Sex and the Ivy

My IUD Debacle At MGH

Filed under: Uncategorized — Elle September 11, 2009 @ 10:46 pm

If you were following my Twitter yesterday, then you might have been witness to my debacle of an appointment at Massachusetts General Hospital (supposedly one of the best hospitals in the country). The short version: I went in expecting an IUD and came out with a colposcopy appointment. For an abnormal pap smear. That I had done in July. The long version requires some backstory:

I went into MGH this summer right before leaving for Germany for an IUD appointment. At the time, roughly late July, I hadn’t had a pap smear in a year, so they recommended that I first get one to make sure I didn’t have any STIs or other issues that an IUD could potentially worsen. At that appointment, they prescribed me a couple painkillers and a mild sedative/muscle relaxant, which I was supposed to take prior to my next appointment, at which time I would get an IUD (assuming my pap came back fine).

I’ve had abnormal pap smears before, back in my sophomore year, as a result of low-grade squamous intraepithelial lesion (LSIL). LSILs are often a sign of human papillomavirus (HPV), some strains of which can lead to cervical cancer. HPV is extremely common and usually harmless. The majority of sexually active American adults will contract it at some point in their lives, but not everyone shows symptoms and most cases clear up on their own, which is exactly what happened with me. After twice yearly check-ups, the LSILs eventually went away. I then immediately got vaccinated for HPV, since Gardasil protects against most cancerous strains of HPV (but not all).

Given my history of abnormal pap smears, I was eager to get back my results from July so that I could confirm that everything was peachy down there. They told me to expect my results in a week, at which time I’d be abroad, so I instructed them to call me instead of mailing a letter. A week passed and I’d heard nothing, so I called back and was informed that the lab hadn’t processed my pap smear yet. I waited another week before calling again, and after repeatedly being hung up on or directed to a voicemail box, I was told once again that my results weren’t in. I kept calling right up until the end of August (by this time, I had returned to the United States) and kept being told that the results “should be available in just a few days”. Meanwhile, since returning from abroad, I found a letter informing me that I’d been scheduled for an IUD appointment on August 17th, an appointment I obviously missed since I didn’t even know about it and wasn’t in the country. I wasn’t informed about it via phone call, and I had previously made it very clear that I would not be in Boston. I rescheduled for September 10th.

So, that brings us to yesterday. I fill my prescription for the painkillers and sedative (which by the way, cost $30), take the medication the morning of the procedure as instructed, and show up to my appointment with Patrick in tow for moral support. He’s blocked out his afternoon so I don’t have to wobble home by myself or navigate the T solo. By this time, I’m pretty woozy and a little absent-minded. (At first, I thought it might have just be a placebo effect, but two friends in different instances pointed out that I was behaving strangely, and though I didn’t realize I’d taken a muscle relaxant at the time, I felt too tired to go to the gym.) I’m told by the receptionist that they are running roughly 45 minutes behind schedule. An hour later, they call my name.

I’m led into a room, where I get my blood pressure taken and am told to undress from the waist down. The nurse asks whether I’m getting the five- or ten-year Mirena, and I decide on the five-year since it has a small amount of estrogen which decreases menstrual flow. She leaves so I can undress, and I’m generally feeling pretty good —- a little nervous, but calm (thanks meds!). And then, everything goes downhill.

My doctor (a different doctor from the one I saw the first time) comes in and informs me that I can’t actually get an IUD after all. Apparently, the pap smear I had done in July came back abnormal, which means I need a colposcopy. The lab processed my pap smear on September 3rd, a week ago. The doctor says I should’ve gotten a copy of the results in the mail (which I hadn’t because I just changed my address). I ask why no one called, and she doesn’t know. Keep in mind that I’m half-naked at this point. And drugged. My boyfriend and I have both blocked out the second half of our day so that I can get this IUD and he can take care of me in my medicated, crampy state.

This situation was entirely preventable. MGH should have told me that I couldn’t make an appointment for an IUD before I got my pap results back (though I should also mention that you need to make appointments weeks in advance). Conversely, they could have also just called me as soon as they got the results, which was what I told them to do after they asked how I wanted to find out. Why would you ask the patient what her preferred method of communication is if you don’t use it? I’m also pretty appalled that the lab needed SIX WEEKS to process a standard pap smear. God forbid I actually had something serious.

All in all, this is not what I expected, certainly not out of MGH, which is supposed to be the best hospital in New England. My colposcopy’s scheduled for next week (perhaps I’ll even liveblog the process) and if it turns out my cervix is just bluffing, then I can get my IUD on the spot. But this time, I’m not going to pre-medicate. I’d rather not make myself woozy for 24 hours for absolutely no reason.

[Correction to my comments on the Mirena]