Wednesday, July 11, 2007

God DAMN I Love it When My Healthcare Provider Doesn't Suck!

This is another TMI IUD post. I write about my experiences with the IUD here because it's been really difficult for me to find fuck-all first-hand information about it, and I figure I'm doing a public service to other women interested in the option, though my results may no longer be typical since the whole diabetes thing.

That said, I do realize that I am, increasingly, actually meeting and interacting with the people who read this blog, and if you're not terribly down with knowing all about my plumbing and health issues and then conversing merrily with me in person, I do advise you to skip these posts.

So, disclaimer done.


____________________________________

The PP in downtown Dayton is open from noon to 7pm, which means I got to head in right after work.

I love PP. Have I told everyone how much I love PP? It's why I'm still going there at 27. OK, and because I'm poor. But goddamn, they treat me like a fucking human being there, and they know what the fuck they're doing and they do it for $89.

After a short wait, the gyno and I sat down and discussed my contraceptive and general medical history.

I explained that I'd moved to the IUD because I had a seriously bad reaction to hormonal forms of birth control. I had severe depression (of the "I can barely force myself out of bed" type) and serious weight gain (50-70 lbs. Seriously).

"If it has to come out," I said, "it has to come out, but if that's so then I really need to discuss other forms of birth control, because diaphragms and other barrier methods don't work well for women in my family either."

"Believe it or not," she said, "IUDs are actually great forms of birth control for diabetics. There aren't any hormones involved, so you don't have to deal with controlling your sugar in response to insulin resistence, and I know you're concerned about infections, but there generally isn't too much more problem with diabetics and infection with IUDs than non-diabetics. We're just more likely to give you antibiotics at the first sign or suspicion of something."

I explained that the pain was primarily on the left side, always had been, and that though Sat and Sun were bloody awful, I was actually feeling a lot better yesterday and today.

"One side?" she said. "A dull ache?"

"Yes," I said.

"Persistent?"

"Yes."

She peered up at me. "You have facial hair?"

I knew then that I'd seriously done my homework, because I was prepared for this question. I knew exactly what she was thinking.

"Yes," I said.

Nair has been my best friend since puberty.

"And you put on weight easily?"

Is that a serious question? "It's been scary how fast I've gained weight since I got out of the hospital. I've always put on weight easily."

"Ovarian cysts," she said.

"That's totally what I was thinking, too!" I said.

I think I actually sounded excited. When you've been in pain and somebody finally gives you something real to point to, it's really exciting.

"Nobody's ever tested you for them before?"

"No."

"Never?"

"It's never come up. If I ever had any pain, I'd just shrug it off as cramps. But before the IUD I didn't really have many cramps. Every once in a while I'd have a morning of pretty bad pain, but only a couple times a year."

Oh, hell.

"But how come it was so painful for a few does and now I feel better?" I asked.

"They sometimes burst, and there's pain for a few days, and then they heal up. I bet it's not the IUD at all. Let's have a look."

So she had a look and did a swab and did all the standard belly-pressing as hard as she could.

"If it was the IUD, you'd have jumped right off the table when I pressed your belly like that," she said, "Or I would have felt it working its way out, but the string's in place, nice and high, and there's no tail end working its way out."

It wasn't the IUD. She was putting money on the cysts.

"You have a couple options," she said, "you could wait for it to bother you again and go in and have an ultrasound - it might not happen again - or you could just go in now and have an ultrasound. I'm thinking you might want the ultrasound just for peace of mind."

"If they find cysts, can they do anything?"

"Standard treatment is to put you on the pill or give you hormones - Depo or something like that, but since you've had such a rough time on them, it might be a matter of just taking some extra pain pills when you have an episode."

"I'll do the ultrasound," I said. "I want to know."

She went out to put the swab under the microscope and get me the referral forms for Miami Dade hospital.

When she came back, she said exactly what the PP gyno said to be back in November during my pap, "You know? You have a few too many white blood cells here for my comfort. I'm going to give you some antibiotics. It's our general cure all. When I get a diabetic in, I tend to err on the side of caution."

"Goddammit," I said. "Those people in the ER said I was fine." So I had, indeed, knocked something about during that MA class. But it wasn't the cause of all my pain.

But she was giving me some drugs! Yay!

So I walked out with what I wanted: antibiotics, and what I needed: a pretty likely answer to the startling pain on Sat and Sun that had gradually gotten worse over several days and has subsequently and just as gradually gotten better.

I'll be calling the hospital to set up the ultrasound for either next week or the week after - I need to doublecheck the date for when my crap insurance kicks in. I can get them to pay for at least half of it. The ultrasound, she warned me, may not find anything at all by that point - it's possible the cyst will have already burst and healed completely - but nothing would also mean absolute proof-positive that the IUD hasn't gnawed any holes in me, either.

I can't tell you how amazing it felt to actually get what I needed: to have somebody actually take the pain seriously and think it all through and talk it over with me. And, like the diabetes diagnosis, it links up a lot of other little annoying things with something bigger and makes them all make sense.

It was just what I needed.

We'll see how the ultrasound goes.

9 comments so far. What are your thoughts?

Jackie M. said...

Boy, it would be nice if you could keep the IUD, at least.

Though what's the facial hair got to do with it? Is this a PCOS thing?

Kameron Hurley said...

Is this a PCOS thing?

That's the chief suspect, yes. Going through the symptoms, it does fit. We'll see what the ultrasound says, tho.

Kameron Hurley said...

Of course, the big piece that doesn't fit there is that I have one of the most regular menstrual cycles of anyone I know. I can peg its start within three days.

So I'm thinking it's probably not full-blown PCOS, but again: we'll see.

Jackie M. said...

Yes, but PCOS seems to be related to blood sugar, right? And yours is regulated by force.

Sidenote: I have girlfriend who manages her PCOS with a strict vegan diet, of all things. I wouldn't think being vegan would help with blood sugar/insulin resistance...? But she's skinny as a rail, so what do I know.

Jackie M. said...

(Sorry, when you said "ovarian cysts" I was thinking of something more general. Ovarian cysts covers a lot, you know? And I'd forgotten what PCOS actually stood for.)

Kameron Hurley said...

There's a correlation between PCOS and *high blood sugar levels.* A low carb diet would help someone who was insulin resistant just as much as it'll help me.

Thing is, gawd knows how wacked out my sugar was the years before and during the time I got sick, and now that I'm sick, sure, my sugar levels don't always suck, but even people with great control only have "normal" range sugars about 20% of the time.

Jackie M. said...

Was your cycle irregular during the year before the ER sugar coma trip?

Kameron Hurley said...

No. The only time it was irregular was between the ages of 13-16, before I went on the Pill. I was on the pill from 16-19, and after that, it was pretty regular. Since I got the IUD, it's totally clockwork.

It's weird.

Steph Burgis said...

Oh, thank God for smart doctors who actually listen to what you say and are knowledgeable about the possibilities. And I love her quote about the ER, too. Good luck with the antibiotics and the ultrasound, and I'm so glad you've got someone good on your side.