Broken, probably embedded IUD
January 5, 2024 11:48 AM Subscribe
Please give me an idea what to expect, advise on any questions I should ask, or things I should do, while awaiting follow-up medical appointments. Don't refrain from horror stories, but please frame them kindly, as this has really triggered my anxiety. Which is also why I'm avoiding Dr. Google.
The now:
I'm a late-40s female who delivered 4 children in my early 20s and has had Mirena, and then most recently, a copper IUD. It was slightly past time for it to be removed.
Attempted copper IUD removal at the doctor's office earlier this week partially failed. (It broke/was broken and one arm of the T was retained.) I'm scheduled for ultrasound in a week and pre-surgery consult later this month.
I'm flipping between this-is-no-big-deal and terrified, and I always do better anxiety-wise when I have good info about what to expect.
Pretty please help me retain my sanity?
The backstory:
This follows an episode in November where, during menstruation (which seemed to last longer than normal), I experienced extreme pain. Excruciating, very difficult to even move around, my entire abdomen felt tender and bloated-ish, basically everything between my armpits and my hip joints HURT. Any pressure or movement (or even my normal deeper breaths) increased the pain.
It occurred over a long holiday weekend, and I didn't think I could bear the ER for hours in awful chairs, just to have them be dismissive and assume I'm narcotic-seeking. (That's the default in this metro's hospital ERs, which always irritates me because I 1) have a high pain tolerance as it is, 2) do NOT like being not 100% in control of myself, and so 3) have a lengthy history of refusing pain meds even when offered.)
By the Monday when I could have called my regular doctor, and knowing that an appointment would be at least 2-3 days out, I could tell that the pain was easing up very slightly, and I had hopes that it was tied to menstruation (though did not at all feel like cramping). So I didn't call then, because if the pain was gone or mostly gone by the time I was seen in the office, I'd likely get a dismissive reaction from my older male GP. (I'm trying to change - this is who I was stuck with when my previous doc left - but it takes months to get in as a new patient.)
The pain did (slowly) reduce, and went back to the usually mild abdominal tenderness that I'd previously had... which I realized I'd been ignoring longer than I meant to, and it had likely been over a year since it began.
Yes, it had been mentioned to the GP, but as I said, he's not doing a great job listening to me. I was also not in the mood to be told that this, too, was probably psychosomatic. (Thankfully, specialists I was referred to prior to ending up with him as my GP are much better.)
I was able to make an appointment a few weeks out with the women's clinic - that's where the IUD removal was done this week. I'm much more confident that I'm in good hands on this issue than I would have been with my GP.
December did not have a repeat of the severe pain. There's been some increase in tenderness/pain since the removal, but it's still ignorable for the most part. I don't know what to anticipate for this month's cycle, but I'm worried, and that adds to my anxiety about the next couple of weeks.
The now:
I'm a late-40s female who delivered 4 children in my early 20s and has had Mirena, and then most recently, a copper IUD. It was slightly past time for it to be removed.
Attempted copper IUD removal at the doctor's office earlier this week partially failed. (It broke/was broken and one arm of the T was retained.) I'm scheduled for ultrasound in a week and pre-surgery consult later this month.
I'm flipping between this-is-no-big-deal and terrified, and I always do better anxiety-wise when I have good info about what to expect.
Pretty please help me retain my sanity?
The backstory:
This follows an episode in November where, during menstruation (which seemed to last longer than normal), I experienced extreme pain. Excruciating, very difficult to even move around, my entire abdomen felt tender and bloated-ish, basically everything between my armpits and my hip joints HURT. Any pressure or movement (or even my normal deeper breaths) increased the pain.
It occurred over a long holiday weekend, and I didn't think I could bear the ER for hours in awful chairs, just to have them be dismissive and assume I'm narcotic-seeking. (That's the default in this metro's hospital ERs, which always irritates me because I 1) have a high pain tolerance as it is, 2) do NOT like being not 100% in control of myself, and so 3) have a lengthy history of refusing pain meds even when offered.)
By the Monday when I could have called my regular doctor, and knowing that an appointment would be at least 2-3 days out, I could tell that the pain was easing up very slightly, and I had hopes that it was tied to menstruation (though did not at all feel like cramping). So I didn't call then, because if the pain was gone or mostly gone by the time I was seen in the office, I'd likely get a dismissive reaction from my older male GP. (I'm trying to change - this is who I was stuck with when my previous doc left - but it takes months to get in as a new patient.)
The pain did (slowly) reduce, and went back to the usually mild abdominal tenderness that I'd previously had... which I realized I'd been ignoring longer than I meant to, and it had likely been over a year since it began.
Yes, it had been mentioned to the GP, but as I said, he's not doing a great job listening to me. I was also not in the mood to be told that this, too, was probably psychosomatic. (Thankfully, specialists I was referred to prior to ending up with him as my GP are much better.)
I was able to make an appointment a few weeks out with the women's clinic - that's where the IUD removal was done this week. I'm much more confident that I'm in good hands on this issue than I would have been with my GP.
December did not have a repeat of the severe pain. There's been some increase in tenderness/pain since the removal, but it's still ignorable for the most part. I don't know what to anticipate for this month's cycle, but I'm worried, and that adds to my anxiety about the next couple of weeks.
I should probably make it clear that the cancer thing and the IUD thing were completely, entirely, definitely unrelated. It was a coincidence that they happened at the same time.
posted by mumimor at 1:58 PM on January 5 [2 favorites]
posted by mumimor at 1:58 PM on January 5 [2 favorites]
The strings for my mirena went walkabout and after both my PCP and a gyn couldn't do a normal removal I had to have it replaced under anesthesia. I went in to the hospital super early, chatted with my gyn and the anesthesiologist, they put me under, did the replacement and I was home in time for a late breakfast. There was nothing to recover from other than the anesthesia, no sutures, no pain of any kind. Your situation may vary since you already have had severe pain possibly related to the IUD, but the surgical removal itself shouldn't be a big deal.
posted by fancypants at 3:27 PM on January 5 [2 favorites]
posted by fancypants at 3:27 PM on January 5 [2 favorites]
I think a challenge of getting feedback is that most online forums* about IUD challenges are almost exclusively horror stories. I know they certainly scared me back in the day!! It's important that people scare their truth, however scary and awful, but it's also important to remember that most IUD issues are resolved without any major lasting side effects. After all, if that were the case, the devices would be recalled and/or banned like the Dalkon Shield was. I'm so sorry that this has become so complicated and scary -- I would be panicking too!! -- and I hope everything gets resolved quickly and safely.
*I am not referring to Metafilter but rather other forums where many people share their IUD stories. (Oh, so many of us have done that late-night panic-googling!!)
posted by smorgasbord at 3:44 PM on January 5
*I am not referring to Metafilter but rather other forums where many people share their IUD stories. (Oh, so many of us have done that late-night panic-googling!!)
posted by smorgasbord at 3:44 PM on January 5
Should you wish for it to be replaced, ask if it can be done in same procedure (probably yes) and ask about new understanding of replacement timelines (which have extended quite a bit - make sure they are looking at most recent guidelines).
Are you traveling at all? This is totally anecdotal but enough so that I’ve done some Dr Googling and it seems like a thing? With my IUD when I got on a longer flight or sometimes really long drive, I have unusual breakthrough bleeding and soreness. YMMV if things are in a new place for you.
I had a replacement awhile back - the first NP I saw was basically like “huh I can’t find your cervix or IUD” which gave me two weeks of extreme anxiety. I went to get ultrasound and the doc was like, wow, no, this is so not an issue and I’m sorry you were stressed. It was fine. I have a cervix in the right location and the IUD was just more out of reach than expected. I wish I’d asked questions like “so what does that mean, and “can you generally…find a cervix.”
Call and ask about pain or anxiety relief options even if you don’t want to pursue. Easier to assess before than in moment.
posted by xaire at 5:49 PM on January 5 [3 favorites]
Are you traveling at all? This is totally anecdotal but enough so that I’ve done some Dr Googling and it seems like a thing? With my IUD when I got on a longer flight or sometimes really long drive, I have unusual breakthrough bleeding and soreness. YMMV if things are in a new place for you.
I had a replacement awhile back - the first NP I saw was basically like “huh I can’t find your cervix or IUD” which gave me two weeks of extreme anxiety. I went to get ultrasound and the doc was like, wow, no, this is so not an issue and I’m sorry you were stressed. It was fine. I have a cervix in the right location and the IUD was just more out of reach than expected. I wish I’d asked questions like “so what does that mean, and “can you generally…find a cervix.”
Call and ask about pain or anxiety relief options even if you don’t want to pursue. Easier to assess before than in moment.
posted by xaire at 5:49 PM on January 5 [3 favorites]
My copper IUD broke at some point, and was found hanging out of my cervix when my OBGYN was doing a procedure for an abnormal pap. She pulled it out and saw that one arm was not there. I had an ultrasound and they saw it in my cervix. I was going to get it removed in the office but as the date neared I just didn't want to do it in office, and my OBGYN set up day surgery to have it removed and a new one placed. I was put under, and it was amazing. I highly recommend that instead of the office procedure which is done with no pain medication. From the time when the IUD was found to be broken, to the procedure where it was removed, was a 3 month period and I had no issues what so evere.
posted by momochan at 7:54 PM on January 6
posted by momochan at 7:54 PM on January 6
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Like you, I went to my general practitioner, and as in your case, the procedure wasn't completed correctly. I was sent to the hospital, and this is where the horror comes in: the OG specialist took out a sharp tool without consulting me, and scraped the endometrium without any warning and obviously without any form of sedation or pain relief. They could probably hear me scream 7 floors down on the parking lot.
However, this was malpractice. It won't happen to you, because that is one of the few advantages of the US system: they are scared of lawsuits. Heck, my hospital was scared, they invited me back for a follow-up thing, where the OG director examined me and reassured me that I would never see that crazy doctor again, while fishing to hear if I was going to sue. I didn't. In the end it worked out just fine and it was less than five minutes of intense pain. It turned out the doctor who did the procedure was from Poland, where they have a weird approach to women's health, a bit like the US religious right.
Soon after, I had my ovaries removed because of a cancer risk, so I haven't had to think of alternative methods of contraception. If this is a concern for you, you should probably turn to family planning experts. They know better.
posted by mumimor at 12:42 PM on January 5 [4 favorites]