Anyway, this afternoon, I had both my hysterosalpingogram (HSG) to confirm that this summer's Essure sterilization had worked and my Thermachoice endometrial ablation to zap the sacrificial goat that apparently lives in my pelvis.
Per my doctors' instructions, I took 800mg of ibuprofen and 10mg of Valium before the procedures. The Valium was more to make sure my uterus stayed still during the HSG imaging, less for anxiety reduction or sedation. I went back, feeling kind of sleepy but not totally out of it, and met with my doctor briefly to confirm why I was here and that I was not pregnant.
(Spoiler alert: I will never fear the ubiquitous pee-on-a-stick test again.)
I then changed into the fun times hospital gowns. We went into the X-ray room, where the doctor who oversaw the HSG introduced himself to me. (He's not my regular gyno. He's a fertility specialist who often works with my regular gyno, and he performs HSGs on a pretty regular basis.) He also confirmed that I was there for an Essure confirmation test -- where "blocked tubes" = "good thing."
He explained that there would be a large speculum, some betadine, a small catheter that would be inserted partway into the cervix, and a small vial of X-ray blocking fluid that would go in. For comparison purposes, the catheter looked to have a diameter that was as narrow as or narrower than a Mirena insertion tube. I could be wrong on that, of course, but the catheter definitely didn't look particularly large or intimidating in the context of all the things that have gone up my cervix.
I climbed up on the X-ray table and was way excited that I'd be able to see the screen from where I was lying. (I like Uterus TV.) The speculum went in; so did the betadine, and so did the catheter. They showed me the image of my uterus and the Essure coils; the doc said the coils looked perfectly placed. Then they told me I needed to keep very still and slowly started filling my uterus with dye.
I will admit, the dye was not particularly comfortable. There was some warmth and some pressure, kind of like the dull ache I have in my uterus for the few days before and during my period. However -- maybe because it was liquid and not unfolding or moving around anything solid -- there was no sharp cramping. The actual procedure -- from insertion of dye to taking of X-ray pics -- lasted maybe only a couple of minutes, about as long as an easy IUD insertion.
I also got to see -- to my delight -- that the contrast dye did a dead stop at my Essure coils. There is basically no way for sperm to get into my fallopian tubes at all, and no way for an egg to make it through the coil and scar tissue to get to sperm on the other side. Good times.
They removed the catheter, I sat up, and all the liquid came running out of me. Which was a good thing, since it meant that I could proceed to the next room to get my ablation. (They didn't want to perform the ablation with a whole bunch of extra liquid hanging out in my uterus, and we weren't really sure beforehand how long it was going to take to come out. Spewing forth like a cervix geyser = all kinds of time saving efficiency.)
For the ablation, I re-met with my own gynecologist and also met a representative who apparently sells the newest incarnation of Thermachoice machines. The machine itself looks like a cross between an IUD insertion tube (only with a balloon on the end), a transvaginal ultrasound and want, and -- in my mind at least -- the world's most awesome bubble wand.
Even though the balloon at the end is pretty very thin and so the whole "bulb" at the end is actually quite small, insertion was still uncomfortable -- and was probably the most uncomfortable part of the whole procedure. There was a cramp that was pretty similar to IUD sounding or insertion while the catheter was going in, but the sharp cramping stopped once the catheter was in place and still. The balloon expanding with liquid felt a lot like the contrast fluid from the HSG. I did feel pressure and discomfort and warmth, but it was an "I have set a heating pad on my pelvis" kind of warmth and not an "I have applied hot flame directly to my body" kind of burning. There was a screen where the doctor monitored what was going on, but alas, I could not see it while lying down. (Since it's kind of there for her to make sure she doesn't jab me and stuff, I understand the reason for this, even if I am disappointed.)
The balloon was inside me for 8 minutes. They set a little timer to ding when I was done. (Like a cooked egg!) And they checked to see how I was doing and let me know when I was half done and when I had 2 minutes left. The balloon deflated; neither than nor removal hurt me at all.
I left with post-ablation instructions: I can expect some spotting, brownish discharge (from the betadine) over the next few days and that clear discharge would also be normal for the next few weeks, though not everyone experiences it for that long. I'm also supposed to abstain from anything-in-vagina sex for 7 days or until my spotting/brown gunk stops, whichever is later. And my first post-ablation period may still be heavy: that doesn't mean the procedure hasn't worked. (It means my uterus may still be in WTF? mode.) Probably by the 3 month mark, my periods will have settled into where they are going to be, though it may take up to 6 months.
My total in-office time for both procedures was something like 35 minutes.
At home, I do have some runny bleeding (I suspect a lot of clear serum with a little actual blood). I'm kind of crampy, and my back hurts. But as I'm at the tail end of my period, it's really hard for me to discern whether those symptoms are from the ablation or whether it's just my natural sacrificial goat kicking and thrashing its horns. Either way, it's not even something that registers as "bad" on my scale of pelvic pain.
TL;DR -- Essure confirmation successful. That + ablation short, discomfort manageable.