Dr. Strangelove, or How I Learned to Stop Worrying and Love My IUD (And the ACA)

Photo: (CC) Sarah Mirk

One of the thing I’ve been told throughout my career is to hide or dismiss any talk of medical issues, either because of insurance risks or discrimination based on a Google search and seeing chatter about different illnesses you have. I personally think it’s bullshit, but sometimes, you have to play the game. Now with the Affordable Care Act in danger, I’ve stopped caring about what people read or decide in terms of my health because the ACA has helped save my life in more ways than one, and that includes in reproductive health.

For example, one of the things I hid for years was the fact that every time I had a period, for 3–5 days at a time, I’d have to cancel everything because my body was at war with itself — extreme cramps, heavy periods, migraines, increased nerve pain from my Fibromyalgia, extreme exhaustion….it was an uphill battle.

For a brief personal history lesson, I started my period when I was 14 on the day of my eighth grade graduation, and even from the start, it wasn’t normal. I had a 14-day period that was incredibly heavy with cramping and I was miserable. I would then go on to have irregular periods for two years — sometimes 3 light days, sometimes 17 heavy days — and lost my period for 18 months when I was 15 years old.

When it started back, I had a 33-day period. Yep. Thirty-three days. The worst part was that I was going through an economy box of Super Plus tampons every day and it was a total nightmare. It finally calmed down again, but then I lost my period for another two and a half years with no explanation. My hormones were normal. I didn’t have fibroids or cysts on my uterus or ovaries. My body just decided not to have one. When it came back for real, that’s when hell began. My body just finally gave up and went into white-knuckle mode.

Besides having irregular periods, my cramps were so severe I couldn’t move. My “Fibro”, already flaring, would get so bad clothes would hurt to wear. CLOTHES. My brain would feel like I was splitting in two. Getting out of bed? Good luck. I’d have to cancel auditions, meetings…if I booked a job, I would take the maximum amount of my prescription anti-inflammatory medication (that would barely touch my cramps, mind you), and fake my way through it, and then the moment I could, I’d run back to my trailer and collapse on my couch in the fetal position. Bottom line, it SUCKED.

After going to my primary doctor, I went to a gynecologist who put me on the lowest of the low-dose birth control pills. But within two weeks, my already bad depression was worse, I gained five pounds in two days, I retained water to the point my shoes wouldn’t fit, and I was crying the moment I woke up every day. I immediately requested off the birth control pills as it wasn’t helping and at the time, it cost $50 a month with the health insurance I had.

Did I forget to mention this was all before the Affordable Care Act came into play?

So let’s rewind again. Even though I’ve had health insurance since I was born, my original policy aged me out when I was 23 years old and still a senior in college. Right before my health insurance lapsed, I was in a severe car wreck where I was lucky to survive it with only minor injuries. However, because my insurance lapsed, I had to wait to get treated for the neck and shoulder sprain and whiplash I had until I could get back on a policy a month later (which we fought tooth-and-nail to get me on because of my pre-existing conditions). I still have residual damage from the delay in treatment.

Going to doctors for everyone in my family was costing a fortune out of pocket, and I delayed seeking a new gynecologist because I felt so bad about the costs. Also, I had other medical problems to be addressed, like how I contracted Parvovirus B19 and worked while I was sick and needed to see an Infectious Disease Specialist. Parvo turned into Chronic Fatigue Syndrome on top of my Fibro and chronic joint/pain issues, and those required numerous medical tests and scans. Reproductive health was just not going to be an option for me to pursue at that time because of other health things that cost money, and so after getting off the birth control pills, I just continued to white-knuckle my debilitating periods.

Then the blood clots happened.

I’ve written about my blood clots before, but long story short, I had surgery a couple of times and after the second surgery (with preventative measures to make sure I wouldn’t have them!), I developed blood clots without knowing I was a ticking time bomb for six months (SIX MONTHS). This was still before the ACA so when I found out I had them, and the medication was still new on the market, I was paying more than $300 every 21 days for blood thinners. Because of the Xarelto, fromwhich I had every side effect imaginable, my period was more often present than not, and involved the worst cramps you can imagine. It was hell.

After the all-clear and having more funds to take care of other problems, I visited another gynecologist who COMPLETELY ignored the fact that I had a history of clots and could no longer take anything with estrogen for the rest of my life. She wanted me to go on the pill. I ran out of there so fast, I’m pretty sure they still don’t have a complete address and phone number on me.

Before the ACA, my pain prescription was $75 a refill. When the ACA went through, I went to go refill my pain medication because I had my period unexpectedly (notice a pattern?) and was doubled over in pain from cramps.
It was zero. I had to double check and ask.

“No, the ACA made it zero co-pay.”

I called my doctors. Made appointments and asked questions. My co-pay now was $20 a visit ($40 for specialists, like my hematologist). Medications like Xarelto? Zero.

I finally realized I could try to find another gynecologist as it was incredibly affordable now (which was pretty well timed as I was in a new relationship and needed to get screened for STDs again anyway).

I found a new gynecologist covered by my insurance and the ACA who, from the get-go, is one of the best doctors I’ve ever had. The first visit, I sat in her exam room in my pink paper gown waiting for her, and when she came in she was incredibly bubbly, not much older than me, and ready to listen.

As a bisexual woman, one of the other things I‘ve run into with prior gynecologists is that they didn’t really ‘get’ women who were not straight and in hetero-normative situations. My previous gynecologist was the first medical provider I disclosed to that, at the time, I was questioning my sexuality. She pretty much looked at me like I was speaking Icelandic. That reaction makes it SUPER difficult to want to disclose sexual identity. But when I started talking to my new gynecologist and disclosed I was bisexual, she didn’t flinch and said “Okay great! What do you use for STI protection? Condoms, dental dams?” and I was like WHOA GIRL THANK YOU FOR KNOWING TO ASK AND REACT ACCORDINGLY????? It was surreal.

As she continued to ask about my medical and menstrual history, I mentioned my previous experiences with gynecologists and she looked horrified.

“She IGNORED the fact you had blood clots and told you it doesn’t matter if you go on estrogen?! WHAT?! No. You can’t. Like, that’s impossible. Let’s talk about options that DO work for you. You can’t live life the way you have been with your period being the way that it is!”

She then presented different options to me and finally said, “So I think the best thing for you would be the Mirena 5 year IUD. It’s progesterone-only, minimal hormones go into your bloodstream as everything is localized, it’s great to reduce cramps, and yeah, it’s the best option for birth control as well. You just set it and it’s good for 5 years.”

“How much would it cost to get?”

My gynecologist smiled. “Well, because of the ACA, we just have to send out a referral and it’s covered. It’s free.”

FREE??????? FREE???????

I couldn’t make the appointment fast enough. The next month, I had my IUD inserted (which I live-tweeted) and although that first month was hell and I had spotting for three months, I’ve now been in minimal-cramping, light (or none at all!) period bliss for over six months. I can’t imagine life without my IUD and I don’t ever want to.

This is only one story about how the ACA and access to good reproductive health care have changed lives. Reproductive health care is about choice and access. We need the ACA and places like Planned Parenthood so we can afford the basic human right of health care, including for reproductive health. We have to keep fighting for it, even when anti-choice and anti-ACA politicians wage war on us. The ACA isn’t perfect but it needs help to grow and survive, not be repealed and leave millions of American lives in the balance without a replacement.