A condensed text exchange from around 5:00pm on Tuesday, June 11th 2024:
me: Hey, so this is embarrassing, but I'm in the ER (haha) and I may have to cancel tomorrow. Just like, a head’s up. I read your manuscript today before I almost died, so I am ready to talk about it, but if I'm like, actually dead, then we should reschedule.
friend: WHAT omg is all okay?
friend: Totally fine to resched and do not be embarrassed.
me: I got my IUD inserted today and something is wrong because I couldn’t speak, I couldn’t feel my extremities. I am in the worst pain of my life.
me: Had to take an ambulance, which was so embarrassing. Like, imagine taking an ambulance because you’re hurt.
friend: Omg NOOOO this sounds so traumatic!!! I am so sorry!!!
friend: Your poor body cannot catch a fucking break.
me: Hey at least I’ll get a newsletter out of it! (I'm so mentally ill lol)
me: Omg imagine if nothing’s wrong though
me: They turned on the siren in the ambulance and I was like “Omg is that for me?” and the EMT was like “Yes” and I got so embarrassed.
friend: Being a human is embarrassing but that being said, your pain and the urgency to get you into a hospital to heal your pain is siren-worthy.
me: That’s a good subtitle, “am I siren worthy?”
friend: It’s funny to be having the worst pain of your life but still be like, “Please, I don’t want to bother the other cars.”
friend: LOL the newsletter is writing itself.
*
At 6:00pm, the OB comes into the room. She sits down on the rolling stool and glides over to my bedside.
“I'm glad you came in,” she starts, and I already know I'm going to need surgery.
This is what happens when people need to have surgery, when there’s not an easy fix. I hadn’t thought of this as a possibility. I thought, at most, they’d remove the IUD and send me on my way with a stack of thick menstrual pads and a few pairs of mesh underwear (being a woman is fun).
I got an IUD after much deliberation due to the lesions in my liver, the lesions that although they are benign, they could continue to grow and rupture, which would be bad. Getting off hormonal birth control (and not drinking or becoming overweight) are the only ways to shrink the tumors. Lesion is another, friendlier word for tumor. So after twenty plus years on the pill, I had to stop. My only option for medical contraception was the copper IUD.
I’d seen ads online for copper nose wands (my mother-in-law has one and swears by it) to prevent sickness. Copper is a powerful semi-conductor and is also known to help stimulate, energize, and promote collagen synthesis. Adding copper to your skincare regimen can also help combat wrinkles, tone skin, and improve elasticity.
A copper IUD prevents pregnancy by creating a toxic environment in the uterus that’s harmful to sperm and eggs. It’s a little piece of plastic, T-shaped with copper coiled around its frame. The IUD causes an inflammatory reaction in the uterus, a reaction that prevents sperm from surviving in the cervix or uterus and changes the way sperm cells move so they can’t swim to an egg.
I have many friends with IUDs. All of them have told me that while the insertion process is pretty painful, it’s very quick. Reddit told me the pain was worse than childbirth, which I guess I can’t fully understand since I had a C-section and didn’t technically push a baby out, but, like, I had back labor, which was horrible and I labored for two days. And a C-section is pretty rough, IMO. Reddit said that yes, there will be mild to severe cramping for the next few days, but to ride it out because overall it was the best decision lots of women made in terms of contraception.
The names of IUDs are all cute: Mirena, Kyleena, Liletta, Skyla—these all sound like pretty popular girls who are either really good at sports or who start their own coven on campus and put spells on other students. The copper IUD, however, is called Paragard, which sounds like maybe a new wave of technology, a software like Adobe or Microsoft. Not cute. But it was my only option besides ~tracking my cycle~ which would require me to trust an app on my phone, my phone that has told me for the last 4 months that it cannot reach the cloud and save my information properly. Cool!
Other Reddit users reported that their bodies rejected the IUDs, or some even said theirs migrated to other parts of their uterus. This can be detected by a pelvic exam or an ultrasound, and usually happens a few months, or even years, after insertion. But a misplaced, wait, that’s too nice, an improperly placed IUD will cause an immediate reaction. Cut to me almost passing out in my bathroom, dripping sweat, unable to speak, horrible diarrhea (sorry), hands numb and tingling and trapped in a claw-shape, feet on fire.
“I'm not joking,” I told Carl when he entered the bathroom. “Call an ambulance.”
*
There were scary areas of Reddit too, the posts where women said they deeply regretted getting an IUD because of all the pain it caused them, how the pain didn’t simply “subside” after a few days, how their periods were heavier, their menstrual cramps worse each month, how it wasn’t worth it after all.
But you’re not supposed to Google your ailments or look online for solace, because looking online usual confirms whatever narrative you’ve already crafted in your head and only solidifies your fears. So I kept the appointment. I showed up, took my 5mg tablet of Valium (prescribed by my OB), and then sat on the table, legs in the stirrups, and got the IUD.
The procedure itself was painful, but very quick. I felt like a bionic woman after. I was proud of myself and I thought this will make my life so much easier and it was totally worth it and all I need to do now is go home and rest.
Reader, I did not go home and rest.
*
Terminal uniqueness is a term usually reserved for people in addiction recovery. It’s a psychological phenomenon that describes the belief that someone’s situation is fundamentally different from others’. That maybe you are special, different, with experiences that are so unique, you might have the impression that you are not subject to the laws and rules that affect others’ recovery.
I.e. This will work for others, but not for me.
When you Google “terminal uniqueness,” there is an image of a sad dude looking out a window. Super bleak, babe. But I do appreciate the spirit of the photo because in my mind, terminal uniqueness carries a sort of cocky connotation, like as if the person is above everyone else. When really, what it feels like is the opposite.
One of my therapists told me to look into the term, as I had been describing that positive affirmations never work for me (funny because my Blogspot that I had for almost ten years was called Daily Ackermations). I always felt like, well these people will get to see their family members recover from addiction or these people will flow into their own arc of achieving happiness or these other people will find contentment, but something is deeply wrong with me and I will not.
I don’t write this letter, or any of my letters, for pity. The last few days, I’ve thought about why I choose to write, in detail, about my worst experiences, how I am mostly writing about the trauma. And I think it’s because I’ve lived to tell the story and I feel blessed to be able to share it. The writing truly is a gift, something I wouldn’t be able to do if I were…dead. And I'm not dead, so why not write?
I could have posted a picture from the hospital, which honestly feels like a missed opportunity. Something like, “Hey, guys, it’s me, I might die, send prayers, ttyl, love u!” Included in my discharge paperwork were a series of photos of the inside of my body (I won’t be sharing these, unless you wanna see! DM me!), photos of my punctured uterus, of the blood in my belly, and then some after photos post operation of a cleaned out organ, all tidy and new. The images remind me of Werner Herzog’s Into the Inferno.
The “terminal” part of terminal uniqueness makes me wonder, okay, so I have this feeling that I am beyond help, but to what end? Where does one go from here? Do I stay stuck in feeling like I’ll never recover, like I’ll never get to enjoy my life because of postpartum OCD, because of generalized anxiety, because of depression?
The thing about being told that you need immediate surgery or else you might die is that you are not unique. You are a person in a hospital bed, and there are many people in hospital beds that are told they need surgery or they will die. The feeling of “oh, but this doesn’t apply to me,” goes away. It does apply. You are actually not that special. You have to immediately give all of that up because now you are in the hands of the medical staff and, if you believe, which I do, in the hands of God.
You are all of those comments on Reddit, the whole spectrum.
*
I Zoom in for a Friday afternoon “Writing and Caretaking” seminar with Elizabeth Brogden. She guides us through an exquisite PowerPoint of how Motherhood came to be equated with the banal, how in comparison to say, being an artist, being a mom is seen as “less than.” Motherhood as mundane; art as cerebral. Over time, the experience of mothering has been recognized as irregularity and interruption; we are always asking ourselves, “What is the most important thing?” and the answer is never our art.
Elizabeth shares an essay by Sarah Manguso, “The Grand Shattering,” and discusses how those who disparage motherhood have “accepted the patriarchal belief that motherhood is trivial…They are taught, as I was, to value self-realization as the essential component of success, the index of one’s contribution to the world, the test of our basic humanity. Service to the world was understood as a heroic act achieved by a powerful ego. Until I’d burrowed out from under those beliefs, being a writer seemed a worthier goal than being a mother.”
Ego, exit stage left. New identity, take center stage. There’s also a corporeal nature to being a mom that is not present, for me at least, in being an artist. The way I felt so close to my baby when she was in my belly, how we communed, as cliché as that sounds. The act of caring for her does not mirror the act of writing. I can love something I’ve written and I can print out pages of a manuscript, but my daughter was conceived inside my body and grew from love and light and now walks on the Earth and she is real in the way a piece of writing can never be really real.
“The point of having a child is to be rent asunder, torn in two…It is a shattering, a disintegration of the self, after which the original form is quite gone. Still, it is a breakage that we are, as a species if not as individuals, meant to survive” (Manguso).
Elizabeth shares the gifts that caretaking can bring to art. With Motherhood comes valence, the ability to divide our minds, and a lightness that was perhaps not there before we became mothers. I find this to be true. Even in my daily musings, it’s no longer me but her, my daughter, that is at the center. The ego has been booted off stage (thank God) and with it has come vulnerability and empathy.
Elizabeth also notes freedom, and I virtually raise my hand.
“I have trouble with the concept of ‘freedom’ in mothering,” I say. “Because I feel like I'm still not there. That one just feels…difficult for me.”
One of the other participants raises her virtual hand in response.
“I see it as…writing is a door to freedom, and I can keep letting myself in.”
Writing is the door. Mothering is the room. Scratch that. Mothering is the whole damn house.
*
Another condensed text exchange from around 5:15pm on Tuesday, June 11th 2024:
me: I'm not going to lie, this is pretty awful, but I’ll be okay.
friend: Yes, I'm sorry you’re in the awful phase and I hope that you accelerate to the healing and happy place phase as soon as humanly possible
me: Thank you. I am channeling Palm Springs peace. Astral projecting myself to the pool.
friend: On the astral plane, I am fanning you with a frond and holding your mocktail.
*
IUD perforation of the uterus is uncommon, occurring in 0.1% of low-risk patients. Not unique, but “uncommon.” What’s more common is for an IUD to migrate weeks, months, or even years after placement. Or, sometimes, the body will reject the IUD. This can also take weeks, months, years.
My plan was to go home and rest. My plan was to ride out the rest of the Valium into a nap and hopefully feel better in a few hours. The cramps were intense, but the Internet said they would be. My doctor said they would be.
But as I lay in bed and tried to get comfortable, it was impossible. The pain got worse and worse and I wondered how much was “normal.” How much is one supposed to endure?
And then the bathroom and the almost fainting and then the last words I was able to say to tell Carl I needed an ambulance and then the ambulance arrived and the EMTs came in and I wasn’t even wearing pants and Carl put all my things in a tote and one of the EMTs found a pair of shorts for me to wear and put my Croc slides on my feet and we hobbled to the stretcher and they strapped me in and I had only seen ambulances on my street before for other people, not for me, and then the doors closing and the heart rate monitor and blood pressure cuff and moving backward through traffic and wondering what my daughter is doing at school and calling my mom and how did shoes get on my feet and is this a mistake because maybe I’ll just feel better soon and then hearing the siren and realizing the sound is for me.
*
The OB tells me I need surgery. Tonight.
“Will it be you?” I ask, hoping it will be. I trust her for some reason. Her hair is in a low ponytail and I make a mental note to wear my hair in a ponytail more often. I really need to change up my style a bit, I think, as I sit in the hospital bed wearing a blue and white zigzag patterned gown, my hair drenched in sweat, the sheets stained with blood beneath me.
“Yes, it’ll be me,” she says, and it only brings a little relief.
I flash back to this morning, my doctor entering the room for the IUD insertion procedure, her telling me, “Don’t worry, you’ll be fine!”
A nurse comes in to start an IV. My blood pressure is 146/90. My pulse is 150bpm.
I say I need to call my husband and the doctor says she’ll talk to him, she’ll explain. And she does. And I cry while she talks and I try to hear what Carl is saying back to her, and then she hands the phone to me and he says he’s putting the baby down and will be at the hospital as soon as he can. His sister is coming over to stay and help. I feel blessed by this orchestra of care. We hang up and I ask the surgeon if she’s confident that I’ll be okay.
“I am,” she says. And there’s no way to tell if she’s putting on a show or if I really will be okay. When you hand your body over to doctors, there is no guarantee that they will hand it back.
She leaves the room and I call my mom. I call my dad. I call my brother. I call my best friend. She says, “I am there with you. You are not alone. I'm right there with you.”
The one person I want to call most, I can’t. I think of this morning, dropping my daughter off at school, how I’d slathered sunscreen on her legs and dressed her in her bathing suit for water play, the pink bathing suit with the flowers, how one of the other dads was there dropping off his daughters, twins, and he’d said to me, “water day!” and I’d said “a perfect day for it!” in passing like two parents do, how I hadn’t thought anything of it, placing her on the floor of the classroom as she walked toward her friends, toward the rest of her day, and how I’d turned around and walked into my own future.
Carl arrives right before they wheel me off to the OR. He sits with me in the prep area as the nurses and doctors explain things to us.
“By the time you get to the operating room, you won’t care,” the anesthesiologist says, and it’s true. All I remember is one of the male nurses leaning over me, his necklace, the charm, a gold bushel of flowers around his neck against his navy blue scrubs.
“What a beautiful necklace,” I said and then was out.
I know there were two nurses in the recovery room when I woke up and I know one of them had a bag from Chopt on the check-in counter and I don’t remember either of them removing the IV or being transferred to the wheelchair or getting in Carl’s truck. I remember hugging my sister-in-law when I got home. I remember that it burned when I peed and Carl saying, “You had a catheter,” and I thought, Oh, okay. I remember asking all the hospital staff if they were mad at me for having to do the surgery, especially since some of them had already left the hospital and had had to turn around and come back just for me. I remember being grateful that our daughter wouldn’t remember any of this, didn’t even know it had happened, how she’d almost lost her mom.
I remember asking if I’d see the OB Surgeon again and being told no, and realizing that there was no real way to thank her, and realizing she was just doing her job but that I still so badly wanted to thank her.
I’ve been having trouble sleeping through the night and I will Google her name and find a picture of her with her hair down and I will say Thank you to the picture, which is just an image on a screen in front of my face and not the person who saved my life.
*
Inpatient Encounter:
Encounter Reason: PERFORATED IUD, HEMOPERITONEUM
Encounter Diagnosis: Essential (primary) hypertension
On ultrasound, there was noted to be a perforated uterus and complex free fluid noted within the pelvic cavity. At that point in time, the decision was made to proceed on to the operating room. The risks, benefits, alternatives and the possible complications were explained to the patient. She expressed understanding.
*
9:00am on Wednesday, June 2024:
friend: Thinking of you this morning, still just beyond sorry that Reddit was right and yesterday became what it did.
*
“On a scale of 1-10, how would you rate your pain?” the EMT asks. She’s sitting behind me and I can only hear her voice as the ambulance drives through West End.
“Is it bad to say an 8?” I ask. “Like, is an 8 too high?”
“If you’re in pain, and it feels like an 8, it’s an 8,” she says.
The truth is, I'm not in as much pain anymore as we drive, that I'm actually feeling a little more stable and wondering if this was all a big mistake, me overreacting, again, like I always do. How embarrassing! I guess they’ll tell me that the IUD is fine and that they can remove it if I want, if I'm too “uncomfortable,” is what they’ll probably say, and then I’ll have to decide if the pain is worth it or if I want to quit, quit is not the right word, maybe give up, give up on this being an option for me. I feel so stupid.
But so many people are able to deal with pain greater than this, greater than an 8. So many women have IUDs and can get through it. So many of them say it’s the best decision they’ve ever made.
“It’s an 8,” I say, not very confidently.
*
Before I go into surgery, Carl shows me our baby monitor app on his phone. Our daughter is fast asleep, her elephant lovie tucked underneath her arm. Honestly, what the fuck else matters besides her? Literally nothing.
The next day, I Zoom with a friend and tell her everything. Her face contorts when I explain how an IUD is supposed to be properly placed, and then how mine was done. “I'm obviously not the poster child for IUDs,” I tell her and I'm grateful that she’s listening, that she’s not totally horrified that I'm making jokes now on the other side of yesterday. I'm grateful to talk to her, to tell her this story, to write and tell this story, to walk through the door and to keep choosing to walk through the door.
“You know,” I tell her, “I spend a lot of time wondering if I want to be on this planet. And I do, I really do want to be here.”
*
My lips against my daughter’s cheek. This is how I let myself in.
—
This Friday, I will be reading a piece at Creative Mornings in East Nashville as part of an event that will be equal parts talk by the wondrous Yurina Yoshikawa, and workshop! Registration is free and the theme is PATTERNS!!
The next Snack Time: Writing Between Meals is on Thursday, June 20th at 12pm PST/ 2pm CST/ 3pm EST!! Reply to this email to register :)
So glad we shared a tiny moment at Elizabeth's presentation. And so glad you are recovering! Hearing your story, besides all the awfulness and trauma, what came to mind is that medical phrase "when you hear hoofbeats, think horses not zebras." Between my husband, me, and my son, we've had way more than our share of hoofbeats, and I'm starting to think we might be zebras. Somehow it helps me to think we're zebras rather than focusing on how little doctors know. They can be amazing in a crisis, but the rest is such a gamble.
I am so glad you’re still here 🤍 and I really need to hear more about Daily Ackermations