Thursday, July 23, 2009

Volunteering at the clinic

A Miltex Vaginal speculum

Fitting sports shields: My time fitting sports shields at the clinic this morning was very busy. A woman’s water polo team was in town, for pleasure, and came in for fittings because one of their moms had been fitted here last year. Each had to have a pelvic exam first to make certain her cervix was healthy. That’s because while wearing a cap will not hurt a healthy cervix for women who have cervical dysplasia a cap will make the condition worse. Chuck let me insert the speculums (warmed and lubed before insertion) and I think that’s the part of the pelvic exam women like the least, having our introitus stretched and held open. Five took 22mm FemCaps and 2 took 26mm and they all wanted strapless caps so afterward I taught a short class about the easiest way to remove them and I made sure each girl could properly insert, to make certain she had her cervix covered, and remove her shield. It was pretty much a communal thing with them all standing around watching as they all got fitted. I’d never had that happen before where a room full of women watched one another being fitted. Usually it’s just the occasional mom with a daughter coming in for her first FemCap for dive-sex. But they were very quiet and none of them was shy so it worked out well and it was certainly a bonding experience for the team.

Contraceptive challenges: After I finished fitting sports shields I assisted Chuck as he saw a series of patients. All had birth control problems of one sort or another; pill side effects, an IUD expulsion, incorrect barrier sizes one that was too large and two that were too small and three abortions, two by Mifeprex and one EVA, electric vacuum aspiration.

Hormones: Of the women with pill side effects two were experiencing heavy irregular bleeding while using progestin-only-pills called the mini-pill or POPs. Chuck had them stop hormones and switch to GyneFix IUD implants. The other has started using Ortho Evra (the patch) a month ago and her breasts were so badly swollen that she could hardly stand to wear a tee much less a bra. Chuck took her off the patch – because of the high estrogen dose administered transdermally by the patch breast tenderness is a common complaint – and because she still wanted an extremely low maintenance method, inserted Implanon, a single rod implant the size of a matchstick, in her upper arm.

ParaGard expulsion: The girl with the IUD expulsion was a rubber-chick who had such a brutal sexual encounter at a fetish club that it caused uterine cramping severe enough to bend the frame of her ParaGard, copper IUD. The IUD was protruding from her cervix so Chuck tugged gently and it pulled out painlessly. An ultrasound showed the arms of the frame hadn’t perforated the uterine wall but she was bleeding so he didn’t want to insert a GyneFix until her uterus had healed. So he fitted her with a Milex diaphragm which she had wanted as protection during pool-sex.

Diaphragms: The girl with the diaphragm that was too large (it kept popping out of her pubic notch and she couldn’t pee very well when it was inserted) had gained 15 lbs and the weight had caused her to need a smaller diaphragm, which she was fitted with. Of the two girls who had the diaphragms that were too small one had been miss-fitted by another clinic in Nevada, not here in Vegas, and the other was 16 and had been fitted a year earlier with a 60mm coil spring. She should have returned for a refit in 6 months because she is still growing and because a year ago she was newly sexually active and a woman’s pelvic anatomy stretches with use. That stretching has nothing to do with how tight she feels to a partner which is a function of the strength of her pelvic muscles. She was fitted with a larger Cooper Surgical (the old Milex) Omniflex which is the only coil spring rim diaphragm still made in the U.S.

Of the three abortions, the two medical ones were started with the women taking the first pills in the Mifeprex regimen and they were given the rest of the pills to take two days later. We keep in touch with these patients to make sure they are doing well and schedule them to come back two weeks later as follow-up. The other woman had waited too late to take Mifeprex so she came in scheduled for an electric vacuum aspiration which is a bit more invasive than a menstrual extraction because it requires cervical dilation because a larger diameter cannula is used. The EVA went well and in an hour the woman was on her way with Ibuprofen for any discomfort and doxycycline to prevent possible infection. I’m CD 21 today, so I’m looking forward to my menstrual extraction this time next week.


  1. Looks like you had a very busy day at the clinic. How typical is this?

  2. Typical for the clinic but I stayed longer than I usually do as there were cases that interested me.


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Powys , Wales, United Kingdom
I'm a classically trained dancer and SAB grad. A Dance Captain and go-to girl overseeing high-roller entertainment for a major casino/resort