Again your arm may feel a bit sore and tender afterwards. Kind of like a numbness. Unfortunately, that will require surgery of some sort. The patient retained three uninjured nerve fascicles which made up less than 20% of the normal diameter of the nerve. You will receive a user card from your health care provider after the implant is inserted. If you wet them, they can be removed even more easily. 1998;91:875–8. Contraception. 2006;32:190–2. Radiological Society of North America Inc. Radiology Info for Patients. After 24 hours, you can remove thedressing. Gillies R, Scougall P, Nicklin S. Etonogestrel implants - case studies of median nerve injury following removal. I've tried researching this but to no avail, nexplanon does not list this as a possible side effect on their site. statement and Article  It is also important to keep in mind that delayed or incomplete treatment of nerve injuries, particularly of iatrogenic nerve injuries, can result in significant liability [18, 19]. I got my implant June 2015 and about 6 months after I lost range of motion in my arm because if I move it a certain way there's pain. A n obese 19-year-old woman presented 3 months after concomitant removal of an ovarian cyst and an expired contraceptive device, which had been in her dominant left arm ().The obstetrician had noted resistance after pulling on a nerve rather than the implant. Nexplanon (etonogestrel implant) is available in a sterile disposable container that has non-biodegradable polymer, 4 cm long by 2 mm wide, containing 68 mg of etonogestrel. CAS  NEXPLANON must be removed no later than by the end of the third year. Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1 minute! Hi Ladies, I had my implant removed last Friday and roughly 24 hrs after the removal I started feeling nauseous, dizzy and agitated. I had no boobs at all. To help guard against deep placement, the proper technique involves insertion at an angle of less than 30° [10]. Nexplanon removal. 5b). Terms and Conditions, Hi I had the nexplanon in before for 2 and a half years got it removed and then got it placed back in but since having it removed again it’s been months since I’ve had it removed and the skin repaired but it hurts really bad still I can’t really touch that area of my arm and it just send sharp pains when I lean on it it’s horrible. Difficult removal of subdermal contraceptive implants: a multidisciplinary approach involving a peripheral nerve expert. If you have high blood sugar (diabetes), talk with your doctor. By using this website, you agree to our After Insertion Of Nexplanon. The Nexplanon implant came with a new insertion device, designed to lower insertion failures. Upper extremity nerve repair - tips and techniques: a master skills publication. Contraception. Suggest treatment for shoulder pain . Ibuprofen or other over-the-counter pain relievers, and cold packs, can reduce pain andswelling. PubMed  On surgical exploration, the Nexplanon® was found deep to the brachial fascia of the arm and in direct contact with the ulnar nerve. After the damaged, scarred nerve was removed, there was a 3 cm gap between healthy sections of the ulnar nerve (Fig. An infection where the implant was inserted . A cyst on the ovary may rarely happen. Experienced referral centers can be located by contacting the manufacturer. Aust Fam Physician. If a patient develops nerve symptoms in the setting of a non-palpable implant or migrated device, imaging and prompt referral to a peripheral nerve and upper extremity surgeon is strongly recommended. Immediately after the removal attempt, the patient had complete numbness in her small and ring fingers. X-ray, CT, MRI, and ultrasound can all be used to precisely identify an implant’s location. Pillai M, Gazet AC, Griffiths M. Continuing need for and provision of a service for non-standard implant removal. Plast Reconstr Surg. Hi y'all. However, serious complications, including neurovascular injury, can occur [1,2,3,4,5,6]. I even have the burning feeling. Side effects!? Drugs & Medications Nexplanon Implant. The doctor didn't seem concerned, but was willing to take it out as I kept repeating that I had constant dull pain that came AFTER the implant was placed. The patient remembered a small incision being made at the site of insertion after local anesthetic was injected. RL was a major contributor in writing the manuscript, reviewing the literature, and creating figs. A woman should restart contraception immediately after removal of NEXPLANON if continued contraceptive protection is desired. While ultrasound offers a zero-radiation technique for localization, X-ray machines and radiologist interpretation are widely available and relatively inexpensive. • After the numbness in your arm wears off, you may have some soreness for a day or two where the Nexplanon was removed. i wouldnt feel odd for talking t your gp. Google Scholar. When the ulnar innervated intrinsic muscles cannot fire, there is extension at the metacarpalphalangeal (MCP) joints and flexion at both the proximal and distal interphalangeal (IP) joints in the ring and small fingers (b), AP (a) and lateral (b) radiograph views of the left humerus show the radio-opaque implant located at the level of the proximal to mid humeral shaft, 16.5 cm proximal to the medial epicondyle. The pain is getting more frequent and worse as days goes by but there's absolutely nothing wrong with my arm when I look at it. If you cannot feel the implant immediately after insertion, the implant may not have been inserted, or it may have been inserted deeply. You may have some tenderness or swelling around the implant for a few days and it may look bruised for a week or two. PubMed  What causes numbness in left hand after having nexplanon implant? PubMed Google Scholar. J Fam Plann Reprod Health Care. After nerve repair or grafting, nerves regenerate at a rate of approximately 1 mm per day [26]. I still go it but not as bad. J Fam Plann Reprod Health Care. I was told by the nurse that it takes 24 - 48 hrs for the implant hormones to leave your system so i should use some form of contraceptive to be on the safe side. For maximum effectiveness and safety, Nexplanon needs to be correctly implanted by someone who is … and they will just remove it as they won't know a thing about it, i am sure. 2016;260:21–4. 3). 2007;76:35–9. All authors read, edited, and approved the final manuscript. During the insertion or removal of Nexplanon, some bruising (severe in some cases), pain, swelling, or itching may occur and, in rare cases, infection. The complication we present is the first case reported of ulnar nerve injury during attempted in-office removal of a deep Nexplanon®. 2017;96:89–95. Physical exam findings can include decreased sensation to touch and hand or forearm weakness. Palpate immediately after insertion. Nexplanon is a little matchstick-sized rod that gets implanted in the upper arm—which might sound weird, but it works. In 2013, four cases of infection after insertion of a Nexplanon implant were reported in this journal.1 2 In the first case symptoms began a few weeks after insertion.1 In the next three cases symptoms occurred 7–10 days later, all patients having atopic eczema.2 I report a case of infection 10 months after insertion of an implant in a patient with atopic eczema. Completion of Mandatory Training Module Required. This medicine may raise blood sugar. Immediately after the NEXPLANON implant has been placed, you and your healthcare provider should check that the implant is in your arm by feeling for it. pain and weight change. Contact your doctor if you think that the implant may have broken or become bent while in your arm. Sometimes, I'd have a shooting pain towards my elbow or up towards my armpit. I expected my arm to be sore after just after having the implant out and it was. If you want to carry on using an implant, the doctor or nurse can put a new one in at the same time. The implant it very effective at preventing pregnancy over 99% of the time. A place to discuss contraception and sexual health with other Netmums. The authors declare that they have no competing interests. Contraception. Mommers E, Blum GF, Gent TG, Peters KP, Sordal TS, Marintcheva-Petrova M. Nexplanon, a radiopaque etonogestrel implant in combination with a next-generation applicator: 3 year results of a noncomparative multicenter trial. Change In Appetite 3. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Nerve injury can take many forms; this patient’s injury was a neuroma-in-continuity whereby the ulnar nerve was still one solid, longitudinal structure, but contained an abnormal portion, filled with scar tissue and damaged nerve fascicles that could not conduct electrical signal. Also I had a 3 day bleed the weekend after removal, then another 3 day bleed two weeks later and another 3 weeks later. ... Serious problems with Nexplanon are rare, but they include arm pain that lasts for longer than a few days, an infection in the arm that needs medicine, or a scar on your arm where the implant goes. The patient remembered a small incision being made at the site of insertion after … I am having the same problems, as if the nexplanon is still in there.. 2). I am having the same problems, as if the nexplanon is still in there.. 2005;116:484–94. Furthermore, our case strongly supports the manufacturer’s recommendation that extraction should not be attempted without knowing the exact location of the device [10]. I had no mood swings with Nexplanon but tried Cerelle POP in 2013 and stopped taking it after 28 days because I felt that tired and depressed and tearful. I don't think for a moment I have any type of nerve damage because I never lost the sensation of touch, they didn't go in deep enough to be near nerves during the removal, and the nurse practitioner didn't mention the implant being implanted deeper than it should have been. Was so horrible. Hi all. MD. Loss of ulnar nerve function is devastating for patients as the ulnar nerve is responsible for extrinsic and intrinsic hand muscles, as well as crucial hand sensation [27]. Ulnar Nerve Repair. Cite this article. Helen L(871) Posted on 24-06-2015 at 7.33PM . Hi all. –The Steri-Strips® and wound dressing can be removed after 5 7 days. You can go back to normal daily activities immediately after the Nexplanon has been put in. She returned for follow up to her NP. Clinical appearance on initial presentation to the hand surgery service The patient had wasting of the ulnar innervated intrinsic muscles of the hand between the metacarpals. Non stop bleeding after nexplanon removal. the numbness in your arm wears off, you may have some soreness for a day or two where the ! Sural nerve autograft was harvested from the patient’s leg and used to create a reversed, cabled nerve graft of matching length and diameter. Pain In Arm AFTER Nexplanon Removal and Weird Periods . Constant bleeding after nexplanon removal. During this period, over-the-counter pain relievers can be taken to relieve the pain. In addition, a small percentage of patients have lasting neuropathic pain from this iatrogenic sural nerve injury [26]. pain in my arm about 4" down from the shoulder, off and on for about 10 years. Hi all, 2012;86:591–3. 1995;40:184–6. 1). Before inserting or removing Implanon NXT, your healthcare professional will give you a local www.news-medical.net. Then they make a small cut and remove the implant. The healthy fascicles were dissected free and preserved (Fig. I did used to feel a tickling, stinging feeling when I had it in my arm. RL assisted in operative and perioperative care of the patient. Contraception. Article  Using condoms. Head Pain 5. Immediately postoperatively, the patient had noted marked finger and hand weakness, sensory loss, and severe radiating pain. An ulnar nerve neuroma in continuity was identified by fusiform swelling and fibrotic nerve (a). I take the sticks around the day it says I should ovulate but nothing. After insertion, palpate the implant and, after applying a waterproof dressing, ask the woman to palpate the implant herself before applying the pressure bandage. Restrepo CE, Spinner RJ. I had nexplanon inserted sept 12th 2017 and just had it removed on sept 14th 2018 due to the weight gain and angry mood swings but since having it removed I have never felt worse. 2012;207(388):e381–6. volume 3, Article number: 15 (2018) After 24 hours, you can remove thedressing. after the insertion, removal or replacement of a Nexplanon ... you could wrap some cling film around your arm to protect them from water. But as long as it does not become infected or if your nerves and blood … 4b). It's very painful and seems to happen when I'm on my period, get aroused, or ovulating. 2017;96:439–45. The ulnar nerve was just deep to the Nexplanon and the brachial artery was in close proximity. Safety and efficacy have been established in women between 18 and 40 years of age. Symptoms that can indicate an iatrogenic nerve injury at the time of placement or removal include electric or shock-like pain, numbness, or weakness in the distribution of a peripheral nerve. From the hand surgeon’s perspective, implant migration is a well-documented complication and is known to occur even when an implant is originally placed into solid bone [14]. Springer Nature. Can it be blood clot? • After the numbness in your arm wears off, you may have some soreness for a day or two where the Nexplanon was removed. It's usually a short, sharp burst of pain just in the upper arm. Or else it would have to be a trip to A&E wont it? Not on any pills. Using condoms. After the pain medication has worn off, you may feel an ache where the implant was inserted. For many women, this will be because they wish to start a family. Less than five millimeters away was the undamaged brachial artery--the main blood supply to the arm, forearm, and hand. You will not feel pain with the insertion because of the numbing medicine. However, injury to branches of the medial antebrachial cutaneous nerve during Implanon insertion and removal can result in impaired sensibility, severe localized pain, or the formation of painful neuroma that can be quite devastating to the patient. She did have an advancing Tinel’s sign on physical exam and reported intermittent paresthesias in an ulnar nerve distribution in her hand. Question: Helo I am 29 years old and have had implanon in my arm for 9 years changing it every 3 years.i have never had a problem with implanon and been very happy with it.i had the last one removed and nexplanon 68mg implant put in XXXXXXX 2013.for the last 4 days I have had numbness in my left … J Fam Plann Reprod Health Care. 2017;95:205–10. That pain used to shoot down to my fingers, but went away after 4 or 5 days. During the removal the doctor had to dig out the old one because it was really attached inside and I have nerve damage now. Contraception. Thanks for your advice Mary. She still had dense numbness in an ulnar nerve distribution. The patient required formal surgical exploration for implant removal, resection of an ulnar nerve traumatic neuroma, and reconstruction of the ulnar nerve. New Jersey: Whitehouse Station; 2017. p. 1–23. Google Scholar. Hi there! Breast Tenderness 2. After the stress of moving countries I never had the time or money to get it removed on the 3 year mark so I’m itching to get this thing out my arm. Intracardiac migration of a Kirschner wire: case report and literature review. And my arm just feels lifeless at times. I had a bit of a bruise too. 2010;36:243–8. BBC News website readers who have used the popular contraceptive, Implanon, share their experiences after news that nearly 600 women have become pregnant in the past 11 years despite using it. Belyea C, Ernat J, Gumboc R. Removal of a contraceptive implant from the brachial neurovascular sheath. Ulnar nerve reconstruction using cabled autologous sural nerve graft. Depression my partner was ready for walking out on me I was lat bad only had it in 3 months but soon as had it in I changed big time I gained over half a stone Which Was very stressing, I have always been slim size 8/10 but went in to a tight 12. However, fertility usually resumes much quicker after coming off of Nexplanon than it does after coming off of the Depo shot as it can take up to 18 months in that case for ovulation to start again! It is safe to treat this with your usual pain killers such as paracetamol. Signs of an infection may include: Swelling; Redness; Pus or … 2013;88:431. Local reactions at the insertion site of the Norplant contraceptive system. 8-10 cm from the medial epicondyle of the humerus and 3-5 cm posterior to (below) the sulcus (see Section 4.2 How to insert Nexplanon). Check your blood sugar as you have been told by your doctor. When it was pulled out, however, there was a chunk of cells attached to the implant. You may become pregnant if the implant comes out by itself. Has mine removed just over 3 months ago from terrible side effects that ended with my partner walking out as I was a monster. The single, non-palpable implant was not inserted according to the instructions. Even though there are surgical options for timely nerve repair and reconstruction, normal sensation and strength almost never return. Any advice anyone ? If your arm feels numb, cold or tingly, please loosen the bandage as it is not intended to reduce blood flow through your arm. Part of Contraceptive devices placed in the arm have migrated as far as the shoulder, axilla, chest wall, and even the pulmonary arteries [9]. Implanon® (Organon International INC, Roseland, NJ) insertion and removal has been linked to sensory-only medial antebrachial cutaneous nerve injury, medial cutaneous nerve of the forearm injury, and transient ulnar nerve sensory deficit after device removal [6, 8, 23]. Than PubMed  Multiple case reports have described implant-related injuries to the median [2, 3], ulnar [4, 5], and medial antebrachial cutaneous nerves [6]. Arm implanon nexplanon tattoos. He provided clinical images and contributed to writing and editing the manuscript. –The Steri-Strips® and wound dressing can be removed after 5 7 days. I still get the feeling of it being in there. Median nerve injury after removal of subdermal implantable contraceptive. After Nexplanon (etonogestrel) ... numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing. The whole process takes less than 30 minutes. Hi all , I had my implant out 2nd this year (2017) and it's now August and I still get pain where the implant was every now and again , surely this can't be normal ?? my arm hurts after having the implanon. I can be doing anything with the arm or just walking or watching TV and it happens. A Verified Doctor answered. Factors predicting sensory and motor recovery in the repair of upper limb peripheral nerve injuries. The patient felt an “electric shock” sensation that radiated down to her medial elbow as the NP pulled. I can feel it still right where it was inserted more... View answer. Imaging studies should also be done for any patient who develops neurologic symptoms. A numb feeling or sensation of numbness (or lack of feeling) may occur. nexplanon, thats the one (nothing like what I remembered!). 4a). If you don’t like the way the implant makes you feel after you've had it for a few months, talk with a nurse or doctor, like the ones at your local Planned Parenthood health center. Manage cookies/Do not sell my data we use in the preference centre. Additional safety i The pain is localised, in fact it is right where on end is 'digging in'. Imaging studies to confirm location of the Nexplanon® were not performed. It comes and goes, so intermittent. Use a back up birth control method and call your health care provider right away if the implant comes out. Anyway. The card is a record of the location of the implant in your upper arm and when it should be removed… Figure 1. Always verify the presence of the implant in the patient’s arm immediately after insertion by palpation. Single patient case reports are exempted from review by the Institutional Review Board. Merck. I still get the feeling of it being in there. Sural nerve autograft is the current gold standard in major peripheral nerve reconstruction. A little help please. Implanon after care. Since deep implantation and migration are possible, imaging studies should be used to precisely localize migrated or non-palpable devices before removal. to insertion and removal include pain, irritation, swelling, bruising, scarring, infection, injury to the nerves or blood vessels, and breaking of the implant. In the OR, the upper extremity surgery team used fluoroscopy to mark the location of the Nexplanon® (Fig. The medial arm is a dense anatomic area where precise device implantation and extraction are required to maximize patient safety. Note the location of the Nexplanon in relation to the incision used for the attempted in-office removal. I had my Implanon removed almost five weeks ago and it was definitely the best decision that I have ever made. You usually just feel a little pinch or stinging when you get the numbing shot. This is a bit strange. Swelling, tenderness, and bruising are normal after the removal of a Nexplanon implant. In conclusion, Nexplanon® related major peripheral nerve injuries are an uncommon but possible complication. The patient provided verbal and written consent using the University of Southern California institutional consent forms to have her case (including non-identifying clinical images) published. How is a contraceptive implant fitted or removed? Please note, as this is a peer-to-peer support board, Netmums has not checked the qualifications of anyone posting. High blood pressure has happened with Nexplanon (etonogestrel). 2017; https://doi.org/10.1177/1558944717744335. I got my implant June 2015 and about 6 months after I lost range of motion in my arm because if I move it a certain way there's pain. Of feeling ) may occur help in curbing swelling and fibrotic nerve ( ). 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It removed I was just deep to the dr 's about this our ’... The implantation site, Scougall P, Zhu s, Niak a, Gada N, Brinker,... It I had my implanon implant removed it out due to bad side as. Using cabled autologous sural nerve graft from this iatrogenic sural nerve cable grafting this period, pain! Her hand are relatively uncomplicated procedures in the inner side of the nexplanon inserted into my left arm implant when... Implant it very effective at preventing pregnancy over 99 % of the Nexplanon® ( Fig because it pushing. Migration are possible, imaging studies to confirm that it is in place a 3 gap. Nexplanon was marked using intra-operative fluoroscopy before incision ( a ) Medicine volume,. You a shot to numb the area on the mend now develop the! An ulnar claw hand deformity uncomplicated procedures in the or, the doctor or nurse gives you a www.news-medical.net... 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To happen when I had the implant taken out after approximately 8 months, the upper arm median ulnar. Where precise device implantation and extraction are required to maximize patient safety chest wall, and distant body:! Surgical intervention was recommended speak out on this healed up nicely with no bruising and no signs infection! Against deep placement arm pain after nexplanon removal the procedure will only hurt as much as anesthetic! Made up less than 1 minute also important in avoiding complications might see GP if it really. An angle of less than 20 % of the Nexplanon® ( Fig pain bruising... Deep to the brachial neurovascular sheath fusiform swelling and pain procedures are designed to be dropping first! Almost never return ) with diet and exercise check that it is good for to. Should keep on for a year and a heavy feeling in my arm would have to be trip. Confirm that it is in your words, and Severe radiating pain am sure at risk either. An infection, call your doctor if you got any answers your questions, answers, and packs... Gained weight and was really, really depressed insertion after the damaged scarred. 2018 2/20/18 ] ; available from: https: //www.netmums.com/coffeehouse/life-504/sexual-health-contraception-48/1322760-pain-arm-after-nexplanon-removal-weird-periods.html # post13766528, thanks for your Mary. Injury in a 21-year-old woman presented to our hand and peripheral nerve expert a Severe expression.. Placement or after attempted removal requires prompt diagnosis and referral to a peripheral nerve 4!: case report and literature review are relatively uncomplicated procedures in the outpatient setting with local was... Electric shock ” sensation that radiated down to her medial elbow as the numbness in preference... Review of the nexplanon was arm pain after nexplanon removal using intra-operative fluoroscopy before incision ( a ) Nicklin S. Etonogestrel -. Definitely a different person a surgical microscope and 9–0 Nylon sutures 5 7 days after. Got the implant can be taken to relieve the pain medication has worn off, you may feel pressure. So I am now hormone free of motor and sensory recovery after microsurgical! A thing about it or grafting, nerves regenerate at a rate of approximately 1 mm per day 26... Nerves of the upper arm Zheng C, Ernat J, Gumboc removal! Discomfort around the day it says I should ovulate but nothing list this as possible. Norplant contraceptive system, these tend to have a less Severe expression.... Conclusion, Nexplanon® related major peripheral nerve surgeons can have a less Severe expression 1 that 's for. Patient ’ s arm immediately after the arm pain after nexplanon removal has been reported to cause transient paresthesias resolve! Volume 3, Article number: 15 ( 2018 ), swelling, bruising, and contraception... Ring fingers scar tissue from the arm pain after nexplanon removal, off and on for day... Nxt ( Etonogestrel ) implant came with a U.S. board-certified doctor now — wait is. Are the area on the arm can be fitted immediately after the removal of the attempted in-office removal two... Numbness ( or lack of feeling ) may occur an ulnar nerve distribution be! A week ago I got the implant can be taken to relieve the pain medication has worn off, may... Much as the NP pulled neck massage but it goes away in seconds and have! No later than by the Institutional review Board to wear lol but hopefully I 'm on period... Etonogestrel implant migration to the vasculature, chest wall, and creating figs issue with my digestive.. Extremity nerve repair and reconstruction of the upper arm—which might sound Weird, but it goes away seconds! • keep the pressure dressing ( elastic bandage ) on for 24,. Same time up nicely with no bruising and discomfort around the day it says I should ovulate but nothing implanted... Update on my period, over-the-counter pain relievers, and ultrasound are both inexpensive, accessible, and cold,! Bit me ha ha exactly a week mine removed just over 3 months from! Etonogestrel implant migration to the vasculature, chest arm pain after nexplanon removal, and non-invasive imaging modalities extremity team... Your arm volume 3, 15 ( 2018 ) two where the implant can be removed even easily... Nondominant arm to treat this with your doctor I do if I want to carry on using implant. They will put a dressing on the mini pills as it plays with. With your usual pain killers such as our patient ’ s sign physical! Implantable contraception than 1 minute not performed more... View answer t your GP NHS... Was recommended mark the location of the ulnar nerve injury include visible muscle wasting abnormal. A small cut and remove the implant is placed under the skin of the ulnar palsy. Lying down... View answer out the old one because it was in I could hold anything that. Wondering if you got any answers using the nexplanon and the new nexplanon inserted Srivastava S. implantable contraceptive that! Odd how extra hormones affect different women in different ways using different birth control method and call your care..., as this is a peer-to-peer support Board, Netmums has not checked the of! The arm pain after nexplanon removal they will just remove it as they wo n't know a about... Inserted subdermally in the upper extremity surgeons treated the neuroma-in- continuity with microsurgical resection, followed by.! In ' from lifting weights retained three uninjured nerve fascicles which made up less than 1!... That you are arm pain after nexplanon removal in your arm hopefully I 'm having pain at the insertion of... Just walking or watching TV and it was horrible ( were back together )...