It was day 7 of my period (still spotting just a little). I'm 31, nulliparous (never pregnant). I took 800mg of ibuprofen an hour before the procedure.
THe lovely doctor I'd seen in my consultation visit was assisted by a nurse. I took off my pants and lay on the table with a wedge pillow under my bum, and my feet flat on the table (unlike in America, in Australia stirrups aren't routinely used in reproductive health checks and procedures). A sheet was draped over me. The doctor did a pelvic exam to check the rientation of my uterus, and inserted a speculum.
Using pincers and cotton balls dipped in antiseptic, the doctor cleaned my vulva, including the labia minora. Then, to my surprise, she did the same thing inside my vagina and around my cervix - it was a strange feeling. I think the first thing she did was pull down on my cervix to measure my uterus. This didn't hurt, just felt strange. Then I was asked to cough hard, and injected with some sort of anaesthetic. This was a really good trick, I barely felt it. These two things may have occurred in reverse order, I can't quite remember.
There was a bit more pulling on my cervix, and this was the first pain I experienced - quite mild, maybe 3/10. Then all in about two minutes I felt the dilation - quite a bit more painful, 6/10 - and insertion - 7/10 - and then the IUD opening up inside me - 8/10. It was REALLY sore, like the worst cramps I'd ever had, for about a minute before it started to subside. She kept messing around in there with the speculum in for what seemed like an eternity but was probably only another 90 seconds. The whole time I had a lovely nurse hold my hand. I was saying 'ow' and moaning a lot, uncontrollably, during the dilation and insertion. I wasn't expecting it to hurt quite so much but it was still bearable.
Within about three minutes after it was all finished it had gone down to regular period cramp feeling (for me that's about a 4/10). I had a strange urge to cry and felt nauseous but not too bad. I got up after another few minutes, put on my pants (with a pad they supplied in my undies) and went into a little lounge area where they gave me a hot pack. THe cramps were getting worse, in my lower back as well as tummy. This is where it all got a bit weird.
I started to feel kind of dissociated from my body. I don't know how to describe it. Faint and nauseous, but in a weird way I'd not experienced before. The nurse was there checking my pulse every few minutes, bringing me candy and tea and water, and I just wanted her to go away and leave me alone. My pulse was around 40 bpm (60-65 is normal for me) for over an hour. I sort of lay down in the chair with my legs up on a stool and couldn't believe how quickly time was passing. The nausea, weird dreamy fainty feeling and general panicky unease continued the whole hour. I think I've only felt similar when accidentally really drunk to the point of vomiting. I was really freaked out, and the nurse was trying hard to hide her concern but clearly a bit worried. My mother came to pick me up and sat with me for a while and I started to perk up but I wasn't allowed to leave the clinic for 20 minutes after my pulse normalised.
This response was not typical, and is apparently due to me being very sensitive to having my cervix messed with. There's a nerve (vagas/vagal nerve) that runs from the cervix right up into the brain, and it causes some women to feel sick, faint, unwell, sad, angry, or any combination of the above. I always get squicked out with pap smears, I guess that's the same thing on a milder scale.
I took some paracetamol (tylenol) with 30mg of codeine about 20 mins post procedure, but even with that and the 800mg of ibuprofen I was in a lot of pain on the way home. I kept taking the codeine, paracetamol, and ibuprofen all night and used two heat packs (front and back). My appetite wasn't very strong. I was planning to go to work today but I'm in too much pain even with the medication. It's getting better though, and I expect I'll be OK tomorrow.
My biggest takeaway from this is that I wish I'd prepared myself better for a longer recovery time. Apparently for women who've been pregnant, even briefly, it's usually much easier.
I would do it again, but under sedation next time to cut down the horrible vasovagal reaction. The staff were amazing. I am really grateful to live in a society that provides universal healthcare (total cost: $140 for all three appointments and the IUD).
Question is this: doc told me no sex/tampons/etc for 72 hours, but the Mirena literature says 24. Which is correct? I'm not feeling anywhere near up to having sex yet but Friday is the last time I'll see my boyfriend for two weeks so I hope 48 hours will be ok!