Update on the IUD! Anything else to expect?

[Callisto]

All of you ladies here on FHH were so helpful a few months ago when I was considering getting an IUD. Thank you so much for all your kind words. (For those interested in GREAT IUD advice see here.

Well I went and got it today! Also I caved and got Mirena, I know its still some hormones but my dr. has had both and recommended mirena over paragard due to the worsened periods with paragard. As someone who''s never had a child it was definitely a painful experience having something put through your cervix, but it''s manageable, all things considered. For me the pain was compounded by the fact that the misoprostil gave me really bad diarrhea (sorry if thats TMI) all morning, so dealing with the terrible cramping and that was not a pleasant combination. SO was not able to come with me so I did drive myself home, but I''m glad I live very close to the dr. office because I was definitely a bit out of it due to the cramps. I had really bad cramping for about an hour and a half and actually feel pretty good right now, just a little sore. I know some of you mentioned that you had reoccurring cramps for the first few days, I really hope mine don''t come back as bad as they were...

I have a follow up in 2 weeks to get an ultrasound and was told to use alternate birth control until then when we know its in the right place. I really really hate condoms so we might just got without sex until then (SO doesn''t know this yet though hahaha, he''s totally supportive and understanding though, I''m sure it will be fine.)

I was a bit annoyed with how expensive this is all going to be at the end though. My insurance is good but not great and final break down of costs is:

$30 consult
$153 lab fees(mandatory STD testing before insertion) that my insurance isn''t covering at the moment which I''m going to try to argue because that''s ridiculous if they were mandatory. If they cover the procedure they need to cover the tests associated with it.
$116 for the procedure
$8 for the misoprostil
$30 for check up appointment (plus if there are any uncovered fees with that... ugh I hope not)
For a grand total of $337

I know its still cheaper than pills after about 6 months but it is definitely a hit to my wallet at the moment.

Once again thanks for all your help in my last thread. Any other words of advice for the first few days of having it?

 

[RaiKai]

Exciting!

I have a Flexi-T (the Canadian-approved copper IUD) and love it. I have had it over 4 years now, and will have to replace it in about a year. After years of hormonal birth control...I would never go back. My periods are a bit heavier (particularly compared to the "periods" I had on the pill) but no big deal honestly. My total cost was only $70 (for the IUD itself) as I am in Canada.

My insertion hurt too (no kids here either). The doctor kept telling me I had the most stubborn cervix she had ever seen. Took a good half hour to get that sucker in! Had some cramping after but went to the gym that night and was running again the next morning. First period had me with a few more cramps than normal but I don't suffer from cramps really so it was a short-term deal - I really don't have any cramps at all during my period. I don't look forward to getting it redone!

Just make sure you learn how to check for the strings. The first while you should check fairly often. After that, just every month after your period as sometimes they get expelled during your period. It was a bit tricky for me at first to find them but now I can easily find them (well - one of them most of the time, sometimes one of them tucks back up into my cervix for some reason).

Don't use tampons for a bit either. And you won't be able to use things like the "Keeper" as there is a risk of it catching the strings and pulling on the IUD.

Oh, and um, this may be TMI but depending on the time of the month and how low my cervix is at that time I can "feel" it a bit at times during intimate moments - like a little sharp twinge. Before the strings soften up (or if they are cut too short and are poking out of the cervix) they can poke your SO a bit too during those moments. Other than that, it is totally unnoticeable. I really forget I have it most of the time.

Good luck - I hope it works well for you!

 

[Keepingthefaith21]

I just got my Mirena removed and reading your post makes me miss it sooo much (but it''s kinda hard to TTC with one in so I kinda had to remove it

).

My first few days were a little strange - I had spotting and cramping both gradually decreasing. It took me a bit of time to adjust to the fact that the first few months I didn''t "know" when AF was going to come for a visit. On pills, I could at least tell when I was on to the week of "fake" pills and could anticipate AF popping up within a day or two of starting the "fake" week. Same with the ring, once it was out, I knew AF would arrive in about 24/48 hours.

With Mirena, the first few months were a little iffy for me. I also had cramping a good week before I would have AF which took some adjusting to for sure (the cramps coming early never went away). As for AF herself, she was oh so nice to me with Mirena - most months I only spotted for about a day or two which was great! For me personally, the way my cramps felt changed dramatically with Mirena. They felt a lot like the cramps I experienced when it was first put in place but again, they lasted maybe a day or two at most and were gone.

Like any change, it takes a bit of time for you to adjust to new signals your body puts out. Once you adjust, it''s great and I can not wait until I can get another one put back in!

 

[sillyberry]

OMG getting the Mirena was AWFUL for me...which happened a year ago yesterday, come to think about it. After I had a pulmonary embolism they took me off regular BC. The doctor did not do a very good job explaining the pain beforehand, didn''t recommend taking pain killers beforehand, didn''t do the softening thing...and it was excruciating. Plus I couldn''t take standard pain medications because I was on blood thinners! Overall a terrible time.

As an FYI, and not to scare you, but I had cramps for over 6 weeks. I really and truly thought that I would have to have it taken out it was so miserable. My poor boyfriend didn''t know what to do with me curled up in a ball crying. But then it just stopped one day and has been fine ever since. I now barely get a period - just a day or two of light spotting. I do get cramps now pre-period even though I never did before.

 

[PilsnPinkysMom]

Congrats, Callisto, on starting your journey with a great BC option!

Every woman is a bit different, but I would expect continued spotting (sometimes quite period-like) and random cramping for the next 30-180 days. It can become frustrating, but stick with it- it gets better!

I had Mirena inserted without having been through labor/delivery of a child. After insertion, my cycle was random/unpredictable and I had almost non-stop spotting (albeit LIGHT, LIGHT spotting) for months. Quite annoying. But after 6 months, everything became more predictable. And now, 12+ months later, I have no bleeding at all. The cramps still show up every month, though.

It''s expensive, but even if you pay full price, it''s generally cheaper than 60 months of BC pills!

 

[PumpkinPie]

I''m glad you''re happy with your decision. I had an IUD for 1.5 years (the copper one) but had to have it taken out because it made me spot EVERY SINGLE DAY for those 18 months. I thought I was going to go completely mad!
But I would try it again because it''s such a simple and easy (and super effective) method of birth control!

 

[PumpkinPie]

I actually had to go in twice to have mine inserted because the dr. couldn''t get it through the first time. It was excruciating and only an enormous force of will got me through the door again a few days later!

 

[Callisto]

Oh my goodness, those of you with bad insertion experiences make me so thankful that mine went "smoothly" even though it still hurt like the bejezzes. She was done in about 2 minutes but it was the worst 2 minutes of my week (maybe month/year haha) I feel pretty sore but really haven''t had any major cramps since the first couple of hours after insertion. When I get cramps like that it makes me nauseous from the pain so not something I want again. We''ll see how I feel tomorrow. It''s SO''s bday tomorrow so I have to put on a happy face no matter how I feel haha. I''m moving a bit slower than usual at the moment but even if I don''t feel any better tomorrow than I do now I''d still be fine.

One of the weirdest things about this whole procedure is not really telling anyone about it. I have NO problem sharing my procedure, but people don''t tend to enjoy talking about your birth control options... my roommate and FMIL asked why I was home for the afternoon and I just said that I had worked 40 hours for the week so was able to leave a little early (which was actually true but not the whole story). I feel silly semi-lying about it, but I don''t want to make people uncomfortable by telling them the truth.

 

[ladypirate]

Man, that''s expensive! I got it done at Planned Parenthood and it was way less expensive, but they didn''t do an ultrasound or anything fancy like that. I''ve had it for over 2 years now and I love it!

 

[Iowa Lizzy]

I have the Paraguard because I really wanted to be done completely with hormones. Well, I looked at my little "period tracker" app on my iPhone and realized that I will be getting my period the day before our wedding and it will last into the honeymoon. Okay, I can handle the bleeding portion of a period. I just shove a tampon up there and I''m good for about 5 hours. However, the acne, cramps, bloating and general bitchiness were NOT going to be okay for the big day. So as of Tuesday, I''m back on the pill. This way I can just skip the period I''d get around the wedding. I''ll get back off the pill as soon as we''re back from the honeymoon. I''m pretty excited to go back to pill periods for a couple months!

My cramps are still pretty awful with the IUD (just during my period and a little bit during ovulation). This was the first month I didn''t have to use a heating pad to control the pain so that''s good news! My periods are heavier and longer but they''re getting better each month.

FI just commented last night at dinner that I''m a much nicer person since I got off the pill. Well, basically, I said "I think I''m much less of a bitch since I stopped taking the pill" and he said "Yes. Yes you are....... Thank God."

 

[mayachel]

Wow Callisto, thank you so much for reporting back on your experience with it. There's nothing like individual stories to get a well rounded picture. Your doctor is right that people do tend to get much more cramping with paraguard then Mirena. As you likely already know, the hormones in Mirena ARE much less than what you would need to take if you were using an oral contraceptive.

Also, as an FYI but not a dissuasion, it is overboard and uncommon for them to have you do an ultrasound post procedure. As someone who is trained to put in IUDs- the standard protocol is to come back for "an IUD check" which means a pelvic exam with a speculum to make sure that we still see (with our eyes) the strings coming out of the cervix. The only reason for an ultrasound would be if the strings were not visible and the woman was certain she had not passed it in the toilet. (You must have some awesome health insurance if they are willing to pay for an ultrasound follow up!)

PS: In your break down of costs you didn't mention the device itself. Was it 100% covered by insurance? The company just raised the price. They now cost $700 for the device alone.

ETA-YES PLEASE argue with your insurance company about the STD testing. Your doctor was correct that it is MANDATORY to have them done prior to insertion. That was not just an "extra cautious choice".

 

[Callisto]

Date: 5/1/2010 6:13:55 PM
Author: mayachel
Wow Callisto, thank you so much for reporting back on your experience with it. There''s nothing like individual stories to get a well rounded picture. Your doctor is right that people do tend to get much more cramping with paraguard then Mirena. As you likely already know, the hormones in Mirena ARE much less than what you would need to take if you were using an oral contraceptive.


Also, as an FYI but not a dissuasion, it is overboard and uncommon for them to have you do an ultrasound post procedure. As someone who is trained to put in IUDs- the standard protocol is to come back for ''an IUD check'' which means a pelvic exam with a speculum to make sure that we still see (with our eyes) the strings coming out of the cervix. The only reason for an ultrasound would be if the strings were not visible and the woman was certain she had not passed it in the toilet. (You must have some awesome health insurance if they are willing to pay for an ultrasound follow up!)


PS: In your break down of costs you didn''t mention the device itself. Was it 100% covered by insurance? The company just raised the price. They now cost $700 for the device alone.


ETA-YES PLEASE argue with your insurance company about the STD testing. Your doctor was correct that it is MANDATORY to have them done prior to insertion. That was not just an ''extra cautious choice''.

Thanks for the thoughts. I''m gonna have them call my insurance and make sure they''ll cover the ultrasound before she does it... I really can''t afford another non-covered expense. Especially if you say its a bit overboard, I''ll ask them not to do it if it''s not covered.

The $116 was the device & insertion, I believe. My insurance is kinda weird and the way they do things is they''ll cover 80% of the costs of things up to $1000 out of pocket costs and then they''ll cover 100% of costs.

I''ll be sure to try to appeal the insurance ruling of not covering those tests. I was pretty annoyed to get that in the mail. Since you''re in the healthcare industry, who do you recommend I talk to? The test was sent to a clinical diagnostic lab so I will get a bill from them rather than my gyno. My mom recommended asking the gyno office to talk to insurance since they ordered the test, but I''m worried they won''t be as motivated to help me since they aren''t the ones out the money if I don''t pay for it. Thoughts?

 

[Clio]

When I got my Mirena, the insertion was not so fun. They had to bring out "the dilator."

This despite the fact that I''ve given birth not one but three times.

I had a little cramping that day and the next, but nothing bad. It was really more that I was aware of it rather than real pain (but I don''t have cramps much in general). I bled for 2 months afterward, but since that point it''s been pretty nice. I''ve had some spotting and one long but light period, but all of that is a million, billion times better than the almost constant, heavy bleeding I had before the Mirena.

My insurance covered everything, with just a $30 copay for the testing and then another $30 copay for the insertion. I did have to order the device myself and have it sent to my doctor''s office, then get reimbursed by my insurance - that''s just the way my doctor does it. My insurance company covered the entire cost, and the check came quickly (I was surprised!).

 

[princesss]

Mine was uncomfortable for about a month (be gentle over speedbumps - they were the worst!), and my first period suuuuuuuucked (it lasted forever, the cramps were miserable, and I was going through tampons about every 2-3 hours, followed by 2 weeks of a light flow), but since then I haven''t noticied it at all. I''ve had it for over a year, and that was the last period I had (though I didn''t get them much to start with - maybe once a year?).

Just be gentle with yourself, and when you do start enjoying time with your honey, remember that rough & tumble isn''t the way to go at first! Ease into it...

 

[MichelleCarmen]

Be sure to carefully track your cycle. I''m one who didn''t do so and had the paraguard in for a few years. At one point I realized it had been A LONG time since my last period and I went and bought a preg. test and it came back positive! I went right into Planned Parenthood the same day and guess what? The IUD was STILL IN PLACE and I was pregnant. The nurse practitioner said that was very unusual 1 out of 500 or 1 out of 1000! Eh. I had already had my two boys. They tracked my hormones and the numbers were going down and I was miscarrying. My husband got snipped after that.

 

[Callisto]

Clio, princess, and MC - thanks for sharing your experiences.

About once or twice a day I''m still getting mild cramps, but nothing debilitating by any means, and really light bleeding which could easily even be the final days of my period so overall I''m feeling pretty good.

Anyone in healthcare have any advice on the issue noted in my last post (about who to have talk to the insurance company)? I''d really appreciate any advice. Thanks!

 

[MustangGal]

I''ve had the Mirena for a year now too. Insertion only felt like a normal pelvic exam, and I didn''t have any cramping or pain, but it also was 10 weeks after having a baby. I spotted for 3 weeks straight, and then AF has shown up every month since then. Although now I''m getting much less bleeding, this month could almost be called spotting.

As for the costs, I didn''t have an ultrasound either, just a follow-up appointment a month later where they basically just checked the string. My total cost was $50, my normal $25 co-pay for the two appointments. I would also think the STD screening should be covered, they should cover those tests anyway I would think.

 

[Callisto]

Date: 5/3/2010 5:23:21 PM
Author: MustangGal
I would also think the STD screening should be covered, they should cover those tests anyway I would think.

Agreed! Why wouldn''t an insurance company want you to be able to get tested (at least once in a while) when they could treat the potential STD way easier than letting it progress to a worse state (or other coworkers on the same plan eek!) and be more expensive to treat. Ugh insurance companies boggle my mind.

 

[mayachel]

Hi Calisto- sorry for the delay in responding. The first thing you should do is call your claims department, make sure you are speaking to someone who can potentially help you. They will likely put you on hold for awhile. Tell them that these tests are required for the procedure and you don''t understand why they weren''t covered.

Persist in asking them what documentation you will need to submit for reimbursement. If you are lucky, it may just mean some paper pushing of getting a note from your doctor stating "medically necessary".

It is not uncommon for insurance companies to reject and tell you, you can appeal. Keep doing it, eventually they''ll reimburse you *fingers crossed*.

 

[Callisto]

Thanks! I''ll try calling the insurance company sometime this week. I also called the ob/gyn last week and asked them to look into my benefits to make sure that ultrasound would be covered before I go in next week, cause I really don''t want to pay that out of pocket, I can''t imagine it''s cheap.

 

[Callisto]

Not to drag up this thread, but mayachel- I wanted to let you know that I called the insurance company and the issue was so much easier than I expected. It wasn''t a benefits issue at all! The testing company had somehow gotten the wrong ID number for me and so they were billing the wrong insurance account no wonder they wouldn''t pay for it! I''m really not sure how that all happened and no one noticed but either way I talked to the testing company and gave them my correct info and they are going to resubmit it and it will hopefully all be covered (or at least the stupid 80/20 rule for my plan). So way easier than I expected. I was all ready to pull out the big guns about how ridiculous it was that they wouldn''t cover mandatory tests and it was all in vain haha. Thanks for the help!