Bye Bye Bad Periods…Hello DivaCup!

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{Disclosure: I was given a DivaCup Model 2 to review in order to write this post. I was not paid for my review, or endorsement, of this product, nor was I asked to write a positive review. The thoughts and opinions expressed here are my own.}

I have always had a hard time with my periods, even before I was diagnosed with a clotting disorder, antiphospholipid syndrome, in 2012. My menstrual cycle has always been heavy, painful, sudden to start, irregular and generally wreaks havoc on my emotions. If I could bury myself in a dirt hole for the duration of my cycle, I would, gladly to spare myself and others the misery of my company. Since my diagnosis, my periods have only gotten worse and while I do have months that are uneventful, my body seems to make up for it the next time with a period like no other.

Throughout the pre-blood clot years of my menstrual cycle, I almost exclusively wore pads (Always, extra long, overnight, jumbo pack) and I continued wearing pads after my blood clot.

My Problem

In the initial months (read first year) of my recovery from DVT and PE, I found that my menstrual cycle was nearly unmanageable in terms of flow. I rarely left the house during my period and if I did, I went armed with a stack of pads (which I changed hourly). I planned out where I was going to go and when I was going to use the restroom. I couldn’t be gone for very long, and I certainly couldn’t do anything spontaneous like drive to another store or friend’s house because I was uncertain of how long it might take. I wore dark pants, multiple pairs of panties and cursed my light car interior. I didn’t sit on anyone’s furniture, as a matter of fact, sometimes I didn’t sit at all for fear of leak.

Flash forward to now, three years after my clotting incident, and my periods are still really heavy, can happen out of nowhere, with no pre-symptoms, and last for an extended period of time. Sometimes, I get a day or two of relief and then it starts all over again. Just when I think it is under control – I tried to wear a tampon at a festival this summer – I am back to running for the car so I can rush home and take care of the leak (by staying in my bed for the next four days). The emotional turmoil and anxiety I feel during my cycle every month is in part due to the fear I have of leaking at work, a friend or relative’s house or anywhere that is not my own room – and even that can result in a fit of tears and anger. It’s miserable, I’m miserable and desperate for relief. 

My Solution 

First and foremost, I was in constant communication with not only my hematologist, but my OBGYN too about my flow and frequency of periods. My OBGYN told me that remaining on warfarin and progestin-only birth control and aspirin will continue to contribute to a heavy flow. He ensured nothing else was going on (i.e. cervical cancer, a miscarriage, etc.) and informed me that my options for controlling the flow included a contraceptive implant, which is not an option I am comfortable with personally. So, after ruling out any medical concerns, I began my search for something to offer the relief I so desperately sought.

What I found is the DivaCup. And the DivaCup is a reusable, bell-shaped menstrual cup that is worn internally (yes, in your vagina), collecting rather than absorbing your menstrual flow. It lasts for 10-12 hours before it needs emptied, is comfortable, holds my entire flow in a day (no, I’m not kidding either), and is cheaper and healthier than traditional menstrual products like pads and tampons. Wait, wait, it’s gross, right? Hear me out before you make a determination about how sanitary it is and enter to win your own DivaCup to try for yourself.

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The Basics

The DivaCup costs around $40 and you can find it online or now at CVS. It is not disposable and you should only need to replace it about once a year, or when it is best as determined by you. It offers 10-12 hour leak-free protection and is made of health-grade silicone. It really holds my entire flow, and I actually found thorough the measurements on the side of the cup that I was not bleeding as much as I thought I was. It comes in two sizes, 1 if you are under 30 and have not had a vaginal delivery or C-Section and 2 if you are over 30 and/or have delivered a child(ren) vaginally or via C-Section. You wear it when you use the restroom, but not during sexual intercourse and it is not a contraceptive device. You wash it using a mild, unscented soap, or the DivaWash, which I prefer to use. Read more details about the DivaCup basics.

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The Pros

I have not leaked at all while wearing the DivaCup, not once, not for the entire 11 or so hours I wore it during heavy flow. The first time I tried the DivaCup I wore it on the heaviest day of my menstrual flow and I was really worried about it, but I did not have any leaks. That to me is worth the entire product. Toward the end of the day, I will say I felt the DivaCup slide down slightly, but it did not leak or spill and I adjusted it upon emptying it. Most people empty it 2-3 times a day, but you may need to empty your DivaCup more often depending on your flow. The great thing about is it is much easier to monitor your menstruation cycle. I don’t have to worry about carrying a bag of pads with me anymore, the DivaCup comes with a discreet cloth bag that I store it in after cleaning and generally I carry it in my cosmetic bags in case of emergency or a sudden start. It’s always available and I’m no longer running to the store at midnight or on my lunch break, praying I make it there and back in time. I save money using the DivaCup (an average of $100-$150 a year) and I am healthier. The last thing I need is a possible health complication, for example, from the ingredients found in tampons.

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The DivaCup has given me back a piece of my self-esteem and self-confidence when it comes to my menstrual cycle. I no longer worry about leaks, stains, unsanitary messes and where will be the next time I need to change my feminine product because the DivaCup holds my entire flow in a day. My periods have become more manageable because they are not managing me for once! I feel like a new woman using the DivaCup.    

The Cons

Wearing a cup is different from wearing a pad or a tampon and it took me a few tries to be able to insert it correctly (although, with practice, it is not too much different from a tampon and I struggled with that at first too). I suggest either wearing a pad with it at first to ensure you have it inserted correctly or wear it in a place (like home) where you know you can handle it right away if you feel a leak. For me, it is very easy to tell if I have the DivaCup placed incorrectly because, much like a tampon, I can feel it. Most of the incorrect positioning comes from pushing it up into the vaginal canal, instead of back, towards the tailbone. You can find great instructions on how to insert it here and the Diva Team is more than happy to help with questions, should you have any. At $50-$55 for the cup and the wash (or about $40 for the cup), it can be expensive to get started, but remember, you are saving money in the long run. Most ladies I have spoken to are most worried about emptying the cup, but when you remove it by pulling is straight down, the contents do not spill out and are easily disposed of in the toilet (then wash the DivaCup in the sink with the DivaWash or mild, unscented soap). The inconvenient part is it is not practical to empty it in a public restroom so I make sure I do that somewhere where I feel comfortable, like my house. To me, it is more sanitary than removing a pad (where the contents are already outside of your body) or a tampon (where there is no container at all). I actually feel cleaner using the DivaCup.

Just For You

Connect with The DivaCup on Facebook, Twitter and Instagram and through their website for great ideas, tips, information, and chances to win a DivaCup.

You can order your own DivaCup through my Amazon Influencer Shop.

There is hope for healing and you are not alone,

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Your Ongoing Care Specialist Guide

Facing recovery from a DVT and PE can be overwhelming, scary and very uncertain, to say the least. Which doctor should you see for what and when? There are so many options available and diagnosis, treatment and procedures vary greatly from one person to the other. Here is your Ongoing Care Specialist Guide from BCRN.

Primary Care Physician/Provider (PCP)

  • Role: The primary care physician is also your family doctor or main point of contact for most undiagnosed health concerns. He or she is the place where you often begin either to diagnose a problem or return for ongoing care. The care of a PCP is not limited by cause, organ system or diagnosis and may also refer you to a specialist. A PCP may be an MD (Medical Doctor), DO (Doctor of Medicine) or NP (Nurse Practitioner)
  • Benefit: Many patients continue visiting their PCP for medication management and regular INR testing. A trustworthy PCP is also beneficial to have as a starting point for any new medical concerns that may arise during your treatment.
  • Personal story: I credit my PCP with saving my life because he was immediately able to identify (via phone nonetheless) that the pain in my leg and the pain in my side as a DVT/PE and instruct me to go to the ER immediately. While I do not see him for my ongoing INR and warfarin management (because he was more comfortable with me seeing a specialist due to the complexity of my case), he is integral in my care and remains my main point of contact for everyday concerns and illnesses.
  • More: Find more information at the American Academy of Family Physicians.

Hematologist

  • Role: Hematology is the study of blood in health and disease. It includes problems with the red blood cells, white blood cells, platelets, blood vessels, bone marrow, lymph nodes, spleen, and the proteins involved in bleeding and clotting. A hematologist is a medical doctor who applies this specialized knowledge to treat patients with blood conditions. Most hematologists are also trained oncologists (specializes in treating people with cancer)
  • Benefit: Any person unsure of why he or she experienced a blood clot, should consult a hematologist for further testing of genetic and autoimmune clotting disorders. In addition, a hematologist can manage INR and medication such as warfarin as well as any underlying diseases of the blood.
  • Personal story: I was referred to a hematologist in the hospital and he has been my primary point of care for my DVT/PE recovery and management of antiphospholipid syndrome (APS), an autoimmune clotting condition, since then. 
  • More: For more information visit the American Society of Hematology

Coumadin (or Anticoagulation) Clinic

  • Role: The Anticoagulation Clinic is a service established to monitor and manage the medication(s) that you take to prevent blood clots (i.e. coumadin/warfarin). Physically, it is a specified location within a hospital or a medical office that is staffed mostly by pharmacists. The pharmacists, working in conjunction with your physician, will check your INR and adjust your dose of warfarin.
  • Benefit: The clinic was set up to be easily accessed to get your INR drawn and know your results immediately. It can eliminate having to make an appointment to see your doctor every time you have an INR check. It is more like a “quick-service” treatment than a full-fledged doctor appointment and should be used in-between doctor (and not as a substitute for) doctor visits.
  • Personal story: There is a Coumadin Clinic where I live, and I was given the option to have my warfarin monitored there, however, I chose not to. I achieve the same results by visiting the hospital walk-in lab who then directly communicates my results (within an hour or so) to my hematologist who then follows-up with me.
  • More: Ask your hematologist or PCP if there is a Coumadin Clinic near you and if it would be beneficial to your care.

Pulmonologist

  • Role: A pulmonologist, or pulmonary disease specialist, is a physician who possesses specialized knowledge and skill in the diagnosis and treatment of pulmonary (lung) conditions and diseases. Pulmonology is a subspecialty of Internal Medicine.
  • Benefit: A pulmonologist generally manages complex pulmonary problems stemming from emphysema, tuberculosis, asthma, complicated infections of the chest, the pulmonary complications of AIDS, injury, and complications of respiratory diagnostic and therapeutic procedures, which often could include a PE. If you have a PE and any underlying respiratory concerns, a pulmonologist may a good option for follow-up care.
  • Personal story: I was evaluated by a cardiologist in the hospital, but do not see him for ongoing care at this time.
  • More: For more information about pulmonology, visit the American College of Physicians.

Cardiologist

  • Role: A cardiologist is a doctor with special training and skill in finding, treating and preventing diseases of the heart and blood vessels.
  • Benefit: If you have survived a blood clot, you may also have damage to your heart and vessels/valves in the heart. A cardiologist is the best person to assess and provide ongoing treatment for any damage caused by a PE, including an enlarged heart, high blood pressure, pulmonary hypertension, etc.
  • Personal story: I was evaluated by a cardiologist in the hospital, but do not see him for ongoing care at this time.
  • More: For more information about cardiology, including inspirational patient stories, visit the American College of Cardiology.

Rheumatologist

  • Role: The role of the rheumatologist is to diagnose, treat and medically manage patients with arthritis and other rheumatic diseases, often including autoimmune diseases. These health problems affect the joints, muscles, bones and sometimes other internal organs (e.g., kidneys, lungs, blood vessels, brain). Because these diseases are often complex, they benefit from the care of an expert. Only rheumatologists are experts in this field of medicine.
  • Benefit: Many times, blood clot incidents like DVT or PE can be the cause of something autoimmune going on. A rheumatologist specializes in these diseases and their side effects.
  • Personal story: Since I have antiophospholipid syndrome (APS), my hematologist referred me to a rheumatologist to best monitor any ongoing or new symptoms that could be related to lupus. APS, blood clots, pleurisy (inflammation of the lining of the lungs) and low platelets are all things I have or had that could also be indicators for lupus. I see my rheumatologist about every six months or when needed. He communicates directly with my hematologist.
  • More: For more information, including how to find a rheumatologist in your area, visit the American College of Rheumatology.

A person recovering from a blood clot may also see these specialists for follow-up and/or ongoing care:

  • Vascular Surgeon – A vascular surgeon is a specialized surgeon of all parts of the vascular system, arteries and veins, except that of the heart and brain (i.e. to repair veins, insert a filter or catheter, etc.)
  • Pain Management Specialist – A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain, including acute pain, chronic pain and cancer pain and sometimes a combination of these for a variety of reasons including, but not limited to, surgery, injury, nerve damage, and metabolic problems such as diabetes (i.e. to mange pain after a DVT/PE or as a result of underlying issues, etc.).
  • Endocrinologist – An endocrinologist diagnoses and treats hormone imbalances and problems by helping to restore the normal balance of hormones in the body, particularly in thyroid disease and diabetes (i.e. many people who have suffered from a blood clot also suffer from some type of hormone imbalance).
  • Neurologist – A neurologist treats disorders that affect the brain, spinal cord, and nerves, such as stroke, multiple sclerosis, headache disorders, infections of the brain and peripheral nervous system, movement disorders, neurodegenerative disorders, seizure disorders and speech disorders (i.e. to find out what is causing headaches, stroke or cognitive concerns after a blood clotting episode, particularly if a blood clotting disorder/mutation carries a neurological component or symptom).
  • Radiologist/Interventional Radiologist – A radiologist employs the use of imaging to both diagnose and treat disease that is visualized within the body (i.e. an imaging scan or ultrasound). Interventional radiology is a sub-specialty of radiology which utilizes minimally invasive image-guided procedures to diagnose and treat diseases in nearly every organ system (i.e. as an alternative to having surgery as the first option to a problem).
  • OBGYN – OB is short for obstetrics or for an obstetrician, a physician who delivers babies. GYN is short for gynecology or for a gynecologist, a physician who specializes in treating diseases of the female reproductive organs (i.e. to manage high-risk pregnancies, heavy menstrual flows, blood clots during pregnancy, etc.).

As you can see, ongoing care will vary greatly from individual to individual, depending on the reason for a blood clot, damage done, individual patient and underlying or extenuating factors. This list is by no means all-inclusive or exclusive either as there are many different options for treatment and specialist available.

The bottom line? I think it is beneficial to see a team of doctors for treatment of DVT and PE. In my case, my care started with a PCP and a hematologist and I was referred to additional specialists depending on individual factors, for example, I see an endocrinologist for an underlying thyroid disease. You may regularly visit an anticoagulation clinic for medication management. Recovery from a DVT and/or PE definitely requires follow-up care in medication management, short and long term complications and monitoring all organ systems in the body to ensure no additional damage has occurred or is occurring. Sometimes, a DVT or PE might be the result of an underlying condition or illness that may be not be discovered, unfortunately, until after experiencing a blood clot, as in my case. My personal level of care currently includes my PCP, hematologist, endocrinologist and rheumatologist.

Reader Writes In. What specialist do you see and for what part of your recovery? Do you also need to see or be referred to an additional one? Are you often overwhelmed or concerned about the amount of doctors you see/have seen? How do you best manage your ongoing care in terms of specialists?

There is hope for healing and you are not alone,

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A Survivor Speaks: A Blood Clot and A Beautiful Baby Boy

March 7, 2013 initially started off like every other weekday morning. I was getting ready to go to work, but for some reason I was having a tough time walking. I had been really sore the last few weeks: back aches, side hurting, and uncomfortable sitting down. I thought it was because of being pregnant at my age of 37. So, I pushed through the pain and discomfort and went to work. As I sat at my desk trying to schedule something, I couldn’t get off the phone quick enough to stand up. I became so uncomfortable at that point that nothing was helping. I looked down at my legs while describing my pain to a coworker and realized my left leg was swollen twice the size of my right leg, was ice cold to the touch and was turning blue. I mentioned it to my coworkers and they sent me home.

Eventually, after running a few important errands, I went to my OB’s office to have them check me. As soon as I walked in the door, the head nurse sent me to the Emergency Room. She said if she didn’t know any better, she thought I had a blood clot and that I did not need to let it go unchecked any longer. I got into my car and called my mom on my way to the hospital to have her meet me there.

Once I got to the ER, they immediately took me back and started drawing blood. A vascular surgeon came in, and upon examining my leg, immediately ran out of the room and ordered an ultrasound of my leg. The ultrasound was very uncomfortable because of the tech having to push down on my leg, but it also became another scary situation: they couldn’t find a pulse in my foot or any blood flow to my foot.

The vascular surgeon came back into my room shortly after the ultrasound to let me know I was being admitted for a couple of days. He said I had a DVT, but that he was so happy that the coloring of my leg was improving some the longer it was elevated. He said if it had stayed blue they may have had to amputate my leg! At that point, I took a trip outside of my own thoughts, as I couldn’t bear to think of losing my leg and was really only concerned at that moment of what all of this meant for my unborn baby.

Come to find out, my DVT is from groin to knee and wraps around behind my knee. I’ve been on Lovenox injections since March 7, 2013. I was told on March 9th when I was released from the hospital that I should be able to go back to work and resume normal activities in a couple of days. I have not been able to return to work, as I’m not able to sit without being in a great deal of pain, so I ended up losing my job.

I still deal with pain daily and have trouble walking and functioning like I used to. I have had doctors give up on me by refusing to treat me anymore, thinking I can’t get any better. I’ve had doctors that have also told me I’m making up all the pain and trouble with moving, and that I should be a fully functioning person within a month of being diagnosed. I’ve also been told that DVTs do not cause pain.

Now, I’m in the process of working with a vascular surgeon that specializes in interventional radiology who believes I have May Thurner Syndrome as well as some other issues with the veins in my leg. It pays to keep pushing forward to find a doctor that really listens to YOU. I’m working daily towards getting better. The great part is that I have a healthy, happy, beautiful baby boy that will be turning 6 months old the day after my one year DVT anniversary.

*Editor’s Note:  Thank you, Debra, for sharing your story with BCRN! Connect with Debra in the comments below.