Medications (to be picked up before surgery as some had to be taken night prior to surgery):
- Ibuprofen 600MG
- Diazepam 5MG
- Hydrocordone/APAP 5MG/500MG
- Doxycycline Hyclate 100MG
- Ondansetron 4MG
- Misoprostol 200MCG
(all this cost me ~$15 because of my insurance)
I followed the instructions on the pills and took several of them the night before and one on the morning of the procedure. I brought the remainder of the pills to my appointment.
My appointment for Essure was at 1:45, but I had to be there at 11:30. My husband dropped me off and, when the time came, he picked me up. The doctor’s office did not insist on this. I did. And I’m glad I did. I wouldn’t have wanted to drive myself home after all that. I was dopey and in a fair amount of pain.
When I got to the office, I paid my $500 deductible and was told I’d be billed for 10% of the balance the insurance company agreed to pay. I waited for about fifteen minutes before I was called back to an exam room. My nurse administered some of the pills I brought with me. I was sent back out to the waiting room and sat another ~45 minutes. At that point, the nurse called back again and gave me a shot in the hip to further soften my cervix.
I was allowed to turn off the lights and lay there listening to soothing music while I got pretty stoned. The doctor came in and gave me about five shots to my cervix. None of them really hurt. It was uncomfortable, but I’d give it about a 3 on a scale of 1-10 (1 being the lowest and 10 being the highest). The doctor left the room to give the shots time to take effect. I listened to music for another ~30 minutes, and the doctor returned and started the procedure.
Nothing hurt at all. The doctor warned that I’d feel some pressure when he removed my IUD, but I didn’t. Then, he began inserting the Essure Coils. I watched some of it on the television, but I was squeamish about it and ended up just chatting with the doctor and nurse. After a very short time, the doctor said he had bad news. He said he could insert the coils into my fallopian tubes, but the coils would not open up due to my tubal anatomy. Now this I had to watch on the screen. He could slip the little thread into the tube, but the spring would not deploy. The doctor said it was because there wasn’t enough pressure in my tubes to cause the coils to open. In other words, my tubes were not narrow enough to cause the springs to deploy. What luck, huh?
The doctor suggested Plan B, which was for me to get a laparoscopic tubal ligation and the Novasure endometrial ablation all in one fell swoop. This operation would have to be done at the surgery center under general anesthesia. I decided to go for it because, otherwise, I wasn’t going to be able to get sterilized, and getting sterilized was/is important to me. The doctor’s office was able to schedule me for the tubal/ablation two days after the failed Essure experience. So that meant it would be on Wednesday of that same week.
I had some fairly severe cramping while I waited for my husband to come pick me up--as in the kind where I was sweating and thinking I might vomit. Hubby came to get me, and I went home and languished on the couch the rest of the day wondering if I was making the right decision going through with the tubal ligation. In the end, I decided to throw caution to the wind and let the chips fall where they may for reasons that may or may not be acceptable to anyone but me.
I believed both procedures had pros and cons, and the only reason I felt as strongly as I did about having the Essure as opposed to the tubal was the fact that Essure could be done in the doctor’s office, thus, saving me from any hospital rigmarole. On the other hand, I liked the tubal because there is no waiting period, no HSG, and the ablation could be done the same day. There was a lot of “six of one; half a dozen of he other” when I compared the two. So, since the Essure placement had failed, I decided to be like those old Nike commercials and just do it.
The tubal and ablation were scheduled for Wednesday, December 3, 2008. They both went a lot better. I figured it was fate that the appointment was open, and I could have the whole mess over and done with before the end of the year. Originally, I thought I’d lose my $500 deductible on 12-31-08 at the end of the calendar year. When I was figuring out exactly what getting this whole sterilization thing over and done with would cost, though, I got some good news. Because my deductible was met so late in the year, it carries over to next year.
This is great news for several reasons. My husband has some upcoming surgery for hemorrhoids (of all things), for which he just couldn’t take off to have done this year--vacation is based on seniority, blah, blah, blah. I’m glad to know we won’t have to pay the deductible again.
In closing, I’ll say this about the Essure: The experience was positive, and I can’t recommend the doctor I used or his staff enough. My age (backside of 35) may have been a huge factor, but I got nary a bingo. If you’re in the Houston, Texas area and in the market for a wonderfully sympathetic and nice gynecologist, you really ought to look into the Women’s Centre for Well Being.
On the Essure, stuff like anatomical problems that cause insertion to fail are apparently nearly impossible to diagnose ahead of time. I did some internet research after I got home from my appointment and turned up an article which mentioned a particular study that showed 58% of the women who had a failed Essure placement had been IUD users--like me. The name of the article is "Success rate and patient satisfaction with the Essure™ sterilisation in an outpatient setting: a prospective study of 857 women." It appears in BJOG: An International Journal of Obstetrics & Gynaecology, Volume 114, Issue 6, Pages 763 - 766. The listed authors are M Miño, JE Arjona, J Cordón, B Pelegrin, B Povedano, and E Chacon. Despite some searching, I have been unable to find the full text of the article for free online, but here is a google search that turns up a link to buy the article and quotes the passage I'm talking about. Maybe someone who is better at this stuff than I am can turn up something more conclusive.
If you are going to have a large out-of-pocket expense on the Essure like I did, it might be worth your while to look further into the Laparoscopic Tubal. I certainly wish I had done so. It would have saved me some $$$. I also guess I should mention that if a vasectomy for your partner is even a remote possibility and desired for the both of you, it might be worth looking into as well. I'm not one of those women who, because my Essure experience didn't work out, am saying you should run far, far away with your fingers in your ears if anyone even whispers Essure around you. I'm just trying to put a reminder out there that your procedure may not work out for reasons you or your doctor could not have predicted.
Expenses: For the Essure, I spent $500 to meet my deductible, and I am sure I will be billed for 10% of what the insurance approves to pay. I spent ~$15 on prescriptions. Luckily one was a fairly large amount of ibuprofen, which I can use for other stuff down the road. The rest of the stuff was used the the Essure placement failed. I also spent ~$5 on a shot of depo, the necessity of which was negated by the tubal I got yesterday. I would prefer not to have these hormones in my body, but the effects of them will be finite as I won’t be getting another shot of Depo. (And, by the way, other than spotting, I haven’t had any trouble with it.) I'm not, in any way, saying this is what Essure would cost across the board. I have insurance that picked up some of the cost, and, in some cases, some plans might cover even more than mine did!
I'm not, in any way, saying this is what Essure would cost across the board. I have insurance that picked up some of the cost, and, in some cases, some plans might cover even more than mine did!
The sunny side is that the deductible carries over, and the medications didn’t really cost all that much. The shot of depo probably thinned my uterine lining so the doctor had an easier time seeing what he was doing for the hysteroscopic ablation. I would have had to pay the office visit for the consultation and the ultrasound anyway.
...And the sun’ll come out tomorrow.... <grins>
Anyway, I’m not trying to tell anyone what to do or what not to do. Be aware, though, that the Essure placement can fail, and, if it does, you have to start all over. I’ll share my experience with the tubal/ablation in my next post.