Goodbye Implanon; Hello life!

May 9, 2010 at 6:31 pm (Uncategorized)
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My poor Blog has been suffering from some severe neglect of late. Since having the implant fitted back in December, I have found it so difficult to write, my thoughts scattered and unfocused, my mental and physical energy depleted. Last week I made the important decision to have the implant removed. On Tuesday, a small incision was made in my arm and within seconds that tiny little rod of progesterone was deftly extracted from my life. For such a small thing it has made a massive impact. If I hadn’t been able to use Utovlan to control the flow, I would have bled heavily for the full five months of it being in my body. Every time I lowered the dose of Utovlan to test if the implant had ‘settled’ (the euphemistic term that my doctors constantly used to persuade me to hang on in there), sure enough I would start bleeding again. This would have been bad enough in itself but what has been far more alarming has been the implant’s impact on my mental and emotional health. In short I have felt dreadful. There were mornings when I sincerely regretted being awake, when I just couldn’t see the point of my existing. I have never felt like that ever before, not even at the lowest moments of my life. It was frightening. Since the removal of the implant my whole mental and emotional state has completely changed; within a day of its removal I could feel the lifting and brightening in my head; each day since then I have felt more and more like my old self; my energy increasing, my engagement with life deepening.

Many of the search engine terms coming into this Blog have been questions about both Utovlan and Implanon. Like me, lots of women are obviously struggling to cope, so to place a line beneath this, I just want to summarise my own experience in the hope that it might be helpful to others.

For some women, Implanon obviously works. For those women who have it fitted in order to help menstrual problems, you need to be aware that there is a good chance that these will be made far worse. The bleeding that I personally experienced on the implant was extremely heavy, to the point that I found it difficult to leave the house. Without the use of Utovlan – synthetic progesterone used to stem abnormal menstrual bleeding – life would have been pretty impossible to negotiate, not to mention exhausting. Also be aware that you might start to suffer from depression or moods swings. For me, these were severe. Judging by the many internet sites of women discussing their symptoms, I have not been alone in my experience. I also found that my sleeping patterns were disturbed. I don’t think I slept normally for the entire five months, waking many times in the night. Usually I have very vivid dreams but these stopped. Amazingly, this week of being implant free, I have started dreaming again and sleeping far better.

For women with dysfunctional uterine bleeding, I believe Utovlan to be really helpful, although I think it also has its difficult side-effects. For a while, I was blaming most of my symptoms on Utovlan, but over time, and having taken the pills last week without the implant, I have discovered that, for me, Implanon was the main culprit in making me feel poorly; Utovlan makes me a little manic but has been far more manageable than Implanon with regards to my emotional state. I would certainly use it again, for instance in delaying a period for going away on holiday (can’t tell you how many holidays have been ruined by my menstrual problems!) or for getting through unavoidable situations. I am viewing it as a temporary but useful ally.

I think that far too often, women with menstrual problems are shunted down the contraceptive route without first exploring more deeply the causes of their symptoms. As a form of contraception, Implanon is extremely good and if a woman is having no problems on it, that’s great. It might be added that if you are bleeding constantly and feeling very depressed, sex is truly the last thing on your mind, so it’s little wonder it works so well as a contraceptive device!!

In the week prior to removal, I started bleeding, even with the assistance of Utovlan. I haven’t actually stopped yet, yesterday being particularly difficult. I am hoping that eventually my body will settle back into its own natural cycle. I have finally been told by my doctor that I have a retroverted uterus (tipped backwards); this might certainly explain the severe menstrual pain I have suffered my entire life. It has also meant that my doctors now feel it important to check if the retrovertion is natural – i.e. the way I am built – or being caused by something else. At last, I might actually get some answers. It strikes me as rather depressing that despite the severity of my symptoms I have never been referred to a gynaecologist and have never been tested for endometriosis. I think after the misadventure of the last few months, it’s now about time that I was.

My advice to women who are suffering from negative symptoms since having Implanon fitted is to not be afraid to ask to have it removed, particularly if it is affecting your mental health and well-being. The makers of the implant themselves recommend that it is not fitted in women who have had a previous history of depression. I have been alarmed at how quickly my emotional well-being crumbled once the implant had been inserted. I have also found that since its removal, despite the heavy bleeding of the last few days, I have at least felt like I can cope psychologically. This alone is so vital if you are dealing with health issues; if both your body and mind become fragile, it is so much harder to retain one’s resilience.

The other point to remember is that devices that are fitted within the body like Implanon inevitably mean that your control is taken out of your hands if things go wrong; you are dependant on others to remove it, unlike taking a pill which you can simply stop. It’s important to think about this. Many doctors seem to want women to persist with the implant in the hope that symptoms will settle. If it hadn’t been for this, I would have asked for it to be removed long before it was. It’s important to remember that it is your body and if you truly feel the implant is making you unwell, you have every right to have it removed.

I had also been feeling a spiritual crisis over these last months. This I now put down to the implant too. It severed my connection to the world around me. I found it very hard to feel anything, as if my ability to be stimulated and moved by my environment had closed down. In the last week, I have been noticing how beautiful everything is, being touched and moved by what I am seeing. How awful that something that I was given to help me, actually cut me off from myself, my world and my sense of spiritual belonging.

I don’t write any of this to frighten or alarm. I think that things probably have to be tried and that each individual response will be different. And yet, I also think it is important to understand that there are very real risks. Despite the uncertainty I face at present, I feel so grateful to be implant free, to be liberated from the emotional and mental fog that has engulfed me for weeks.

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Gratitude Amongst the Chaos

March 26, 2010 at 12:00 pm (Uncategorized)
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A moving highlight of my week was Julie taking our Yoga class for the first time since her son’s tragic death in January. At one point Julie talked us through a healing breath, centring ourselves in our heart chakras, asking us to focus on the gratitude we feel for the love and blessings we have in our lives. Given what Julie has endured over these last awful weeks, I felt humbled and touched. With extreme loss and grief, it can be so easy to slip into bitterness, to feel cynical about being thankful when someone you dearly love has been taken from you. To be guided by Julie to open to gratitude was a lesson for me and it moved me greatly. Julie is going through an incredibly tough and painful journey right now but her willingness to stay open to love inspired me. She is an amazing person and I feel grateful and blessed that our paths have crossed.

Crises, loss, grief, ill health, all teach valuable things. Staying centred in our hearts, keeping open and not closing down on life can be a challenge when we are hurting and afraid. If we trust in gratitude, regardless of the loss, we can find strength. It doesn’t necessarily allow the pain to ease but the sense of meaning at the heart of that difficult journey takes on its own depth, and I suspect is the seed of future healing.

I lowered my Utovlan dose at the weekend to only one tablet a day. I had already dropped to two and my doctor had advised me to stay with this dose for a few weeks before dropping further. Sick of the way the drug has been making me feel – extremes of tiredness, mood swings, depression, anger and interrupted sleep – I made the decision to drop the dose sooner. Within a day I started to feel so much better psychologically. I could feel this lifting and brightening in my head. I suddenly remembered what it felt like to be me and how scary it is that a drug can have such a drastic impact on our personalities. It became clear that Utovlan has been making me feel ill physically and psychologically.

The joy was not to last. Within a couple of days I started bleeding again and this has continued. It is clear that at present one tablet of Utovlan is not enough to overpower the Implant. It is also clear that after three months, the Implant has not settled down. I am being told to be patient, to wait out the six months but deep down I suspect that Implanon is never going to work for me.

I have upped my Utovlan dose back to two after wrestling with the choice of what was worse: constant bleeding leaving me low and depleted or Utovlan leaving me low and depleted but blood free. It’s Hobson’s choice really. For the last couple of days I have felt wretched physically and emotionally. It is obviously going to be a massive challenge for me to hold out until June and the only thing that is keeping me going is remembering Julie and her bravery.

Compassion and love are such powerful healers; I haven’t felt nearly enough of either of these things towards myself of late. A great deal of what I am feeling is obviously being exaggerated and distorted by the Utovlan which is why it is so important to hold on to that fragile thread of my true self that is being submerged by the hormonal chaos that is happening inside me. Via that thread I need to take care of myself, nourish myself and keep open to the blessings that Julie so poignantly reminded me are always there in our lives, no matter how awful things might feel.

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Bodytalk

February 15, 2010 at 7:45 pm (Uncategorized)
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To understand the body, we have to be the body. We have to be its pain, its pleasure, its fear and its joy. To see the spiritual being as separate is to cut ourselves off from our ground, our root, our home. – Anodea Judith

So much of my Blog of late has been taken up with me venting my frustrations about my current physical predicament. My Implanon ‘journey’ is rather dominating my life at present. Reading the above quote, as a Pagan, it articulates exactly what I feel to be true. What is interesting about my current physical symptoms is that I am challenged to really embrace this idea in its totality– it is easy to delve into our material selves and live them fully if we are experiencing pleasure and joy, a little harder if we find ourselves caught in a body that is sick or ailing. Of course, for all of us, our lives will at some point include experiences of fear, pain and illness. We will all have to face this dilemma at some point. As with most challenges, it is how we respond that makes all the difference.

After only a week’s break, I started bleeding again after having bled for fourteen days straight. After about four days it seemed to be lightening and I had hopes it would finish. The unpredictable nature of the implant had the flow suddenly becoming heavier again and here I am, another fourteen days later, still bleeding and no sign of it stopping. Out of six weeks of the implant, I have bled for a whole month of that time. The face staring back at me from the mirror this morning had the pallor of the Bride of Dracula – thank the gods for blusher! I have been trying to take care of myself: extra iron, eating well, resting and yet I still feel physically exhausted and mentally vague and flat. The only blessing in all of this is that the implant seems to have stopped the intensely painful cramping that has been such a signature of my periods. Hurrah for little victories!

I am my body and this is where I am at present. The human, fragile part of me feels a little caught between the proverbial rock and hard place: if I have the implant removed, I go back to not only fourteen days of heavy bleeding a month but also vomit inducing and persistent pain, an unhealthy level of painkillers and the fear of worsening symptoms; of being housebound; of not be able to sleep through the night because of having to rush to the loo a billion times; of feeling so insecure each time I leave the house for fear of flooding; of fearing that people might misunderstand my distance; of feeling cut off and tired so much of the time. If I stick with the implant, I have what seems like endless bleeding but little pain and an uncertain future. It might be that in a couple of months it will all settle down – the doctors advise waiting – and yet I wonder how much stamina I have got for this. No one is built to bleed continually.

I have no idea what to do and my best strategy is to wait – not sure what choice I have at the moment. It’s a strange place to be and I desperately want to trust in a happy outcome. My resilience is wavering, which is the scariest thing of all because if I stop being buoyant, I sink. Maybe in truth I need to sink; maybe what my body wants is for me to acknowledge its hurt and pain and stop trying to rise to every challenge. I have this inner, punch drunk warrior self that just can’t help itself taking up arms and feeling like it has to be heroic against the odds and if it isn’t all will be lost. I feel sure that the answer to all this will be found in my body – bodies articulate and speak a greater truth about where we are – there is no self-deception in the language of the body. Let’s hope I can listen well.

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From Uncertainty to Trust

January 20, 2010 at 4:52 pm (Uncategorized)
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The bleeding continues – it has steadied and shows absolutely no sign of changing. It’s been seven days – certainly I’ve menstruated for much longer before but this feels different, like it has set in for the long-term. It’s manageable although the constant ache in my groin has become a little wearing over time.

When the doctor fitted the implant, he told me that if I was one of the women who suffered ‘break through’ bleeding or worse, I could take Utovlan to control it; this for many women helps them until the implant settles down – that is the hope anyway.

This morning I sat staring at the Utovlan box next to my bed wondering if I should take one. I have had these tablets for months, since the failure of my Mirena coil fitting. I had been given them in an attempt to lessen my flow; taking them had stopped the bleeding completely but coming off them felt hormonally hellish and the excessive bleeding merely started again the moment I stopped. The rather girly and innocent looking pink and white packets of pills have been gathering dust on my bedside cabinet ever since.

In my last post I spoke about acceptance; today the topic of the moment is trust. Despite the fears I have of what the hell all of this synthetic progesterone will do to me, this morning I had the strongest urge to take the Utovlan. I don’t know if this is being driven by a sense of desperation or it’s my intuition prompting me. I feel completely at the mercy of something beyond my control at present.

I again trawled through page after page of medical message boards relating women’s experience of bleeding with the implant. I felt utterly envious of the women who were period free and feeling fine on it – up until a week ago, so did I. Many with ‘break through’ just gave up and had the implant removed but many more found that their symptoms settled over time. So, despite it all, I feel like I must give the implant a chance to work.

About an hour ago, I went with the urge and took one little Utovlan – time will tell. Noticeable, the pain in my groin has gone, so I am hoping this is a good sign. Reading about women who have been bleeding non-stop for months, I am ready to try whatever I can to prevent this from happening; I know from my recent problems how physically and emotionally exhausting an experience this would be. I need a physical break from it – yet more bleeding fills me with dread. I knew it was a risk but my choices had started to dwindle and so my journey with trust really does start now in earnest. I am placing myself in the hands of a little plastic stick, a tiny pill, my poor old beleaguered body and whatever other forces in life there might be to get me through this.

I keep thinking of the trauma my mother went through, particularly in her forties. She had the added problem of multiple fibroids. The sight of lots of blood was something I got used to very early on because mum suffered so. I now feel that the years of blood loss related anaemia, the fainting fits, the panic attacks and the emotional and physical exhaustion that excessive bleeding brought my mother, might well have been an aggravating factor in her early demise. I have become my mother; these are her symptoms but this is my body and I am me and I feel that for both of us, I have to find a better way through than just to suffer with dignity. I am too impatient to be dignified!

I am being forced to open myself to possibilities that, until now, I have been stubbornly resistant to. This in itself is an interesting and useful process – so much of our thinking defines what is good or bad for us, not necessarily based on fact or experience but on the peculiar prejudices that our minds build over time, through fear and defensiveness. The ‘unnaturalness’ of synthetic hormones and their impact on women’s reproductive and hormonal health has always bothered me; it feels ironic that I am now in such a state that I am prepared to embrace them like a pharmaceutical knight in shining armour – ironic but on some level a little liberating.

After moaning about the lack of certainty in life in my last post, at present – as I happily (well sort of!) down the Utovlan – it occurs to me that the gift of uncertainty is actually infinite potential and possibility. I guess it is up to each of us whether we recognise that we might have more choices than our fears and resistances allow us to acknowledge.

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Riding the Uncertainty

January 18, 2010 at 6:39 pm (Uncategorized)
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Riding the uncertainty of situations and working with acceptance have been the themes of my week. In reality, maybe they are the themes of every week but this one has seen them sharply defined and prominent, as if life is being very insistent that I take note.

It has been a few days of great sadness and frustration and also of little glimmers of hope too. On a global level, Haiti has been distressing and, like everyone, I have been wrestling with the tension between accepting that the earth is just doing her bit to keep the balance of life going (earth quakes are not judgements of an angry god but the planet’s way of keeping the conditions for optimum life ticking away) and feeling horrified at the human tragedy.

Closer to home, I heard the shocking news that a friend’s son had been killed. He died in a seemingly insignificant accident that he should have walked away from unscathed. It struck me how one unremarkable moment and one small decision suddenly produced the most momentous and tragic consequences. I cannot begin to imagine what my friend must be going through; the death of one’s child is the most profound of all losses.

The night I heard about the accident was also the night I started bleeding. After the implant had been fitted a couple of weeks ago and my period had failed to arrive, I began celebrating, rather prematurely, that the vomit inducing pain and the debilitating heaviness were going to be a thing of the past. It started with light spotting and has gradually become heavier.

My initial sense of panic was rooted in uncertainty. Was this my period finally arriving? Was it the implant playing havoc with my body (some women start bleeding and don’t stop for months!)? Five days later and still bleeding, I am hoping that this is just my period and that soon it will finish. I have been trying to comfort myself that – if I am merely menstruating – by my normal standards it’s a huge improvement. The relentless and intense cramping I usually encounter is absent; in its place is a griping ache in my groin which painkillers strangely won’t shift but the hot water bottle does, and although it has become heavier, the flow seems to have peaked and is no where near the amount that the last couple of months has seen me struggling to deal with. In short, it’s manageable and a step in the right direction, at least.

I would be fibbing if I said I wasn’t disappointed and I still feel a little nervous about the route this might ultimately take. Ideally, the implant and my body will eventually find a happy balance. I have spent some time checking out women’s experience of Implanon on the net and the symptoms are about as varied and contradictory as you could imagine. Each women responds differently; some stop bleeding – others can’t stop; some put on weight – others lose it; some get depressed –others feel more level; some recommend it with glowing praise –others say it was the worst decision of their lives!

Thinking about the events of this week, I feel myself resisting the fact that I must ride the uncertainty. As humans – bearing witness to the suffering that life can sometimes produce – I feel that we can forgive ourselves for, at times, yearning for security. Who wouldn’t be tempted to reach for certainty amidst what often appears as seemingly chaotic happenings with unpredictable and painful outcomes? From the deep sadness and tragedy of loss to the less drastic, but nevertheless irritating, curve balls of life, we can only ultimately embrace each moment as best we can; live it, trust it, feel it – and out of the uncertainty –actually probably because of it – Grace finds us, quite often just at that moment when all feels lost.

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The Little Stick of Happiness

January 4, 2010 at 6:29 pm (Uncategorized)
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In my post of 07/12/09 Learning to Love the Limitation, I wrote about my continued frustration with the severe menstrual problems that have been undermining my life and well-being. After yet another cycle where I heavily bled for almost two weeks (!?), I had started to feel a real sense of desperation and so went back to my GP just before Christmas. This year has seen the gradual breaking down of my mistrust of synthetic hormones. As I began to truly acknowledge how appallingly bad my periods had become – of how much of my life and sense of well-being was being eroded by such extreme symptoms – I began to open up once again to the possibility that they might provide a positive solution.

On the second to last day of 2009 I had fitted a progestogen-only implant – otherwise know as Implanon. It is a tiny match sized rod that is inserted under the skin in the upper inside arm. You are given a local anaesthetic and the procedure is over in seconds. Having chosen to have this done just before Xmas, I spent the days running up to my fitting referring to the implant as my ‘little stick of happiness’ – I figured I might as well be positive!

For the first couple of days after the fitting, my body wrestled with itself. My period was due and I was having all the symptoms of PMT but with a strange new undercurrent. The shedding of the lining of the womb during menstruation is triggered by the sudden drop of hormones in the body; this had already started to happen in my natural cycle this month but then suddenly progesterone was being pumped back in again. I could feel the confusion of my body. Laurie pointed out that I was being incredibly grumpy – both he and my Dad tip-toed around me – I felt emotionally brittle and I began to panic that I might stay caught in this premenstrual netherworld for ever; it’s not a great place to be– everything and everybody are intensely annoying and loosing a sock is a major world crisis! As the days have passed, my well-being has increased and the PMT has vanished. In fact, today I should have started my period and I don’t feel in the slightest that I will.

Implanon has a mixed impact. Some women find that their bleeding ceases completely, others bleed sporadically, while other poor souls have constant bleeding. Like the Mirena Coil, Implanon is another contraceptive device that has proved helpful in the treatment of severe menstrual problems. I have reached the stage when the thought of not bleeding at all seems blissful. The desire to have ‘normal’ periods has always been there but hanging on to some concept about ‘naturalness’ has only led me to feel more and more ill and run down by the impact of my worsening symptoms. Implanon was a risk (it could have made my symptoms worse) but my inner resources were running so low that to continue as I was, without taking that risk, felt a far worse fate.

I have never felt so well on what is supposed to be the first day of my period. I am now getting to grips with the possibility that I might not be having another one for three years (the life of the implant). It is a heady thought. All the things that have fallen by the way now have the chance to be reclaimed. I think I’m a little stunned! This time last month I endured the heaviest bleeding I had ever experienced. It was frightening and exhausting. How different today! This morning, I realised how much I psychologically hunker down at the first signs of bleeding and pain – every month stealing myself to cope with what is to come. I didn’t have to do that this morning and I really can’t explain how good that feels. The timing has been rather nice: a new year; a new decade and for me – perhaps (fingers and toes crossed in every possible way) – a new life!

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