One of the things I'm supposed to do as part of this treatment is remove my IUD. Now, I admit that I'm actually not quite sure why I'm supposed to get it out -- it might be that its efficacy might be compromised due to the chemo drugs. More likely, it's because it's putting out small doses of hormone, and since my tumor is triple-positive for various such hormones, it seems better not to poke at it with extra hormones? Something like that -- I admit, my grasp of the science here is really weak, and I'd actually appreciate a better explanation. In the flurry of all the medical stuff, this wasn't one that I took the time to get a good handle on -- I just accepted that both oncologists I spoke with seemed certain that the right thing to do was remove the hormonal IUD.
Now, they do want me on birth control. I want that too! It would be very bad if I got pregnant right now -- it would knock me out of the clinical trial, and regardless, chemo + pregnancy don't mix well. So my first doctor recommended switching to the copper IUD. The Loyola doctor couldn't recommend any such thing, even if it is the best medical approach because....
...she's at a Catholic hospital, and they're not allowed to say that.
This is where you want to bang your head against the wall. Doctors at Catholic hospitals aren't allowed to recommend any birth control *as* birth control to their patients. Interestingly, they get around that a lot, for a lot of things. Birth control pills, for example, are used to treat other medical conditions, such as excessive pain / bleeding during periods (dysmennorhea, I think it's called?). So doctors can prescribe you the pills for that, and if, as a side effect, you're also getting birth control, well, that's not their fault.
Some of the other birth control methods that are *also* very effective at treating dysmennorhea, possibly more effective than the pills, are not yet approved *for that other treatment* by the government, which means that even if your doctor believes that the best way to keep you from suffering miserable painful periods is to have you on something like Norplant, if they're at a Catholic hospital, they can't prescribe that for you. Technically, I don't even think they're supposed to *tell* you about it.
(Similarly, if I were teaching at a Catholic university like DePaul here in Chicago, I'd have to sign a morality clause restricting my ability to give such information / advice to my students. I did interview at one Catholic university, but when I realized what I'd be asked to sign, they dropped off my possible list. Just last year, I had a student who dropped out of my class because he'd gotten yet another girl pregnant and he was just overwhelmed with his parental responsibilities. You're telling me I can't talk to this kid about the possible utility of condoms? Go to hell, I believe, is the correct response.)
So, the upshot of all this for me is that at Loyola, my doctors can remove my hormonal IUD, but they can't insert a copper one, even if that is likely the best approach to keeping me from getting accidentally pregnant during chemo. It took me an hour and talking to three different people on the phone before one of them finally admitted that the reason they couldn't give me a referral to someone who could insert a copper IUD was that they're a Catholic hospital. "I'd have to talk to my insurance provider."
And, of course, it turns out that when I do talk to my insurance provider, that since my hospital-of-record is Loyola for the cancer treatment, I can't go to any of the other doctors in my network who are affiliated with other non-Catholic hospitals. So if I want a copper IUD, I'm pretty sure my only option is to pay out of pocket for it. We are likely stocking up on condoms for the next few months.
And yes, abstaining from sex would be an option, thanks for asking, folks, but given that I'm expecting my body to feel yucky for much of the next four months, I am disinclined to give up opportunities for it to feel good. And yes, we could just engage in non-possibly-procreative activities, and those are also lovely, but god damn. I am a little infuriated that my hospital and my doctor should have any input into our choice of bedroom activities whatsoever.
Short version -- this morning, I'm going in to having my IUD removed. I am hopeful that within the year, I can go get it inserted again, because the IUD is a lovely, lovely thing. And if that means that after my cancer treatment is over, I'm going to have to switch hospitals again, so be it.
I am normally a fairly cheerful agnostic, and I don't hold a grudge against my Catholic upbringing, but right now, I am the most lapsed of lapsed Catholics. I'll just be over here, impotently shaking my fist against the Church, and insurance companies too, for good measure.
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