Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Friday, November 25, 2011

A change of topic: Mirena review at 3 months

I am boring even me, so thought we'd have at least one post about something a little different.  This may be a girls' only post unless you are a man really interested in what we used to call in college "pink stuff".  Now that feminine hygiene products come in about every color but pink that makes less sense but back then it worked well.

As you know if you've been around a while, back in August I had gynecological surgery.  There were various reasons and so a number of procedures were performed.  One of them was the placement of a Mirena IUD.  This was done because my very messed up menstrual cycle needed correction and I can't take birth control pills, both because of my age makes me a lesser candidate and because they make me crazy.  I was on them the first year I knew I had bipolar because PMS time was a bit scary, and they made me sick and they made me cycle.  There were other reasons that this was the best option for me that I don't need to share.  I will state clearly since I've had someone ask me, while the mirena is not like a typical IUD in that it releases low dose hormones, this results in the lack of a formation of a uterine lining, so it is possible to conceive a child and then have that embryo not have a place to implant.  This goes way into the politics of abortion and we're not going there because for me it's not a consideration with 0% chance of my conceiving anything.  Even if I were sexually active there would not be accidental or unassisted pregnancy.  So that's just off the table, but I know I trolled the internet intensely reading everything before the Mirena was placed, so I wanted to throw that out.

Thus far the Mirena is doing its job.  I was told I would be likely to have 6 months more of the very heavy bleeding that led to the surgery.  I have been fortunate to avoid that.  After surgery I bled for a little over a month.  This is not because of the Mirena but because of my other procedures.  I had a very weird experience of about 9 days after surgery my cramps increased as did the bleeding slightly.  I had to call the nurse line to ask if this was possibly my period.  I felt so stupid given my 20odd years of experience with cramps and menstruation but cramps seemed odd.  Turned out some people are unlucky with the D&C/mirena combination and their cycle restarts quickly.  I was one of them.  I had another period soon after the bleeding stopped that consisted of a day of spotting.  Since then I had one period that kind of freaked me out because it wasn't as gory as before but it was not shorter.  I've also had one cycle that was much lighter and shorter than before.  This is the way the thing should work, hopefully resulting in nothing in a few more months.

The one thing I didn't know about that I wish I had known was no matter what the cycle happens to include in terms of need to use pink things I would still have hormone changes and will still have PMS, even if there isn't MS.  It's not bad, but it is there and can be confusing.  The other thing is that the bleeding doesn't completely correspond to the hormone symptoms.

On the other hand, based on my response thus far my doctor thinks I may be totally without bleeding by the end of a year.  The other thing is that the Mirena is currently approved for 5 years, but other countries use it more like 7.  The plan now, because getting a new one into me would be a major production, is to leave mine in at least 7 years and hopefully that will get me to menopause.  They haven't said precisely what happens then but I believe at that point I'll be a candidate for a hysterectomy because what was learned in surgery was that my lack of ovulation leads to nastiness and the Mirena is preventing the build-up of nastiness. They told me if it weren't for the Mirena I'd be getting frequent D&Cs or having the same issues I was having before.

So I am pleased thus far and they tell me if I like it now that I'll continue to do so.  In the ER last week the psychiatric resident was a bit concerned that I was having a reaction to the hormones but that was easily disproven by my lithium level.  I haven't written too much about last week (it's coming) but the decision had been made if they found toxicity or other neurological/biochemical issues I'd go to medical and if I was just hallucinating I'd go to the psych unit for observation.  Seemed fair enough.  If I'd gone to psych I would have had a lot of assessment regarding the use of the Mirena.  So for the bipolar woman it is not ideal but it beats constant anemia that was just close to needing treatment and able to make me feel lousy but not treatable, and it beats the horror films that I was dealing with for 50% of each month.

When hormones are needed and other options are not choices this is a good thing.

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