Because bureaucratic nonsense has been par for the course for this entire experience, it was fitting that I got a confirmation call on Wednesday which said my appointment was at the downtown clinic. That was interesting, since when I scheduled it two months ago I'd been told it was at the Mira Mesa clinic, significantly closer to home. I called back to verify that the appointment really was downtown -- which it was -- and it was too late to change it. So Ken took me to the downtown clinic, which was in an old building right on a flightpath close to the airport. The place was a bit of a dump, but I guess that's mostly due to its age.
For the actual x-ray, I was in a room with a flat table and a large x-ray machine that could rotate over the table or away from it. Among the scary instruments on a smaller table there was a largeish syringe with yellowish liquid in it. The contrast dye, I guess -- it was a surprisingly small amount, but I guess the unoccupied uterus is smaller than one tends to imagine. The radiologist's assistant helped me get ready; she seemed very nice, and we talked as I got ready for the procedure. She said she'd had a tubal ligation and hadn't heard of Essure; I had to spell it so she could put it on my paperwork. I explained the procedure, and she told me what they'd be doing today (injecting dye into my uterus and taking x-rays of it). She said it wasn't generally very painful but would probably be a bit crampy. She took a preliminary x-ray of my abdomen and went off to develop it for the radiologist. He came in a few minutes later, saying, "So, you've had this Essure procedure, which I just heard about for the first time five minutes ago." I explained it to him, too. I am a one-woman force of education. With only twenty-odd doctors in the city who perform Essure, I suppose it's not that surprising that a random radiologist hasn't done any followups on it yet. He did say that he's occasionally done a HSG to check on the success of tubal ligations, so it's not like the idea of wanting the tubes blocked was totally foreign to him.
Once we'd cleared all that up, it was time to get started. I had to scoot down to the end of the table in classic pelvic-exam position, unfortunately without stirrups. This position always, always gives me butt cramps, so I was actually sort of relieved to find out I'd only need to stay in it long enough to get a catheter in and then I could lie down. I'm a little baffled that a place that regularly does HSGs is lacking in stirrups, though. With my socks on, I had a hard time keeping my heels on the table. The assistant was hovering and patting me reassuringly; I considered telling her it would be more useful to grab my right ankle, because my foot kept slipping.
I find pap smears uncomfortable, so it didn't surprise me that I found catheterization uncomfortable too. Oh well. I got to lie back, and they moved the x-ray machine over me and presumably began injecting the contrast dye, because I started getting cramps. I could see my glowing uterus on the video monitor, which was pretty cool, except the cramps were a little distracting. Roll a little one way, hold your breath for an x-ray, okay, now the other way -- OW -- the cramps went beyond the just-like-a-really-bad-period point, but then the doctor took one more x-ray and it was over. He seemed to think that last stab of pain was a good sign that he'd gotten the pressure high enough. Thanks. Luckily it immediately ceased, and I only needed a minute or two to recover.
"Okay," he said, "None of the dye went up your tubes. Looks like it's working." It was almost... anticlimactic. The assistant went off to develop the x-rays for my permanent record, then came back to help me go change. I was a little dizzy for a minute or two, and somewhat crampy, but not too bad. She said the doctor would make his official report to my gynecologist within a few days; presumably he will contact me when he gets it. The radiologist had no doubt that the tubes were blocked, though, so I don't expect any surprises.
So I guess that's it. I'm sterile. Strangely, I feel less jubilant now than I did in the recovery room after the original procedure when the doctor stopped by and said he'd gotten the coils placed properly. It's almost a little hard for me to trust that I can really rely on this. I can't wait for my Depo to wear off -- I am finally, finally free of hormones and quarterly office visits -- but it's not like there will be any fanfare when that happens either. I'm likely to have irregular periods for quite some time, so I see a lot of paranoia in my future. It's silly; this is more reliable than even the Depo was, and I've actually had a test to prove it worked, reassurance that even people who get tubals usually don't have. Maybe it's just taking a while to sink in. But it's done. It worked. I've been following Essure since before it received FDA approval (seriously! It used to be called STOP, Selective Tubal Occlusion Procedure. At least the pronunciation of that was obvious) and I'd always hoped someday to have it done. I'm just amazed that it was so easy, once I finally set things in motion.
This icon feels strangely appropriate to me... :)