Thread: Essure and what to expect

I actually had some minor complications and had to have the procedure done twice. I think it may have had something to do with where I was in my cycle and the fact that my doc removed my IUD (paraguard) in the same visit. So here's my story:

First round (April 2009). I had started the pill and still had the IUD, so my uterine lining was abnormally thick, part of the reason why this may have been so difficult. So first piece of advice - make sure you've just finished your period before getting this done. He put me in "twilight" anesthesia via a mobile anesthesia service that operates in-office, so I was out the whole time but here's how he told it-- It took him an hour to place the right-side insert because my fallopian tubes started spasming (something I never knew was possible). He finally got the right side in. The left side also took over an hour and kept sliding back out because of spasms. He finally gave up. When I came to, we discussed my options. I decided to wait the 3 months and have the HSG on the right, completed, side to ensure that worked. If it did, then we would schedule a second appointment. If it, for some reason, didn't work, then there would be no point to doing the left side. I experienced no cramping, a tiny bit of spotting for a couple of days, and that was that. No problems at all (other than the incomplete procedure). My doctor said it was the most difficult placement he'd ever attempted.

First HSG Test: Talk about WEIRD. I can't even begin to describe the tools that were laying on the tray - It seemed like some weird horror movie. This hurt more than the procedure itself, because I experienced cramping when they pushed the dye through. It was cool being able to see a real-time x-ray of my body on a tv screen and watch the dye move. The right side insert was completely blocked and successful. So we scheduled the second insert appointment.

My doc recommended me being awake during this one, since he thinks the anesthesia may have been a contributing factor to the spasms.

Second insert appointment - last week (Sept 2009): MUCH easier. Several factors contributed to that, I think. 1) being on the pill for several months with a regulated cycle. 2) the appointment was for the day after my period ended. 3) no IUD to remove at the same time.

For those considering the anesthesia vs. awake method, I can say awake was a better experience for me, overall. But everyone is different.

I took a small dosage of a drug to start softening/dialating the cervix the night before the appointment (mysoprostol?). I took a vicodin and a valium 1 hour before my appointment (highly recommended combo - great for parties, I'm sure . Then, they gave me a shot of liquid motrin which was DEEE-LISH. Never having had any major surgeries or medical procedures before, I was unaware of how nifty pain medication could be.

Here's the worst part: The shot they gave me to numb my cervix and that was SO not pleasant. It's ironic that something that is supposed to prevent pain can cause so much pain. Thankfully that was over quickly - but just be warned - that part SUCKS.

This time, he had a rep from the Essure company in the room just in case there were complications and she could advise. They set up the procedure and I felt a little bit of pressure, but no pain at all. I got to watch on the monitor as the insert was placed. This procedure, from start to finish not including the prep work, took 20 minutes. Compared to 2 hours. I have experienced more spotting this time than last time and am going to call my doctor tomorrow if it does not subside.

We'll never know if it was just bad luck, the anesthesia, the IUD, or a combination of factors that made the first appointment so difficult. But just be warned that you might have to go back.

I go back for my second HSG in three months.

Overall, I'm happy with the procedure. It's a great option for women who are positive they don't want any (or any more) children and don't want to rely on other methods of birth control that have various side-effects and risks.

27 Sep 2009

Began my period. It was a bit heavier but less painful and only lasted 4 days instead of 5 or 6 and I didn't have a break day in between like I normally did. I couldn't use my diva cup and I ended up changing pads every two hours because they were just soaked. By day 3 it was like a normal period but the first two days were crazy.

07 Oct 2009

Woohoo, I had sex for the first time since the procedure. Still using birth control of course. I was thrilled to find out that it wasn't painful and had absolutely no effect on my sex life. I got my one month follow up this Friday so we will see how that goes.

I noticed a few questions from women wondering about the Essure procedure and wanted to share mine. I'm 41 years old and my kids will be starting high school next year. Like a lot of people, I've been on birth control pills for the better part of twenty years and have been wanting a more permanent birth control option for the last year or so. My husband and I considered tubal ligation and vasectomy but didn't really feel comfortable with either option.

10-07-2009: After hearing about Essure, I did some research and made an appointment with an OB/GYN in my area who is licensed to perform the procedure. The physician I selected has performed quite a few and has been doing them for over five years--which I think makes a great deal of difference in your overall success rate and experience. During the first appointment, the doctor answered my questions and explained the process in detail. He also performed a speculum and bimanual pelvic exam to assess the position and condition of my uterus and cervix. I made an appointment for the following week and he gave me a prescription for pain medication to take prior to the procedure.

10-13-2009: I ate a light breakfast and took the tablet of Phenergan (anti-nausea), Valium (anti-anxiety), and Vicodin (pain relief) an hour before the procedure. I arrived at the doctor's office and was checked in by the nurse. She administered a shot of Toradol (NSAID to reduce muscle spasm and cramping). She also conducted a urine pregnancy test to ensure that I wasn't pregnant. After confirming that I wasn't pregnant, she gave me a shot of Depo Provera which should last until the follow-up HSG test. She asked that I undress completely from the waist down and gave me a sheet to wrap around me.

The procedure was performed in a regular exam room in the doctor's office which was cozy and beautifully decorated and did not feel at all like a cold, sterile hospital environment which was really nice. They had a chair next to the exam table for my husband to sit in and so he could rub my shoulder and hold my hand which I also appreciated.

The doctor started by helping my into the lithotomy position (similar to the position you're in for an annual exam or pap smear test). He inserted a speculum into my vagina, and swabbed the cervix with an antiseptic solution. He then gave me three injections in my cervix to help numb the area (paracervical block). The first two injections were somewhat uncomfortable like any shot would be, but the last one hurt quite a bit more. I'm not sure if it was the location or the depth of penetration that made a difference, but it felt different than the first two. The good news about shots, is that even when they hurt, the pain is pretty quick and over with. He then waited for a few minutes for the injections to set in and numb up the area. The nurse stayed with me the whole time, talked to me and was setting up equipment during that time.

The doctor returned to the room and talked me through the next few steps. He inserted a cervical dilator for a few minutes to help my cervix expand to accommodate the hysteroscope. The dilation did not hurt, but did result in some mild cramping. After removing the dilator, he gently inserted the hysteroscope into my vagina, through my cervix and into my uterus. They positioned the monitor so that I could watch the procedure and explained what we were seeing. The doctor used the scope to assess the uterus and to make sure that both tubes were open before placing the Essure implants.

The first implant went in quite easily; but the second one was a little more uncomfortable and took longer simply because one of my Fallopian Tubes was sitting at an odd angle and it took more maneuvering to get it in place. At this stage in the procedure I was feeling some moderate cramping (similar to bad menstrual cramps) and also in my legs. If you can, I'd ask about having them use the kind of stirrups that fit under your knees and support your thighs and calves a little better. I think that the regular feet stirrups (while they work well for an annual exam) are more difficult during a procedure simply due to the length of time your legs are in that position.

Once the implants were in place, the doctor checked their position visually with the camera one last time just to make sure everything looked right and then withdrew the hysteroscope. He used a few more swabs and antiseptic gauze to wipe me down, removed the speculum, and helped me move my legs into a more comfortable resting position on the table.

The total time (start to finish) for the whole procedure was 30 minutes. The actual hysteroscope time from insertion to withdrawal was 13 minutes. The only difficulty I had was that my blood pressure dropped significantly at the very end of the procedure which resulted in my feeling dizzy, light-headed, sweaty and on the verge of fainting. The nurse was terrific during this whole time and reassured me that I would be ok and to lie still until I felt better. She brought me cold water and my husband held cold washcloths on my forehead and arms, which helped a lot. Nothing you can do about a vasovagal response--but I felt bad because I had done so well through the whole procedure and felt like a little bit of a wimp to have crashed right at the end! They let me rest until my blood pressure resumed to normal, and then my husband and I drove home. I did have some fairly painful cramping right as the procedure was ending, but it had subsided almost completely by the time we headed home.

I was sleepy from the medication and took a three hour nap that day, but returned to work the next morning. The nurse and doctor had told me to expect some cramping and bleeding, but honestly, I had very minor spotting for the first few hours and then nothing after. The cramping lasted for only an hour or two after the procedure and by the next day, I physically felt great.

I also like that this OB/GYN does his own follow-up HSG's, which is reassuring. (I have a sister who is a radiology tech, and she said HSG's performed by GYN's as opposed radiologists tend to be much more comfortable for the patient). When I asked about it during my initial appointment, his response was 'most of the radiologists haven't been on the working end of a speculum in ten years, and I won't put my patients through that kind of discomfort.' A doctor with a good sense of humor is always a plus!

I know everyone's experience is different--but overall, mine was very positive. I think a lot depends on the skill, competence and bedside manner of your doctor and nurse--so do your research and get recommendations. The team that took care of me was terrific. The benefits for me were: no hospital stay, no general anesthesia, no scarring, short recovery, highly effective, and my husband could be there for support.

I'll go in the first part of January 2010 for the HSG, and hopefully, all will be well. If any of you have opted for Essure and have been through the HSG, I'd love to hear from you in regard to your experience so I know what to expect!

16 Oct 2009

I had my follow-up apointment and it went great. No infections or swelling. The doctor joked about how I reacted to the vicoden and explained why I felt so dizzy and sick when I had the proceedure done. Apparently it lowers your blood pressure which makes you drowsey. She asked about my recovery and how the pain and bleeding were after the proceedure and took notes. Then she scheduled me for the HSG test which I will have on 9 Dec 2009. I can't wait. Just like LRP in Idaho's doctor, mine also does the HSG's herself which I feel very comfortable with.

i had the procedure done sept.2oish of 09 and i started the nuva ring a week b4.the procedure wasnt bad i recovered late that evening.bled 2 days 5 days after it was supposed 2 b safe 2 have intocourse so i did .the day i took the nuva ring out because of bleeding i bled for atleast 5 days heavy.put the ring back in for about a week &took it out waiting for my period and im still waiting it usually comes by the 10th and its now november 9th still very late.im not pregant but i asked the ob nurse she says this is normal &probly due 2 the ring.and i asked what if i dont have one by 3months(oh it would still b normal,the dr would only concerned if u were pregant)i never put another ring back in ,but i dont really understand why im not having a period.has anybody elses been that delayed

I just had my HSG test today and found out the Essure worked and my tubes are completely blocked. I did have some problems though. Turns out my cervix is the longest my doctor has ever seen and it kepts pushing the catheter out. It was hard enough for her to get it in and hurt about as much as the proceedure but again my doctor was persistient and she managed to get it in. Here is a picture of one of my HSG images in case anyone has never seen one. You can see the big black spot which is the cervix but it doesn't go into the tubes. You can still see the tubes which are black but if it had not worked the dye would have leaked all over and the tubes would have been more prominent. I have an appointment a year from now just to follow up but as of right now everything is great. I would definetly recommend this to anyone who is skeptical of surgery. I was lucky to have a great doctor and very knowledgeable staff that worked with me and I would highly recommend Dr. Connery to anyone in the Tampa Bay area.

Correction, the thin lines are the essure coils at the entry points to my tubes. You can partially see around the edges (the very pale white puff around the coils) where the tubes themselves are. Had the procedure not worked these would have been filled with dye. I read on several forums that the dye used was a sugar based and that it was very sticky. My Doctor actually used iodine and it wasn't bad at all. They gave me a pad to wear afterwards and a towel to clean up with but the amount of blood from my cervix being opened and the dye wasn't a whole lot at all. They said it would be normal to spot for about three days. So far I've had very very little spotting. Not even enough to have to use a linner. From start to finish the whole thing took about 16 minutes. Most of that time, about 15 minutes was spent trying to open my stubborn cervix. I did used 800mg of ibuprofen for 12hours before since it was recommended by someone else on another forum and I'm glad I did but I'm sure anyone who has had kids before probably won't have the same problem. Another piece of advice for anyone getting the procedure done is to make sure they give you the cards. I don't post anymore in the Essure failure forum but I do read them and keep track of what to keep an eye out for and I've noticed many of them said they did not get the cards. The cards keep track of the serial number for the coils. Sort of a legal tracker in case something goes wrong. Mainly though the are used in case you have any pelvic problems the doctor will be informed and can contact the doctor who did the procedure or Conceptus and work in conjunction with them to resolve any problems. Also, it's a good idea to update your emergency data cards if your work has them. If you are injured at work you want someone to be able to give EMS or the hospital a heads up for what to look for. If they do x-rays and see the coils they could mis-diagnose. Not something I would have thought of except I was filling out my EDC for a new job and it occured to me.

I had the procedure done today at my doctor's office. There was some concern that they would not be able to do it because I started bleeding over the weekend, but after some complications it was complete.

Here's the run down.....

I ate a very light breakfast at about 7am. Showered, at then took Zantac and 800 milligram Motrin at 8am. I arrived for check in at 9am and was given a Valium and two Percocet.

They gave me some magazines and a nice pillow and I rested for about twenty minutes until the meds kicked in. I was taken to the surgical room and was joined by my doc, two nurses and the Essure rep. I've never had so many people looking at my vagina at once! lol

The doc gave me numbing shots around my cervix which pinched a bit. They had difficulty getting my cervix dilated and had to use several instruments before it was dilated enough. I didn't really hurt, but I could feel pressure and an occasional twinge of pain at certain angles.

Once that was over, they had difficulty finding my tubes due to my bleeding and the thickness of my uterine lining. They tried for about 15 minutes and almost concluded that they would not be able to complete the procedure today. Then my doctor tried one more thing and we got both the coils in!

They cleaned me up (lots of fluid) and I rested in recovery for about an hour with a monitor. I was then released. I was at the office for a total of three hours.

The pain had been mostly moderate today...like bad menstrual cramping. I have prescription strength Motrin and Percocet still and have taken two of each so far today and the pain is manageable.

Truthfully, other than grogginess from meds and a little cramping, I don't feel too bad! I'll update as I progress through recovery and the test in 90 days! Feel free to ask me any questions!