And Everyone Loves a Furry Pelt!

I have seen reproductive endocrinologists, standard endocrinologists, obstetricians, gynecologists, perinatologists, and psychiatrists, but with the exception of a few visits to whomever-happened-to-have-an-opening-that-day (once for a kidney stone, once for a foot injury secondary to pathological clumsiness), I haven’t had a general practitioner in years. Alas, my perinatologists finally stopped refilling my prescriptions, so I picked a doctor off a clinic website and made a date for this past Wednesday.

It was mostly uneventful, though I did leak milk on the poor woman during my breast exam. I emerged with an appointment for next week to have a Mirena inserted into my…cavity. As odd as it feels after years of burning money and neurons in single-minded pursuit of a child, birth control is a necessity. I have gotten pregnant on my own before, though briefly, and as much as I would like—in a purely theoretical fashion, and that’s a whoooole other post—to have another child someday, the thought of pregnancy still fills me with a dizzying, sickening terror, and besides, I want to give Simone my full attention for the next few years. I have been taking Micronor, but I am seduced by Mirena’s ease, compatibility with breastfeeding, and low side effect profile.

HOWEVER. Because of my creatively arranged lower anatomy, insertion is sure to be tricky, and my new doctor waved aside my request for a morphine drip, spinal block, injection of Torodol, and handful of Percoset—maybe washed down with a Valium milkshake—instead making the laughable suggestion that I take a pair of ibuprofen half an hour before the procedure. Listen, lady. A very fancy and expensive reproductive endocrinologist was unable to slip two microscopic embryos past my cervix without aid of a custom-bent catheter and spelunking headlamp, and even then it took multiple attempts and was easily the most painful part of my IVF cycle. So inserting a pronged plastic anchor is going to require more than this “ibuprofen”’ you speak of.

Are any of you harboring Mirenas (Mirenae?)? Are you fond of your wee uterine hangers-on? Did you hemorrhage during insertion? The strings worry me as well. I am trying to think of them as festive, like intravaginal streamers, but they disturb me all the same.

The other item on the agenda was my Metformin prescription, which proved problematic. When I returned from my appointment, I had a message on my machine from a nurse: the doctor hadn’t been able to find any studies regarding the safety of Metformin for breastfeeding mothers, and so she had decided not to phone in the prescription. I called back and left a message of my own, very politely citing Thomas Hale and several studies indicating that Metformin does NOT pose a risk to nurslings. This morning I got another call saying that the doctor was not impressed with these studies because they were not long term, but that while she would still advise me against taking it, she would write the prescription. Basically, “Go ahead, just don’t come crying to me when Simone grows a horn and possibly a sleek, furry pelt!”
I am conflicted. The NICU lactation consultants and Medications and Mothers Milk seemed to agree that it is safe, and it may even help me maintain milk supply in the face of my PCOS. Metformin doesn’t even TRANSFER into breastmilk at anything approaching clinical levels. Besides, would a horn really be SO bad? Maybe we could hang tea towels on it.