ARGH!

I just need a freaking IUD!

Today was my second visit to a gynecologist in two months. Not because I've got any "women's issues", but because I'm on a tetragenic drug that is so bad for a fetus/embryo that it has a special administration program associated with it that requires me to use two methods of birth control.

Now, I'm already on Depo-Provera. It was my last option after I had my pulmonary embuli back on '03. Estrogen can cause blood clots and we don't want to go increasing my risk of developing one when I've already got so many other things that could. So most hormonal forms of bc are out because practically all of them contain some form of estrogen, but I had to be on something because the blood thinner is also tetragenic. Depo is estrogen-free and therefore, okay for me to use, marginally. It still isn't the best thing to be using when you're taking prednisone because both can cause bone loss - so I have to take lots of calcium and vitamin D and a great new drug that I get infused via IV at my doctor's office once a year (even with all of this, I still have osteopenia, the stage of bone loss before full blown osteoporosis).

So up until the PAH diagnosis and treatment, I had the birth control thing all worked out. Now I need a second form that doesn't interfere with any of my drugs and won't cause blood clots. I'm just not a "barrier method" girl. First of all, I don't trust them. The failure rate of every single barrier-method form of bc is far from what I would find acceptable. Second, they're icky. Yeah, I said icky and yeah, I know that's silly, but I just can't deal with spermicide or used condoms or any of that icky stuff. I need another form of birth control that is hormonal, but acceptable.

Now I mentioned to both of my pulmonologists and my rheumatologist that I wanted to go on Mirena to fulfill the requirements of this drug program. None of them even raised an eyebrow. The level of hormones in the IUD is so low and the risk of forming a clot with my anticoagulant level where it's supposed to be that they have no problem with it. Finding a gynecologist that understands my medical situation and is comfortable enough with it to actually prescribe and administer the IUD is another story. And that is why I spent the whole afternoon driving to Northeast Philly only to be told for the second time that the doctor feels that my medical profile is just too complicated for them to prescribe Mirena and they think that I should go with ParaGuard because it has no hormones and won't interact with anything. And that would be fine, I would try it out even though it carries a higher risk of increased bleeding and longer more painful periods. Hell, I might not even get any of the side effects because I'm already on the Depo; HOWEVER! my health insurance will not pay the six hundred dollars that the ParaGuard goes for. I'm unemployed, have been for a year, wasn't even making a substantial income before that and don't anticipate anytime in the forseeable future that I will be earning any money. I don't have six hundred dollars lying around so that I can "try out" an IUD and see if it works for me. If I knew it was going to work, that this would be a great form of birth control for me for the next ten years, I could swing it. If three months go by and I'm having my period again and having a bad period like I used to before the pill and the Depo and we have to pull this thing out and start over, I can't swing it.

ARGH! Nothing can just be simple.

I'm going to try to get my pulmonologist to pull some strings at Temple Gyn and get me an appointment before the mid-November one they offered me over the phone. Hopefully the possibility of a pregnancy killing me will be enough to get them to squeeze a bit.