ESSURE: The Permanent Sterilization Birth Control Option I Chose To Have Done

Ah yes, what fun would my blog be if I didn't dip a toe into controversial waters from time to time, go out on a limb, and try to disturb my male readers? Why, NO FUN AT ALL!

Today we're talking about birth control. Why? Because I recently underwent the Essure sterilization procedure, and I like to get the word out to others and educate people about my experience--that's why.

"But Whitney!...you make cute kids! Why would you want to take away the possibility of ever creating more of them?" Here's the dealio--usually the "making kids" thing is a joint effort. I don't know that I will ever get married again, and even if I did, I would not want anymore children. I got over being pregnant in my 20s. Time to move on with my life. I have a child who is nearly 21 and I don't need one in college, and one in diapers. Time to close down the baby-makin' factory for good. I'm also not getting any younger, and my kids are goofy enough without playing the odds that I'm going to make exponentially more goofy kids due to carrying around a bunch of rotten eggs.

I realize that there are a plethora of options out there for birth control. However, I will say that I am totally anti-hormone therapy birth control. It is my personal opinion, and some experts will probably tell me I'm F.O.S. on this one, but I think the reason breast cancer rates are so high these days are because women are on so many dang hormone therapy birth control methods. They aren't good for you! Neither is having 750 kids. But that's neither here nor there.

I have only ever been on birth control one time, and that was a flipping nightmare. I had the Depo Provera injection back when I was in my early 20s and it jacked me up something fierce. I bled 24/7, 7 days a week, for 365 days per year. And it was a shot so it wasn't like I could just stop taking it. The damage had been done. I should've taken out stock in feminine hygiene products during that time because I think that's where half of my salary ended up going. Not to mention I had raging PMS for an entire year. And I gained about 15 lbs on the stupid stuff. Who could ask for anything more? Weight gain, pissy attitude, bleeding like a stuck pig everyday of my life--It was fabulous. NOT! Oh, and spare me the jokes about how you still think the shot must be in my system because I still have a pissy attitude. I don't know what the half-life is of Depo Provera, but I'm pretty sure it's under 10+ years.

Because I am so anti-hormone therapy birth control, I had limited options when it came time to choose how I was going to be able to move onto the next chapter of my life without risking another pregnancy. It basically came down to two options--a tubal ligation, or Essure sterilization.

I have had super extensive abdominal surgery in the past three years, so after talking to all of the OB-GYN doctors that I work with (I'm a labor and delivery nurse), it became very clear that no one would touch me with a 10-foot pole for a laparoscopic tubal. I have WAY too much scar tissue in my abdominal cavity, and the risks were too high that the surgeon could potentially perforate my intestine. No thanks. I've had enough fun with my guts over the years. I think I'm good.

SO ESSURE IT WAS! What is Essure? Essure is a safe, permanent method of sterilization that can often times be performed right in your doctor's office. It involves the physician using a speculum to access your cervix, going up through the cervix into the uterus, and then inserting small coils/springs into the fallopian tubes. Over a few months, the fallopian tubes will produce scar tissue around the coils that will then occlude the fallopian tubes and prevent eggs from passing through them, as well as prevent sperm entry.

Among many important things to consider about Essure is cost. I did a bunch of research regarding the cost of Essure, and most internet sites said it would likely be "the cost of my insurance copay". This was a crock of crap. I have Cigna health insurance, and I have a 75%/25% split. The insertion procedure ended up costing me upwards of $470 out of pocket, and the HSG will be another $450 out of pocket. Be sure you do your research, know your insurance coverage, and know what the hospital and provider charge. Still cheaper than having another baby, but it can still be spendy.

The day of the Essure procedure I had my daughter as my designated driver (this is required--you aren't allowed to drive on benzodiazepines (valium) and narcotics (percocet)). I was given valium to take an hour prior to the procedure, and then percocet and zofran to take 15 minutes prior to undergoing the scope. Unfortunately, during the time that I had my procedure, there was a nationwide shortage of the drug, Toradol, which is an NSAID drug that they inject intramuscularly prior to the procedure to keep your fallopian tubes from spasming during insertion and to help with pain. As you can imagine, this meant that my procedure hurt like an S.O.B. Instead they had me power load 800 mg of ibuprofen prior to the start of things. Big whoop. Didn't really do a thing for me.

Normally, an Essure procedure takes about 10 minutes. Although it is only 10 minutes, it is a very uncomfortable, painful 10 minutes. Mine took over an hour, and my doctor said I was the hardest case she had ever had, but this was due to my previous surgery, and the fact that my fallopian tubes spasmed like a MOFO due to the Toradol drug not being available.

During my procedure I had three people in the room; my doctor, an Essure representative, and a medical assistant. That's a lot of people oogling your goodies while you lay there spread eagle on the table. However, just remember that health care providers see naked people all the time, so it's really not a big deal to them, and you should relax and just git 'er done.

I had full intentions of doing just that, but then the procedure ended up being so painful for me, and taking so long, that my doctor's lucky my thighs didn't slam shut and crack her head like a walnut.

Anyway.

After you're up in the stirrups, the doctor inserts a speculum into your lady parts, and then inserts the scope through your cervix. This part almost killed me. A closed cervix should remain closed unless a fetus convinces it to open up--and even then, that whole process hurts like a son-of-a--ask any laboring woman how much fun cervical dilatation is.

Once the scope is through the cervix, a bunch of water pressure is used to perform the procedure. This part also hurt quite a bit because that water pressure causes SEVERE cramping. Once the water pressure is present, then the scope is used to place the coils in the fallopian tubes. This part was particularly horrible for me because my tubes decided to fight my doctor. She had to reef on them pretty hard to get the coils in place. Because of this, she called me every day after my procedure for a week because she thought she might have perforated my tubes. We would not know until months later if the coils were in place, or floating up into my abdominal cavity (aka outer space).

Finally, the procedure was done. I do pity anyone who is actually considering getting Essure and reading this because I make it sound horrible. However, MY procedure was horrible. It KILLED me. I was lying on the table in a puddle of tears, and had I known how the procedure was going to go, I WOULD NOT HAVE WORN BLACK EYELINER that day because I looked like a flipping raccoon by the time I got off the table.

BUT DON'T LEAVE JUST YET!!!!--IT GETS BETTER! AND YOU WILL STILL PROBABLY WANT TO HAVE IT DONE!

I know you are thinking I'm crazy by now to think that you would still even consider Essure, but although undergoing the insertion of the coils sucked serious fuzzy butt, the bottom line is that it is still a very effective method of birth control. I was a hard case to perform, and I think anyone can suck it up for 10 minutes pain-wise should the procedure actually go how it is supposed to.

So after the insertion I was very crampy for about three days. My next period also had more intense cramping, but it was shorter than normal. Then the next one was shorter, and most recent one was short, too. My normal cycle is 5-6 days, and now I'm down to 3. I'm okay with that! **WOOT**WOOT**

THEN COMES THE WAIT...AND DON'T FORGET DURING THE WAIT THAT YOU STILL NEED TO USE BIRTH CONTROL!!!!!!

So what's "The Wait?". The wait is 3 months. That's how long it takes your fallopian tubes to completely scar over and occlude.Then you have to go to the hospital for an outpatient procedure called a "hysterosalpingogram" which is a dye test that is performed to make sure that nothing can penetrate your tubes.

The hysterosalpingogram (aka HSG test) was something I was terrified to have. The Essure placement hurt so much that I was done having people fiddling around down in my southern region. I was actually so traumatized by the insertion that I almost put off my HSG for the rest of the year. However, I put on my big girl pants, decided to suck it up and go get my confirmation that I would no longer be contributing to overpopulating the planet.

I scheduled my HSG test. This test needs to be performed 6-10 days after your period cycle. I went in to the hospital, and went into the radiology department. They had me put on a gown, and placed the speculum again to access my cervix. I was shaking during this time in anticipation of what the little tube that had to go back up into my cervix would feel like. Fortunately, I felt only very mild cramping--nothing like the coil insertion procedure that I had in my doctor's office. Then they confirmed with the injection of dye that my tubes were indeed occluded.

 After they injected the dye, they placed the x-ray machine over my abdomen, and had me tilt side-to-side to distribute the dye in my uterus. THAT WAS IT! It was actually a very easy procedure, and KA-CHING!!!--NO MORE BABIES FOR THIS GIRL!

Long story short (ha ha), the Essure procedure is not very comfortable, but it gets the job done. It was the only option I had for permanent sterilization, and although it had some ups/downs and scary moments for me (with not knowing about tube perforation), it was totally worth it. I feel like now I can move forward with my life and open the next chapter THAT DOESN'T INCLUDE MATERNITY CLOTHES! :)

(And please keep in mind that Essure does not protect against STDs, and it is VERY important that you continue to use some form of birth control during the three month waiting period unless you want to be called "Mommy" again!)