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.**