In search of a mirena coil

“Look at the screen” Dr Brew said. I turned to my right and looked at the screen. I felt a sudden rush of excitement. “Look over here. Can you see that?” He pointed to an area on the screen that looked like an upside down triangle with rounder softer edges. “ That’s your womb. And over here, that’s the membrane of your womb”.  In response I could only say, “Wow”.

“So everything looks good. I’m just going to do a vaginal probe”. I watched as the Dr removed a long narrow phallic like device from the back of the machine he had just scanned my womb with. He smeared some lube on the device and rolled a condom over it. Surely he should be putting the lube on the outside of the condom I thought.  “Just relax, it will be a little uncomfortable but not painful” said the Dr. I tried as much as possible to relax – as relaxed as you can be when you’re lying on your back with your legs wide open in front of a man you don’t fancy. “So I’m just going to need to move this around a bit so I can see everywhere”.  I could feel my vaginal muscles tighten in response to the probe. Relax Nana, I reminded myself.  “Ah. Look at the screen. Can you see that?” “What’s that?” I asked. “You’ve got a tubular fibroid right here,” he said pointing to a small cylindrical shape on the screen. “But I’ve seen 3 gynaes and they all said I don’t have fibroids” I said. “This didn’t show up on the scan so maybe that’s why they didn’t see it. Or maybe you didn’t have the fibroid when you saw them. The fibroid is pressing on your membrane. This could be why you have such heavy periods.” I wasn’t shocked to hear that I had a fibroid. I heard years ago that 50% of black women get fibroids and concerned about my heavy periods and distended belly I had gone to see Dr Akwei who practiced at the Ferry Lane clinic in Tottenham, North London. “What makes you think you have fibroids?” Dr Akwei asked? “Do you have…” he reeled off a dizzying list of symptoms… “Well I have very heavy periods and my stomach is always big no matter what I do. “Maybe you’re just fat” he responded. “Lie down on the bed”. He massaged my stomach. “Do you have any pains here? How about here? Do you feel anything here?”  I shook my head. “You have no fibroids,” he concluded. That initial diagnosis had been given over 12 years ago but in the past year ago another Dr had also come to the same conclusion. Dr Brew continued to move the vaginal probe from side to side, as I tried to relax. “I can only see one mass”. That’s it he said as he removed the probe from my vagina. “We’ll go to the room next door so I can examine you on the bed properly”. He indicated to the room through the half way open door and went in the opposite direction. I knew he was trying to preserve my modesty by allowing me to walk to the room next door without revealing my bare buttocks dressed in one of those ridiculous hospital robes which only cover you from the front and are secured with ties at the rear. Ei! What am I supposed to do with the stirrups on this bed? I wondered. I lay on the bed and tried to figure out where to put my feet. Dr Brew walked in. “Your feet need to go here” he said as he slid my feet into the stirrups. “Scoot down, scoot down. Scoot down some more”. I was now lying on the bed with my bottom dangling on the edge of the bed. The angle of the bed was such that the top half of my body lay lower than the bottom half which was raised for the viewing pleasure of whoever stood at the end of the bed. Random thoughts of horses and slavery flashed through my mind. “This is a speculum,” the Dr said as he picked up a silver coloured instrument. “I’m going to use it to have a look inside. It will feel a bit uncomfortable”. I looked back up at the ceiling and saw cobwebs, and 3 spiders. “You’ve got cobwebs on your ceiling Doctor” I said. He looked up and laughed somewhat embarrassed. “I’ll have that cleaned. I haven’t been in here for about three weeks. Normally the nurse does pap smears in here.” I couldn’t help saying, “And I guess you never lie on this bed yourself”. He laughed again. “Please allow me to call the nurse in. I will need her to mix a solution for me. I can see lots of white bits which I need to clean”. Earlier on when the Dr had seen me in his consulting room he had asked if I had wanted a chaperone whilst he examined me. I had turned down the offer. He had also apologised for being two hours late for our appointment explaining that he hadn’t saved my phone number so had been unable to call me to move our appointment when he found out that he had an exam to invigilate.  Dr Brew was the third gynaecologist I had been to see in a year. It’s not very easy to see specialist doctors in Ghana. Most of them work in either the Korle Bu Teaching Hospital or the 37 Military Hospital. To make extra money, and to provide a much-needed service a lot of specialists also consult at private hospitals and clinics or run their own private health institutions as a side venture.  The first Dr I had seen about my heavy periods wondered why a beautiful woman like myself was single and offered to give me a baby. The second gynaecologist had diagnosed me with poly cystic ovarian syndrome (popularly known as PCOS), abnormally high testosterone levels for a woman, and said since I had no children I would need to convince him before he would fit me with a mirena coil. This was in spite of my desire to use a non-chemical based contraceptive that would reduce the heaviness of my monthly flow. All the Doctors I had seen about my gynaecology in Ghana seemed to be in an unholy alliance with my mother – “Don’t you want to have children?” “Think carefully about whether you want a mirena coil fitted and then come back to me”, and my personal favourite, “How come a nice woman like you isn’t married.”

My mother is desperate for me to have children. She vacillates between trying not to pressure me about being a 34 year old woman who has no children, to convincing me that the best thing I could do right now is to have a child. She’s even offered to raise my child for me. All I need to do is fall pregnant. She’s clearly given up on the idea of me securing a well to do husband with whom I could have her grandchildren. I’m somewhat amused by this. My memories of my Mum growing up include us watching Obra or Osofo Dadzie on Ghana television. Inevitably a young girl who had a boyfriend or Sugar Daddy would fall pregnant, drop out of school and live unhappily ever after. At that moment my Mum would inevitably go “Aha. You see what happens when you mess around with boys. You will fall pregnant, drop out of school, and as for the boy dier he will continue his education.” That admonition rang in my ears for a long time.

The nurse came into the room and walked to a white cabinet in the corner of the room. From the direction I was facing, she now stood a little bit to the left, and behind the doctor at the foot of the bed where my vagina remained open to their gaze. “Shall I use the vinegar?” she asked the Dr. Yes, he responded.  He placed the speculum in my vagina. I could feel him open up the instrument and felt the walls of my vagina stretch. He was right, that was definitely uncomfortable. Way more uncomfortable than the phallic vagina probe with the lube on the inside of the condom. I told myself to relax and looked at the ceiling. I hope these cobwebs don’t fall on my face. Are the spiders dead? They don’t seem to be moving. I could feel the Dr swab the inside of my vagina with the vinegar solution the nurse had handed him. Gradually he tightened the speculum and removed it from my vagina. The nurse left the room. “That’s it. That was a basic test for cervical cancer but everything is fine. You have a bacterial infection. Your cervix is covered with mucous.” I looked at him in surprise. I didn’t even know he was testing me for cervical cancer. I had told him about the colposcopy and loop excision treatment I had a number of years ago. Every year since then I had faithfully done a pap smear and confirmed to Dr Brew that my last pap smear had been within the month. He must be really thorough I thought. I’ll give you some time to change and will see you in the consulting room he said as he walked towards the consulting room. I changed quickly and easily into my gray peplum dress. I had given careful thought to what I would wear to the gynae. I didn’t want to wear anything that showed cleavage or could be construed as sexy in any way even though my high-necked blouse and knee length skirt hadn’t deterred the Dr who had offered to impregnate me.

I walked into the consulting room and sat in the uncomfortable straight-backed chair that seems to be standard issue for all doctor. “I’ll give you some medicine for the bacterial infection. You wouldn’t necessarily feel that you have an infection. It’s an upset of the normal flora in your vagina. I’m going to give you some medicine to clear the infection including some vaginal suppositories. You will have to abstain from sex for six days”. I nodded at the doctor. He didn’t need to know that I hadn’t had sex for three months.

“Give me a call when you’ve finished taking the medicine and let me know if you still want to have the coil fitted. You have to remember that fibroids love a fallow womb,” said the Dr. “Do I need to have the fibroid removed?” I asked. “No it’s too small at this stage.” “Can the fibroid make sex uncomfortable” I asked. “Yes” he responsed. Ah. Maybe that’s why penetrative sex feels uncomfortable sometimes I thought.  “Also the mirena coil costs GHC650 from Ernest Chemists”. That’s almost a quarter of my monthly salary I thought as I thanked the Dr. I left the clinic wondering how my Mum had managed to connive with all the doctors in Ghana to persuade me that having a baby would be better than getting a mirena fitted.

P.S: I wrote this piece a year ago. I am no longer 34 🙂