Mirena insertion Tuesday, starting to get nervous...

[phirey]

Since I've never had a vaginal birth (2 scheduled c/s) how uncomfortable is it REALLY? I've actually done the insertion of bunches of these in patients myself, but I'm still chicken! Any BTDT mamas who got one after a C-section? I cannot tell you what a bad patient I am -- I'm one of those that nearly bends the speculum I'm so tight-kneed during a Pap! So tell it to me straight, Mirena moms, in case I need a driver to my appointment and some major Valium! :-D

[MarisaSF]

Peggy-
Good luck with it.
I have one and several of my patients have gotten them too. As you know, the experience totally depends on the patient... and the provider.

Well... is your cervix particularly senstive? (Seems like it, or is it just the speculum that bothers you?) My cervix apparently is not. I took 800mg ibuprofen, didn't get a block and I did not even feel the single-toothed tenaculum(!). Do you always use a tenac? I know it can be done without. The weirdest feeling to me was actually *in* the uterus, believe it or not. Zip-zap and it was done though!

Since you're sensitive, I'd opt for the valium. I had one ready to go just in case! :)

[kristenk]

I'm the person you want to talk to! LOL Let me back up a little to give you a bit of background. During pregnancy, I knew that my cervix would be checked and I didn't think it would be a big deal at all b/c routine exams weren't fun but they weren't a big deal. Fast forward to the first time that my cervix was checked and I was amazed at how incredibly uncomfortable (aka painful) it was.

So, I believe I was understandably concerned about the pain involved in inserting the Mirena after my c/s. I talked to the nurse and nurse practitioner about it before the insertion and they made me feel a lot more relaxed. The nurse practitioner who did it did an incredible job and it was soooooo much better than I thought it would be! Of course, it wasn't something that I'd go do for fun, but it wasn't bad at all and I really think that having my cervix checked during pregnancy was a whole lot more uncomfortable.

Make sure you keep breathing during the procedure and don't try to hold your breath b/c that'll just make you more tense. I don't think you'll need valium or a driver, though! I'm sure Tuesday's going to be fine!

[phirey]

No, I've always used an Allis clamp if i need better visualization, just since the patient's awake it seems less, well, brutal. Everyone in my practice always used Hurriacine spray, until one of the docs got one. She said the spray burns like heck before it turns numb, and that that was the worst part. So I stopped using the spray and did my best to avoid the Allis as well. When you force yourself to do without it, it's really not much harder.

What do you mean the feeling was *in* the uterus. Like wiggling? Tugging? It's the cervical dilation that has me freaked. Was you're discomfort after that part?

[tarahsolazy]

Peggy:

I have had two Mirenas, one when I was a nullip, and another after my c/s with DS. I only dilated to 4 during my failed induction (pre-e), I don't know if that makes a diff or not.

The first insertion required some dilation, which was crampy, but the second required none. I got a slight sympathetic? reaction to the Allis clamp both times, a slight facial flushing and feeling that something was not right. Lasted about 30 seconds. I hardly felt the insertion with the second insertion, and the flushing thing was shorter, too.

I had no block either time, my OB (who also has a Mirena) thinks the shots are more painful than the insertion.

After the first insertion, I got up off the table and did 16 hours overnight in the NICU without trouble. The second time I was nursing a five week old, so even more strenuous, and no trouble.

Good Luck!

[daniele_ut]

When I had my Mirena inserted back in June, my doc used Lidocaine and I didn't feel a thing. I've been surprised to hear that more docs don't use it. Is there a reason not to?

[MarisaSF]

>What do you mean the feeling was *in* the uterus. Like
>wiggling? Tugging? It's the cervical dilation that has me
>freaked. Was you're discomfort after that part?


I didn't want to comment on the dilation part because I didn't have a c/s, so thought I'd let others comment on that. I also apparently don't have a very sensitive cervix in general.

The feeling inside uterus was just very "weird" to me. Like a tickle. But that area doesn't ever get tickled, so it's just very "weird." Sorry, I can't explain it well because it was a first and didn't last very long.

Looks like you got great advice from others! Good luck on Tuesday!

[pritchettzoo]

My midwife did mine, and I don't think she used any numbing anything. I had a pap at the same time, and it was about the same pinching feeling. Then the tugging, weird feeling. Not painful, just a WTF-exactly-are-you-pulling-on?!? kind of feeling. Anyway, 2 c/s, never dialated beyond a pity fingertip, and the Mirena was much better than any of my cervical checks!

Anna
Mama to Gracie (Sept '03) and Eli (July '05)

[MegND95]

I've had a c/s and 2 VBACs. I am a complete wimp about pain, and I really thought the Mirena insertion was not bad. I liken it to an uncomfortable pap, but very, very bearable. I took some 800mg Motrin prior to my appointment and that helped, I think. No other pain relief was offered, and for me, not really needed.

Try not to worry! Heck, you've had a c/s....this is nothing compared to that!

[phirey]

Thanks so much for the encouragement. i'm just sitting here giggling at myself. Tarah talks about facial flushing, others of you liken it to a cervical check or a Pap. Yes, most of you know I DO THIS FOR A LIVING, but EEEEK I'm a bad patient! I get facial flushing whenever I'm in a stressful situation. I turn beet red public speaking, I flush just walking into the Dr.'s office. I have to take a Beta Blocker every time I have an interview/evaluation/planned confrontation with the boss, etc. And for those that compared it to a cervical check, I NEVER HAD ONE OF THOSE, since both c/s were planned! Sure, I've been through a C-section, but that's EXTERNAL pain, not YOU-KNOW-WHERE pain. Ooooooh! Heebie-jeebie heebie-jeebie heebie-jeebie. I feel like such a liar when I've talked so many patients through it and even more invasive procedures.

[Hangs head in shame] OK now everyone giggle at my expense....

[trumansmom]

Peggy -

I really hesitated to post anything, because I didn't have a c-section, and I really want you to be comfortable in your decision. However, I had mine done around 2 months PP and my Mirena insertion wasn't quite as easy as others who posted. I don't remember exactly what the problem was, but it hurt like heck at the time. I've had two LEEP procedures (which may have had something to do with it), and I would rate it as comparable to that or the biopsy. And I was pretty much in bed for the next 24 hours with moderate to intense cramping. I do have 'touchy' cervix, and regular Paps are often painful and crampy for me as well.

All that being said, it has been so easy since, I would still do it again. My doc convinced me they were the most wonderful things in the world. Now I'm going to have to go quiz her about hers and see if she had the heebie-jeebies, too!

And I would NEVER giggle at someone's hoo-ha heebie-jeebies! *snicker* :P

Jeanne
Mom to Truman 11/01 and Eleanor 4/04
Independent Consultant, Do-Re-Me & You!

[tarahsolazy]

Look at it as a career building experience! Imagine your new capacity for empathy! Mostly kidding here, but hey. Having pre-eclampsia, a failed induction, and a c/s was very helpful to me dealing with new mothers at work. Not to mention the increased empathy for just how frickin' hard it can be to have a newborn.

[Tori_s mom]

Peggy,

Thanks so much for posting this question! After reading about the Mirena on this board, I'm going to ask my ob about it this week. I still have a ways to go before I need it, but I'm glad to read about other people's experience with it. I hope everything goes great on Tuesday. Do you at least have something nice to focus on while they do it? Like a pretty mobile or sexy pinups on the ceiling ? ;)

Tasha

[marcywench]

I just got mine last Tuesday. I had a c section on 10-08 after dilating to 10, but no pushing (cord compression, plus meconium, plus baby had not descended at all.)

I didn't take anything in advance. No lidocaine or anything used. I felt a little pressure from the tenaculum (I don't think it was much worse than an allis...I'm an OR nurse, so I was visualizing all of the equipment...which made for a fun section!) The dilation didn't bother me. Trying to relax your knees (hahahaha! just relax!) and deep breaths are key.

I was nervous, but it really wasn't bad. I was pleasantly surprised. I mean, I wouldn't choose this over a pedicure or a bubble bath or anything, but I don't think that you need sedation at all. I can't imagine that some ibuprofen would be a bad idea, though.

Good luck, and let us know how you do! The imagining is always worse.

[jennifer13]

It definitely hurt, but it was SHORT. I think that's the thing to tell yourself, that you can handle anything for such a short minute. And for what it's worth, it never felt anything like dilation to me, it never dawned on me until your post that that's what was happening! What hurt more was just the general thing since I had had a vaginal birth (vbac) and had stitches and I just didn't want anyone messing around down there. ANYWAY, as for more encouragement, I had no cramping at all afterwards, although I did spot for several weeks. Totally, totally all worth it, by the way. Good luck! You can do it, and you'll be glad you did.
Jennifer
Mom to Norah 5/23/03
and Leah 3/24/05

[phirey]

I premedicated with 800mg ibuprofen about an hour before. No, it wasn't fun but the ibuprofen was plenty. I feel silly for being so nervous.

I'll go ahead and tell you how it went since I know there's a few others looking for information/scared of the discomfort.

The whole thing took about 3 minutes. I'm never very good with the speculum. Then the discomfort came in three waves. Since I know how they're inserted I knew exactly what was going on and that added to the angst, although I was able to comfort myself since I knew the three steps, so when she got to the third i knew it was over. I'll spare you the details but each step of the procedure has a twinge of discomfort. I'd love to say it's just a twinge, but I admit I grabbed the table and yelped a couple of times. I breathed through it and it was over before I could really compain. I'm not sure I'd compare it to cramps, more like I imagined labor pains. Either way, as I said it was over in 3 minutes. I've had very minor cramping this afternoon and evening, easily controlled by ibuprofen.

Compared to the PITA of pills, plus the future benefits of reduced menstrual bleeding, I'm thrilled. My insurance (Coventry) covered it 100%, except the office copay, which I didn't have since I'm still in the maternity global period.

HTH someone.

[MarisaSF]

Glad to hear it wasn't too bad, Peggy!
Hope the first bit of bleeding doesn't last too long. I know a lot of women don't bleed at all... I spotted for a month. ickaroony! x(
Did you feel the uterine "tickle"? It was so weird for me!