You have a bad day, on the day before Valentine’s Day, when you go in for a routine gynecological check-up and hear your doctor say, during the pelvic exam portion of the appointment, that your IUD has gone missing.

You: It’s not in there?  What? Where did it go?!

Doctor:  My best guess is that it was expelled. Or, it could be embedded.

You: If it was expelled, wouldn’t I have noticed?

Doctor: Not necessarily.  The IUD is tiny, right?  It can be missed if it makes its way out during your menstrual cycle…if you have a heavier-than-usual period.

You: Hmmmm….and if it’s embedded, where is it now?  In my lungs?

Doctor: (chuckling) No. In the uterine wall. It would be a perforation of the uterine wall. I’m going to go get the ultrasound machine and take a look.

Minutes later, the doctor returns, rolling in a black and steel cart with a tray that carries the ultrasound machine. She shuts the examination room door with a small kick behind her.  Once everything is in place, the doctor begins a new search for your IUD… with the machine this time. You breathe in and out, reclined on the table, looking up at the white dropped ceiling square tiles.

You:  Doctor, you’ve said before at other appointments that I have a very large uterus….after birthing four children… so could it just be that the IUD is lost in there….it’s swimming out of reach in my…vast…uterus?

Doctor: (chuckling again)  This is an extremely powerful ultrasound machine here so I am fairly certain that I would see it if the IUD were still here…and I’m not seeing anything. (She pauses.) Everything looks normal.  Your uterus looks normal…except for the missing IUD, of course. To absolutely rule out the possibility that there has somehow been a perforation, I’m sending you over to get an x-ray. Okay? If the uterus has been perforated, we’ll have to remove the IUD laparoscopically.

You: As in surgery?  With anesthesia?

Doctor: Yes.

You:  Fuck.  Is is okay if I say “fuck?”

Doctor: Yes.  By all means.

You:  And if this thing is not embedded….if it came out and I didn’t notice during one of my last periods, there’s no way of telling WHEN it actually came out.  During which period… right?

Doctor: (nodding) Correct.

You might be hyperventilating a bit, but you try to keep your inhalations and exhalations even while you do some quick math.  If you’ve already determined that you will be sixty years old when your youngest child graduates from high school (she is four years old; you are forty-six), then it only requires some fast addition to understand that, after adding in the nine-month gestational period, you are likely to be sixty-five years old at the high school graduation of a fifth child…if the missing IUD has actually caused a pregnancy.That would be unfortunate.

The doctor hasn’t even left the examination room and already you are ripping off your blue paper gown, dressing quickly, not a modest care in the world.  Let’s get to x-ray, pronto, you think.  The doctor probably wouldn’t force the issue with an x-ray if she thought you were actually pregnant, right? You think you remember hearing from another OB/GYN in your past that it’s not safe to have an x-ray when pregnant. You aren’t really able to ask about possible pregnancy, though, because you can’t concentrate on careful breathing, dressing yourself, calculating high school graduation ages, continue with your f-bomb mutterings and formulate a thoughtful question all at the same time. Nope.  You cannot.

Doctor:  This kind of thing rarely happens.  Very low percentage of cases. Your uterus is large and strong…after four kids.  It probably expelled the IUD.

You: (only able to mutter one word now) Vasectomy.

Doctor: Yes,  That might be an option for you and your husband.  But remember the placement of the IUD was intended, first and foremost, to relieve you of your extremely painful menstrual cycles because of the…

You: …very large uterus.

Doctor:  Yes.  I’ll read the x-ray, then call you at home in a couple of hours to discuss options. Can I leave a message on the machine with your medical information?

You: Yes. Yes. Thank you, Doctor.  (You walk swiftly from the room toward x-ray.)

You have your x-ray taken. You call your husband. You go to Whole Foods and buy a double layer chocolate cake, which is in the shape of a heart, for Valentine’s Day.  Happy Fucking Valentine’s Day. You go to your daughter’s pre-school to retrieve her.  The thought of the chocolate cake with the thick chocolate frosting for lunch settles your nerves and you are able to avert your mind from the fucking IUD news.  You greet your four-year-old with a big smile.  You and your daughter then head to CVS where you purchase a package of three pregnancy tests so that you can double check and triple check the results.

Back at home now, you head straight for the bathroom to pee on a pregnancy test stick. It’s been ages since you’ve done the pee-on-a-stick routine. You don’t set the stick aside on the floor or bathroom vanity to come back to it, with undisguised anticipation, later.  No, you wait, seated as you are, and watch as one line appears.  Is that a second line you see, as well? You realize you will need to put your “old lady” reading glasses on if your vision is to be clear enough to accurately read the results, because right now, one pink line is too easily blurring into two.  You retrieve your glasses from the desk in your bedroom, pregnancy stick in hand, and check the result window with the glasses on.  There is one line.  Only one line. Not even the slight indication of a second line, which can happen, as you know from experience, when you’ve tested very early on in a pregnancy. You are NOT pregnant.  You realize that this pregnancy test session, here in your bathroom in California, is not like any other session you’ve had before in your life. You have always prayed for that second line.  You can recall moments of standing, in your bathroom in New Jersey, willing the urine, as it slowly spread across the result window, to reveal that second line.  You have birthed four children.  You have had one appendectomy while pregnant with your third child. You have had one miscarriage. You are forty-six years old. It is enough. You are exhausted from it all…and from this latest worry, the missing IUD. It’s true that the worry has turned to relief, but still, you are depleted of energy. Sighing loudly, you throw the pregnancy test in the trash.  You wash your hands at the bathroom sink. You don’t bother to look at yourself in the mirror.

On the way to the kitchen, you check the phone answering machine and see that the message light is blinking.  The doctor has called.  “There is no evidence of the IUD in your uterus based on the x-rays. The inter-uterine device must have been flushed from your uterus,” the doctor says with a voice that sounds bright and cheerful.  “I’ll call you tomorrow to discuss next steps.” You then phone your husband to tell him that the scans indicated no need for surgery to remove an embedded IUD, and also, by the way, you took a pregnancy test, which was negative. Isn’t that great news?

You pull the cake box from the refrigerator and cut yourself a piece of chocolate heart cake.  The piece you have cut is lopsided because the heart shape doesn’t allow for a clean square slice.  You are alone in the kitchen. Your youngest daughter rushed up to her bedroom to read books the second you arrived home, just as you rushed off to use the bathroom.

You can hear her now, as she pretends to read the words in her book.  You’ve had a bad day you think to yourself. Your shoulders slump as you place the piece of cake onto a plate. The sweet melody of your child’s voice, which reaches you now, on the first floor in the kitchen, accompanies your first bite of the sweet chocolate goodness.  The dessert slides down your throat, the frosting so thick with sweet that it almost stings.  The “song reading” is a pleasant sound and the chocolate cake is a pleasant taste and you enjoy this quiet moment to yourself… thinking about nothing but the sound and the taste…for a while…on this day…that you are living.