Honest To Betsy: Cervical cancer

Part VII - Happily Ever After The End Part, or LUCKY

Monday, March 29, 2010

Part V - The Happy Part

I just blurted it out when he opened the front door for me, our baby dangling off his arm.

"I have cervical cancer but I'm going to be okay."

Then we laid down on the living room floor in front of the big sunny picture window with our baby and made him giggle. And I explained the details of my diagnosis while we tickled his widdle chubby belly.

This was hard, we decided, but not disastrous. It was a bump. An entirely surmountable bump. Together - we would surmount this bump. And it wouldn't change much. We wouldn't let it.

We made a plan to try for number three after I returned to work in about a year or so. It meant spacing our kids more closely together than we would otherwise but it would be okay. In the meantime we'd research the snotcrap out of our options. We'd see some other doctors for a second and a third opinion and we'd make sure that my gyn wasn't some sort of hysterectomy-happy Victorian-style mad doctor who spent his evenings creeping through foggy cobblestone alleys with a scalpel glinting beneath his overcoat.

We'd deal with this privately. There was nobody, really, we needed to even tell at this point.

When our little daughter woke up from her afternoon nap she came and joined us on the floor. We made a pile. A happy pile.

It's pretty normal -- clichéd, really -- for something like a medical scare to bring your life into sharper focus. You look out over that terrible precipice and think about all you have to lose. And you're reminded of what's really important. And you feel such intense gratitude that you don't have to let go of those things.

Since baby number 2 had come along I'd been running three times a week. I was, actually, in the best shape ever. Every week and month since his birth I felt stronger and faster. I didn't have to let this whole thing become my identity. I wasn't cervical cancer. I had cervical cancer. Past tense. That damn virus had been in me for who knows how long and my fantastic body had kept it from harming my reproductive life. Yay, body!

I felt so fit. And so loved. And so lucky.

So when my libido came knocking on the door I was all like, "Hello, Stranger! You must be here for my New Lease on Life!"

Now. The trouble with Lactational Amenorreah as a method of birth control is that it basically only works if you don't really want to have sex. If you're totally run-down and exhausted by small children who are constantly at ya but every now and again you give it the old college try basically because you feel sorry for your husband since he's starting to get a wan look and has begun to give himself prison tats, you probably won't get pregnant. If, however, you are overwhelmed by lust and can't get enough of it and suddenly your three-year old is allowed to watch as much TV as she wants whenever the baby naps, it's because you are ovulating. And you will so get pregnant.

It's like my ovaries heard the doctor.

It's like that little bell they ring before the bobsleds are supposed to rip down the ice chute went off and they were all, "AGH! ACK! Shoot one down the pipes, girls! Go Team Canada!"

And that's the gist of how I got diagnosed with cancer and pregnant in the same month.

It was a shock.

Followed by another shock.

It was awful timing.

I was tandem nursing my first two children --ohmigod-- and pregnant with my third.

How could I go back to work again, after my mat leave, pregnant again?

It is so far and away above and beyond the most financially irresponsible thing we have ever done. Like, way worse than that trip to the Mayan Riviera we took with the buy-out money the company my husband used to work for gave him when they laid him off.

Eeeeeeeeeesh.

That fateful day when my doctor said "I think you should get pregnant tomorrow" and I basically did was just over a year ago.

And now baby number three is here.

Our finances are a mess.

My libido has long since folded up the blankets neatly on the guest bed and left through the side door.

With three little ones, every little thing we do is an enormously taxing exercise in logistics and Zen.

But she is a cupcake with chocolate frosting and pink sprinkles on top. She is a pot of gold. Whenever I catch her eye she grins so wide my internal organs turn into marshmallows and spontaneously toast just so. She is a giggle laughing at a chuckle. She is so delightful.

I'm sure if this whole ordeal didn't shake us down we would have had number three at a perfectly reasonable time in our lives. Like when at least one of us was gainfully employed. And we'd love that other, much more reasonable baby very much. Just as much as we love our baby Josephine.

But that isn't how it is with your babies, is it?

They arrive and you meet them and you say, "Oh, you're exactly the one I wanted. You're perfect. I'm so glad it's you and not some other baby."

It's like she really needed to be born. And she seems so very glad to be here. She's the cherry on top of our happy pile.

Down the Rabbit Hole: An HPV Story

by Betsy B. Honest

Part VII - Happily Ever After The End Part, or LUCKY

Friday, March 26, 2010

Part IV - It Ain't Over Yet: The Diagnosis

So I was playing with my kids when I got the next phone call. A nurse said the doctor who performed my LEEP wanted to see me in his office.

"That sounds like really bad news," I said.

"Not necessarily. He just wants to review some treatment options," she told me.

For some strange reason I made the appointment a whole three weeks from then. Whatever it was, I didn't want to get on with it. I didn't want to hear it.

He asked me for about my medical history. Then he asked me how many kids I had.

"I have two," I said.

"How many kids do you want to have?"

"Three," I said, surprising myself by how confidently I answered.

"Well I think you should have that third kid tomorrow," he said. "I want you to have a hysterectomy."

"No," I said.

"Yes," he said, nodding.

"I don't want that," I said.

"I know you don't, Kiddo, but you have cervical cancer."

"You won't die of this," he assured me. "You'll die of something completely unrelated when you're much, much older. This is treatable. We've caught it early. You're lucky. You can still have that third baby. But we will have to remove your uterus."

Then I cried a bit.

"A uterus," he said, "is just a bag in which to hold babies while you are gestating. That's all it is. That's all it does."

He was talking about my womb. He was talking about something at the very center of me. He was talking about my sexual organ.

Then he drew me a few pictures. One explained what CIN III carcinoma-in-situ means. It means that some rogue cells on the top layer of my cervix started spreading into the deeper tissues. But they didn't make it across a certain barrier yet. He drew the barrier with his ball point pen. If those dots were allowed to make it past that line the cancer would proceed to spread into my lymphatic system and throughout my body.

"But we're not going to let that happen," he said.

Then he drew a picture of a uterus and some ovaries and explained how you can take the uterus and the cervix and leave the ovaries behind. They're a separate system.

"You'll still have PMS. You'll still go through menopause. But you won't have periods."

Then he asked me if I had any questions. I did.

"What will be where my uterus was? Just, like, empty space? Just, like, a hole?"

"Everyone asks that," he said. "You've got hundreds of feet of gut that will be happy to fill up that space for you. Next question."

"I can't have a baby right now," I told him. "I just had a baby. He's six months old. How long...?"

"I'm not going to tell you when to have a baby. You'll have to decide that on your own. But do it as soon as you can. Do it in the next three years."

The confusing part to me was whether I had cancer or whether I did have cancer before they removed the cells, before the LEEP.

"This is very difficult to explain to people who aren't familiar with cancer," he told me.

The cancerous cells were gone. They had been removed from my body before I ever knew they were there. I didn't feel them. The flesh they were growing on had been taken away and sent to a lab to be biopsied. Then healthy flesh grew back there. The lab looked at that piece of excised tissue and ascertained that the dysplasia had advanced to the stage of cancer.

The trouble is that once your DNA figures out how to make those cancer cells, once that human papillomavirus attaches itself to your DNA and starts calling some of the shots, once it knows how to grow squamous cells on your cervix, it might succeed at doing the same thing again. It will certainly try. That's what it does.

Then the doctor sent me home to tell my husband.

"Go straight home," he said. "And make another appointment and bring him along with you. We can talk about this as much as you need. You're really lucky though. I know you don't think so right now, but you will. This morning I had to tell a 13 year old girl that she had invasive cervical cancer and that she will die. Yours is non-invasive. It's in-situ. That means it will stay put for a while and we can take care of it for you."

He looked very tired and very sad.

I'd brought my dog Gus along for moral support. He was waiting for me in the car. When I got there he licked all the tears off my face and then fell back asleep.

Then I drove home to tell my husband.

Down the Rabbit Hole: An HPV Story

by Betsy B. Honest

Part VII - Happily Ever After The End Part, or LUCKY

Thursday, March 25, 2010

Part III - The LEEP

I guess I'm kind of a pussy about my vagina.

I mean, if there was in infection in my inner ear and a doctor had to look into my eustacean tube with some flashlight thingy I don't see myself getting all weepy about it on the examination table.

But there's something very special to me about my vagina and stuff. Which is that it is my vagina and stuff.

Leading up to my LEEP, which is a day surgery, all I did in every doctor's office was blubber. But by LEEP day I kind of had my head wrapped around the whole HPV thing. I'd done a lot of research and had some conversations with friends that made me realize dysplasia (abnormal cells on your cervix) is really common and really treatable. And I was just glad that it was something they'd be able to take care of with their thingies and stuff. Yay modern medicine! I say this without irony -- if not treated dysplasia can turn into cervical cancer which is a huge killer of women in the developing world.

Also, my baby was six months old at this point which meant I was worlds saner than when he was three months old. They say it shouldn't take more than a couple of weeks for your weepy-go-nutsy hormones to pass after childbirth but for me it definitely takes longer. Much longer.

A LEEP is a loop electrosurgical excision procedure. They are for removing abnormal cells found on your cervix. A doctor uses a super-electrified loop of wire to burn a kind of cone-shaped chunk out of it. I had a pamphlet that explained it all to me. The pamphlet urged that while it wouldn't hurt a bit (because of the anesthetic) I should take the rest of the day off work.

No problemo. We packed up the wee ones and headed to the hospital where my daughter was promised ice cream and chocolate milk if she'd wait nicely with daddy in the cafeteria while mommy got a big needle.

I was already familiar with how to put on the gown and get through the medical history and yadda yadda yadda.

And it was fine. The smell of burning flesh was definitely disconcerting but other than the poke of the anaesthetic needle, I felt nothing. If you're reading this now because you've googled LEEP and are about to have one done I'd like to caution you that they put the anaesthetic needle directly into your cervix. I know, right? It's kind of obvious if you think about it, but who would think about it? Heebeejeebeejibe.

Afterwards the doctor made me promise not to have sex for two weeks and I was, like, "No problem."

Then he added, "and no other physical activity whatsoever."

I knew our sex life wasn't what it used to be when my mouth dropped open in horror and I spluttered, "You mean NO HOCKEY?"

"No. Definately no hockey."

"For TWO WEEKS?"

"Yes."

"And no running?"

"No running."

"But I can go cross-country skiing, right?"

"No." It was then that the doctor and the nurse exchanged a "well this one is kooky" look.

"Really? But it's so gentle...."

"Really. You don't want your wound to tear. You don't want to rip and hemorrage. I want you to just do nothing for two weeks."

"So no housework, right?"

"You can do light housework, sure."

On the drive home I explained to my husband about the no sex and the no housework of any sort for two weeks. And as we headed down the freeway the aenesthetic wore off. And as it wore off it kind of struck me how the doctor had removed a fairly large piece of my flesh. And it started to hurt. And it kind of hurt for the next week or so. Mostly just when I stood up or sat down. But it was allright. I was allright.

It was just before Christmas and I was a little heartbroken to miss the sporty parties I'd been planning to go to with my stroller running group and with my hockey team. But I just made do with the regular kind where you eat too much baked brie and too many truffles while watching everyone else get blotto around you and your nursing baby.
I didn't really tell anybody about "my gynelogical procedure." Except one friend. It didn't go well. I kind of casually mentioned it over a plate of antipasto. And I was going to say it wasn't a big deal but my voice kind of cracked while I tried explaining that it was no big deal. And then I was embarassed and she had no idea what to say and her toddler tripped on his own feet so she leapt up to comfort him while I wiped a quick tear away and had some antipasto.

And that's the thing. If it was toe surgery or nose surgery or something in my eye or my ear, I would have told more people. It would be a pretty good ice breaker at a party. And I wouldn't get all leaky and cracky talking about it.

But I'm kind of a pussy about my vagina and stuff.

Down the Rabbit Hole: An HPV Story

by Betsy B. Honest