been operating at about 95% from 1:30pm on. I drove home from lunch and drove to pick up my prescriptions, and I've been managing my pain very well with OTC doses of naproxen and regular strength Tylenol. I mean, I wanted to have the prescription meds around just in case (and can't guarantee that I won't need them in the night or the morning), but I've not yet really wanted to use them.
And though I'm sticking to my decision to skip my Friday night vinyasa yoga class, if I had gone, I probably would have been just fine. It wouldn't have been the night to practice very vigorously or really push my edge, but exercise that's within my range of "moderate" would likely have been safe.
I'm also still spotting a little, which is pretty normal. It's very thin, so I'm guessing it's mostly discharge or other fluid with a little blood mixed in. A thin cloth pad is handling it just fine, and something pantyliner-sized would likely work if mine weren't in the wash.
My biggest concern now is to whether to start taking HBC again or continue with FAM. One is way easier and statistically more effective; the other is more happy-making for my body.
That, and I believe we have been discussing the possibility of pizza for dinner....