Content warning for explicit medical descriptions.
Insertion: Nexplanon Implant Procedure
Day of Implant Removal
I’m going to be honest with you, I was high AF yesterday. That’s when I was supposed to be starting this post. But, I started a new medication as swapping to pain patches from pills and woah, did they hit me hard! In fact, they keep hitting me hard, however …
The Nexplanon implant is FINALLY getting removed today! I’m so freakin’ excited. So excited. I both can and cannot wait. I’m a bit apprehensive about the ‘hormonal storm’ that will happen once the extra progesterone leaves my body, but happy that after an unintended 6 extra months it’s coming out.
Post Implant Removal
I’m not gonna lie, due to the medication I was also a little bit (very) high before going in. In fact, I only wrote a few sentences before the appointment because I was so nervous and off my tits on my meds.
Even though there was no one in the practice, the doctor was still running around an hour late. For some reason they let us wait inside instead of outside – I’m guessing because of the wheelchair. After an hour of sitting there in my Darth Vader mask, we were finally called in. During that wait, I went in and out of being with it (due to the meds), and put hand sanitiser on my hands about 20 times. Definitely not an exaggeration, though in my defence it was only my second time out of the house since March.
After exchanging the typical British social niceties, ‘we wear masks now/the weather/sorry for the wait’, the doctor ran through the reasons for getting the implant out. Mine were: two stone weight gain, nightmares which increase in frequency and intensity before my period, hormonal acne, worsening of all current symptoms since the Nexplanon implant went in, and pain from the implantation site that has not gone away. Of course, I didn’t remember all these at that time, so I blurted out three and then the rest I remembered over the hour I was there.
Before I get into the removal, I want to set the stage. The doctor that removed the implant is the one doctor at the practice I have historically not gotten along with. However, I wanted it out of my arm, so I was willing to put myself through that potential trauma. Before any doctor’s appointment, I have to mentally prepare myself to be questioned about being in a wheelchair, my pulse taken on my feet without asking, and for general touching of my feet depending on their colour. I also have to prepare myself for when the doctors inevitably get distracted by my feet and ask a million questions – the main one being, do they always look like that? To which the answer is always a resounding YES.
It would be remiss of me to mention that the lights in the doctor’s office were also flickering every few seconds, there are cracks in the wall (it’s an old doctor surgery), and it’s an uncomfortably long and thin room.
It would be great if this is the point where I say the implant came out just as easily as it went in, but this is me, so of course, it didn’t! If you thought it would you must be new around here.
As an aside, I don’t know what it is about me that makes doctors tell me terrifying medical information, but I would like it to stop. For example, I got told that the guidelines changed a few years back so the implants were supposed to be put next to an artery – though I was high, so don’t remember a lot, but long story short this new recommended placement caused a few implants to hitch a ride and travel around to the heart. If you ever had an implant, this is probably your number one fear. I know it is mine – I would obsessively check that the implant hadn’t gone wandering every single day.
But back to the story, I have had two implants out before this one. To memory, they both came out pretty easily and they were both done in about five or so minutes. This one took half an hour. It took a few rounds of poking and waiting to make sure I was fully numb and I am very glad I was completely honest and said I could still feel things when I did. I am usually a very bad doctor pleaser, and I have a tendency to just say ‘it’s fine’ all the damn time.
After a few minutes of poking around, I gave in and found the implant for the doctor because it was in a finicky placement. And what followed was basically a small incision and half an hour of the Nexplanon implant trying to escape with a lot of slow and steady tugging of the implant.
Even though I had only had the Nexplanon implant in for less than a year my body it seems that my body overreacted – it went above and beyond in the creation of scar tissue. Now, I’m not squeamish. I have dealt with a lot of body horror before, but I was not prepared for the feeling of scar tissue breaking away from the implant. It felt like Poprocks in my arm. I will admit it was at that point I nearly passed out, mostly because it was such a wrong sensation that it made me feel a bit queasy, and again the new meds did not help.
Because of the half an hour plus I spent with my right arm in a ‘damsel in distress arm above the head fainting position’, my right shoulder had consequently decided that it wanted to get in on the action and pop out a little. My body is a drama queen. I will also admit that my body got very confused the night it was removed as my left arm throbbed in the same position as the right, which is really amusing to me for some reason.
What is the Nexplanon implant removal supposed to be like?
- Arrive at doctor surgery.
- Make small talk with the doctor about why you want it out and make sure all forms are signed.
- During this, they will give you the rundown of side effects and what you can expect if something were to go wrong, including ‘we will send you to a specialist if we cannot remove it’.
- After all this is done and you have no questions, you will hop on the minimally coated doctor examination table, the right way round so your implant arm can be accessed.
- The doctor will then find the implant – you might need to help because the arm is a big space and implants move (especially if you gained weight, this can also mean the implant can be more difficult to remove).
- Once the implant has been located the doctor will give you a numbing injection, they should then keep hold of the implant as apparently the numbing injection can make the implant go deeper and her skin, who knew!
- The doctor will poke you a few times to test that you’re fully numb, make sure you are fully numb! Do not say yes you are fine when you are not. You will thank yourself later.
- The doctor will then make a small incision at the end of the Nexplanon implant, closer to your fingers than your armpit.
- The doctor will coax the implant out with a range of moving the skin, clamp, and pleading … in my experience. Side note: I didn’t actually watch for doing this it’s just what I felt yesterday, have watched on YouTube (this links to a real Nexplanon implant removal procedure, contains blood and a scalpel) and experienced through the other removals.
- Depending on how much scar tissue has formed around the implant, this part might take a while, especially when compared to the implant insertion. My insertion took five minutes, the removal took over 30. Yanking the implant out quickly will cause more damage in the long run, more pain and more bruising. It’s better for the doctor to take time to gently break the scar tissue.
- During this process, the doctor might have to grip your arm tightly as the last thing they want to do is lose track of the implant.
- Once the implant is, finally, out the doctor will then clean the area of any blood, and place Steri-Strips or butterfly strips over the wound to help the scar heal well. Ideally, they will then place a waterproof plaster over the strips to keep them protected. (I left mine on for 3 days, then took it off, cleaned the area then put a standard plaster on for another 3 days. If you heal slowly, you might need to keep yours on for longer.)
- The doctor will then put a compression bandage on the arm to try and prevent bruising, and if you feel it’s too tight, speak up. One time my arm got pretty swollen from a compression bandage, and they’re really difficult to re-bandage by yourself in that area.
- After that, you’ll be told about any side-effects including the possibility of infection, and general aftercare instructions.
- Then you’re free to go!
Because it is COVID times, whenever I leave the house upon reentry I remove my clothes, disinfect glasses/phone/watch/wheelchair and shower. Even though I’d a bandage on my arm, I still removed everything I could and showered. All I did was remove the compression bandage and wrap a shit tonne of clingfilm around my arm with the help of my partner, had a quick shower, remove the clingfilm post-shower and use a few disinfectant wipes to disinfect the area, then – since I am a medical preparedness person, I rewrapped the arm with a new sterile compression bandage. It’s not my first rodeo.
I took the compression bandage off before bedtime and was able to keep it off the following days. Had I shown signs of bruising after waking I would have rewrapped the arm, however, I was able to get away with minimal bruising for a change!
Post Implant Thoughts
After nearly a year of having the Nexplanon implant inserted, it is officially out (and healing well).
I went into the appointment terrified. The doctor hadn’t treated me well in the past and honestly, the scariest thing was that I did not have a clue what anyone was saying to me. Normally I have a fair bit of trouble when out, but I couldn’t understand anyone. In the end, though the doctor kept making small talk I just nodded and made non-committal sounds. However, I came out of the appointment so relieved. I almost cried when she showed me that the Nexplanon implant had finally been removed. I rolled out of the doctor’s surgery a very very happy person. Had I been able to, I might have even danced.
I know I’ve talked a bit about the pressure doctors can put upon patients to try a procedure or medication (I’ll talk about it more another time), but the Nexplanon implant was truly a doctor pressured procedure. Since I’ve already had it in twice, I was hesitant to try it again, but I very much got the ‘you need to do this before I will believe you’re willing to help yourself’ vibes from all the doctors I saw.
So, I vow to myself that I will not willingly put a contraceptive implant back in my body again. I vow that if I even think about it I will come back and reread these posts until I know them off by heart. And I vow that I will practice saying ‘no’ before any medical appointment.
My question to you is, have you ever had the Nexplanon implant? What was your experience of it?