Tuesday, March 15, 2011

the nitty gritty

**Warning: this post includes the words "uterus" and "cervix" multiple times and possibly other words that may make 12 year old boys and immature women uncomfortable and/or giggle uncontrollably. If you are one of those people, click the red "x" at the top of your browser window, now.**

For Christmas this year, M got me a spa day. A complete, 5 item package. Hair, nails, massage, facial, the works. I was so excited! The day of my appointment I got all ready to go, said goodbye to the kids and headed out, blaring my music and singing at the top of my lungs on the way (I am so glad I didn't happen to butt dial anyone on my cell that day). When I checked in at the spa, the bimbo receptionist looked at me and with a super snotty voice said, "Um, we don't take walk-ins". Long story short, when M booked the package and paid for all of it, the bimbo never actually booked my appointments in the computer, so there was no one there to do the services for me. I have to say, I was pretty disappointed. I knew M had put a lot of thought into it and I was looking forward to a nice day, and dang it, I had shaved my legs which is no small deal in the middle of winter.

So out of spite, I literally called my doctor's office and scheduled a Pap smear. Because I would seriously rather have had a Pap done than reschedule with that front desk bimbo who ruined my Christmas present. It had been about 14 months since my last one, so it was time. I called to make the appointment, expecting to get an appointment date a month or so away, but they just so happened to have one for the next morning, at 10am. Less than 20 hours later, there I was, feet in stirrups, getting my Pap done.

For the couple of months before that I had a feeling something wasn't right. I just didn't feel good. I had a weird pain in my ovaries and my uterus HURT, I was tired, had headaches all the time and my periods were horrendous. And right after New Year's I got the call that I dreaded. Of course, the nurse called right before dinner time, on a night when M was running late and the kids were super cranky. All I heard her say, between the babies crying, was "HSIL and follow up testing using a colonoscopy to do a biopsy, as soon as possible". Um, hold up. I don't know what "HSIL" is right now, I will google that later, but I'm 98% sure that a colonoscopy has absolutely nothing to do with a Pap, and I would prefer NOT to have that done, at this time... And she laughed and said, no, a COLPOSCOpy. Not a COLONOSCOpy. Thank goodness.

So after I googled "HSIL" and proceeded to have the most massive panic attack I have ever had, I waited for a call to schedule the colposcopy. And a week turned into 2 weeks and the pain kept getting worse so I requested to get an actual GYN appt to see what was going on. And that doctor decided she wasn't comfortable with my case, so she was going to refer me to the specialty GYN clinic on Post. And that was going to take about 2 weeks. 2 weeks passed and I still hadn't heard from them, so I got ahold of a super secret phone number and called to see what was going on. The woman on the other line told me that they didn't have any room available to see me, so they were going to have to refer me to an OB/GYN off post, and that paper work would take about a week to go through. Ok, so we were 5 weeks past the "highly abnormal" test results and about 4 weeks past when the doctor originally wanted my "as soon as possible" urgent follow up biopsy.

As soon as the referral went through I called the office to set up an appointment and the soonest they could get me in was 4 weeks and 3 days from the time I called. Awesome. So I waited extremely impatiently, in pain, until the appointment day. On the way to the appointment I called to confirm that the appointment was still on, as no one had called me to confirm the day before. I was told, yes, yes, you are still booked, come in. So 20 minutes later I arrived, only to be told that they had to cancel my appointment because the doctor had to leave, but they could reschedule me for 3 weeks later. And that is when the temper tantrum began. I had already waited 9 weeks for this effing appointment. I had JUST talked to them, 20 minutes before, and they said I was still on for the appointment. I had driven 45 minutes to get there, with 3 cranky kids AND I had woken up early to shower and shave my legs and I was NOT going to wait 3 more weeks to get this done. I was NOT.

I called my insurance and told them what had happened and they were not happy at all. They gave me the names of some providers in my network to try to see if any of them could get me in sooner. But the soonest anyone had any "new patient" appointments available was in May. May. MAY. I knew in my gut that I could not wait that long. I knew that even waiting 3 more weeks for this biopsy was going to be too long. So in desperation I called the specialty clinic on Post and got the most wonderfully patient receptionist who was able to decipher what I was saying between sobs. Within 20 minutes her boss had called me back and asked me what was going on and when I told her, she was very upset. She knew I should not have had to wait over 9 weeks to get this appointment and that it just wasn't safe or responsible to wait that long. So she asked if I could go into their clinic at 2:30 the next day and I said YES!

It wasn't that I wanted to have this done. I mean, no one really wants a chunk cut out of their cervix, but I knew it had to be done. So the next day, I went to have the colposcopy done. I had to take the 3 girls with me, as I didn't have time to get anyone to watch them and M didn't have a chance to get time off and that proved to be an extra fun challenge because MJ really didn't want to be put in the stroller. The only way I could get her in the stroller was to give her my iPhone and turn on The Backyardagains (she has a wicked crush on Pablo). Then the doctor, his nurse, and his NP Trainee came in the room.

I'm all for people learning how to do medical procedures, I just don't want to be the one they learn on, especially when they are taking sharp instruments to the inside of my body, without any kind of anesthetic or shot of tequila to take the edge off. But, it was time for the NP to do her FIRST colposcopy!! Oh yay. So with the doctor telling her what to do she started the examination... and they used a lot of big words in concerned voices while looking inquisitively into the microscope thing. And then the NP asked the doctor if she was seeing the right thing (!!) and he was like, I don't know, scoot over so I can take a look... and I was like, dang, I should have sold tickets! 

The doctor was really not impressed with what he saw and wanted to biopsy 2 different areas of the cervix. So he handed the NP the long knife thing they use to do the biopsy and started to tell her how to do it (!!) And then she stabbed me in the vagina, which is NOT supposed to happen so I kindly requested that the doctor do it instead. Two samples from the cervix and a stab to the vagina later, I was done. And it hurt, but I knew it was necessary. The doctor told me as I left that he would have the results in a week (the next Friday) and to "have a nice weekend". Yes, yes, me and my wounded cervix will have a fantastic weekend, thanks.

3 days later I got a phone call from the clinic and instead of hitting "accept",  I hit "decline". I have never been more upset about making such a stupid mistake. Their office was closed so I couldn't call back to see who had called me and I tried not to worry about what the phone call was about, but I was freaked. The day after, at 8 am, they called back. And you know it is never good when the patient advocate calls you, with her super nice and sweet voice, and tells you that she has some news and asks you if you would rather come in to hear it, or hear it over the phone. I chose to hear it over the phone.

CIN III, Severe Dysplasia. Not cancer, but precancerous. They will have to do a Cold-Knife Conization to remove the abnormal cells, which cover over half of the transition zone. This is the best treatment for these kind of cells and provides for the best sample of tissue to test for cancerous cells deeper than the surface cells. Oh. Joy. Thankfully, this is a fairly common and fairly simple procedure and has a high success rate but it is still not something that I really want to do. It is going to hurt. It is going to require general anesthesia. It is going to take awhile to recover from and it might have some side effects.

The truth is, we want another baby. And I know that disgusts some people (why on earth would I want another child when I already have 4???) and it is hard for others to understand, but I don't feel like our family is complete. And this surgery will make it potentially difficult to get pregnant and carry a pregnancy to term. And that is assuming that the cells are not cancerous and don't come back. So, while minimal on the grand scale of things, this is still a lot to take in and digest.

I am not writing all of this out to gross you out or get the "TMI Queen of the Month Award" or even to  be all "pity me, please" but more as a PSA to get your freaking Paps done regularly. I have never, ever, had an abnormal Pap. Never. Less than a year and a half ago I had a normal Pap. This has gone from nothing to "holy crap!!!" quickly and you never know who it is going to hit or when or how fast. Normally these kinds of cells to not grow this fast, and normally only become abnormal and/ or go away on their own over the span of a few years but I happen to be in a special subset of women who's body's react this way.

I'm sure this is payback from my cervix for all of the trauma I have put it through over the past 5 years. "You want to have 4 babies in 3 years?? Fine, but payback will be mine." It is angry. Very, very angry. Your cervix might not be as angry as mine, but it might be hiding a secret. It might not. You never know and the only way to stay on top of this is to get checked regularly. There aren't many obvious symptoms and the only reason I know what is going on is because I got spiteful one day and on a whim made an appointment. Believe me, the last thing you want is to go through this, or worse, go through cancer treatments. Cervical cancer is treatable and has a high cure rate if it is caught early, but don't even let yourself get to that point. It isn't worth it to you and those you love.

**Please, please, do not SPAM me with HPV vaccination info, debates or scolding. I don't need it or want it. I am not interested in engaging in a conversation about it. I'm not an expert on this, and have only started learning about any of this in the past couple of weeks. Please call your doctor if you have questions or concerns or want to discuss the HPV virus and/or vaccination and the side effects. I am also not interested in engaging in discussion about the health care system-- thanks for understanding.**

Monday, March 14, 2011

uber, super reality check

I am so glad that February was a short month because it was all kinds of dumb. It started out ok but somewhere around the middle of the month it just got stupid after a container of yogurt tried to kill me. Yes, it did. I was famished one night and grabbed a container of yogurt, not realizing it was past its expiration date AND had sat in the warm car for about 2 hours while I drove it home from the store. I didn't think it tasted too funny when I ate it, but it certainly didn't taste good about 4 hours later when I was in a heap on the bathroom floor, using a damp, most likely dirty, towel as a pillow and praying for the rapture to happen immediately.

A few days later, M had LASEK done on his eyes, which was great, except for the unforeseen complication of getting MRSA inside his eye, which lead to the threat of a cornea transplant, should his eye not get better and scar. Because that is just what we needed... a cornea transplant would most likely squash any hopes of him meeting his career goals, so we decided that if he did end up losing his eye, he'd stay home with the kids and wear an eye patch while I went off and joined the Airforce so we could keep our benefits. Neither option is anything we had ever thought put in our "5 year plan" so it was pretty scary having to consider all of those potential possibilities. The kids just thought it was cool that daddy might stay home with them and best of all BE A PIRATE!!

As he was healing up, thanks to heavy doses of steroids and antibiotics, CB woke up one morning with purple pin prick spots under her skin on her face, neck, ears, eyelids and chest. It was the weirdest thing I had ever seen. And because she had been complaining about her legs hurting badly the day before, of course my first thought was LEUKEMIA so I raced her to urgent care right away. The doctor came in and kind of glanced at her and said something about how she was sure it was just a reaction to something and that it would clear up soon with some benedryl, but when I interrupted her and said  that I had never seen a PURPLE PIN PRICK rash UNDER THE SKIN as a reaction to some kind of food, she looked up and then proceeded to join me in freaking the freak out. After labs in the office we were sent to do more specific labs at the hospital and then to the pharmacy for more steroids to see if that would help clear it up. Wanna know what a cup full of pee, 6 vials of blood and 2 finger pokes from a distraught 4 year old cost me? $19.99 for a Barbie and horse and another 20 bucks worth of Dollar Spot stuff, and I think I got off cheap. Thankfully, all of the labs were normal and the rash faded after a few days. We still don't know what caused it, but are praying hard that it doesn't come back.

Then MJ decided that sleeping was stupid, as was eating, and that she was going to throw up almost everything she did eat for a few days. Poor little thing was so miserable and pitiful and ended  up losing a couple of pounds. And in between all off that, I had a follow up appointment for my whacked out blood pressure and told the doctor that I didn't care what he said, I was going to have a stroke anyway at age 50 if I didn't stop waking up 47 times a night to go to the bathroom and practically passing out every time I stood up. So I got to stop those meds and, shockingly, my blood pressure actually went down!

Unfortunately, my whacked out blood pressure and kids being sick and all of the other garbage of February, piddle in comparison to the fantastically awesome news that March brought. M was sick with a nasty cold, and now all 4 kids are sick, and then there's my issues...

I am still very much in denial about what is going on with me right now. Blood pressure aside, I appear to be healthy but inside my body is a raging time bomb of cells, reproducing at an abnormally fast rate. A time bomb that was silent until a couple of weeks ago when I got the dreaded phone call and heard the words "precancerous" and "needs to be removed immediately".

So, there is your daily dose of happiness and joy. Holy Debbie Downer, I know. I have my pre-op appointment today, where we will discuss the specifics of what is going to happen and how it will impact our lives. I am so, so thankful I don't have cancer and that this was caught early but scared about going under the knife and anesthesia as I've never had to do either.

I really hate it when people are super cryptic about things and say that there is some life altering thing going on in their lives, but won't share exactly what it is... but I am going to be that person today. I'm not begging for prayers or asking people to be worried about me, because I WILL be fine, but both are appreciated if you feel so inclined. I promise to share all of the gory details once I know all of the facts and have a plan in place. Promise. Cross my heart, pinkie swear kind of promise.