Showing posts with label dysplasia. Show all posts
Showing posts with label dysplasia. Show all posts

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



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