Thursday, March 10, 2011


So. A letter just came through the door inviting me down to the girls room for a poke-n-prod.

Erm. To rephrase. I've received correspondence from my local NHS trust informing me that I have an appointment for a colposcopy. Apparently my most recent Pap smear turned up a HSIL, or High Grade Squamous Intraepithelial Lesion, or Severe Cervical Intraepithelial Neoplasia, which I've had a fun hour or so of reading about. At my appointment in 2 weeks I'll get the fun experience of having a 3% acetic acid solution spread on my cervix to see if it turns white in areas where there's a high concentration of cellular nuclei. I'll probably be biopsied and may even get to experience the sublime joy of the LEEP (looped electric excision procedure, which sounds a lot like the slice-n-toast knife in The Hitchiker's Guide to the Galaxy film) And then, joy of joys, I'll get two more Paps over the next year, and annual pappage over the next 10. Whee, who doesn't love the sound of that?

Interestingly, in my last hour of low-grade-panic-driven research, I've learned that the plastic broom I've always associated with Pap tests is not very good at collecting cells, which might help to explain why my 2009 Pap came up completely normal but all of a sudden in 2011 it's come up hellafuckedup (technical term).

I've also learned that the person who detected my abnormality is called a Cytoscreener, which is awesome. Thanks, Cytoscreener, for helping me stay healthy.

I've known for a while that most everyone has at least one, and probably several strains of HPV. I know I have had at least 2, now--I also got a verruca from lifeguarding at a summer camp in 2004. Kids are gross. I had to have the verruca frozen off with liquid nitrogen which was astonishingly painful. Like, it felt kinda funny for a sec while the doctor was applying the goop, then he got up and left the room just as a bolt of lightning shot from my heel to my hip, causing me to clench up and jerk around like a rabbit in a snare while emergency lights flashed red in my head alerting me to the fact that my foot had been cut off. If the same thing has to happen to my cervix, be prepared for a killing spree. Getting an IUD was bad enough.

I like the way the letter was phrased. To paraphrase: "you're probably fine, this is all fine, don't worry, you're great, we love you, cancer, you're a good person, you're better than healthy, it's probably nothing, do not miss your appointment for any reason, this happens all the time, it's downright routine, hugs and kisses, NHS." Kinda like that time I was grabbed by a London transit police officer to have my Oyster card checked after a fault caused me to get smushed in the gate--ID badge, big smile, mind if I check your card? big smile. I'm sure it's fine, you look like a good person who wouldn't try and get away with not paying, criminal, big smile, there we go--the person ahead of you must have not touched the reader properly, big smile.

Oof. What is it, when people tell you not to worry, it just makes you even more anxious? Like when people tell you it's not going to hurt, you totally know it's going to be a gore-splosion, or when someone in a bad movie says "nothing could possibly go wrong." I'm sure I'm fine, I'll be fine, and even if it has the potential to be not fine, it is still in a it's-fine stage of not fine. But nevertheless...AAAARRGGGHHH.

As for silver-lining thinking: At least I'm not in the USA without health insurance right now. I have a valid NHS number and a valid work visa.

As for appropriate responses to that line of thinking: FUCK YOU, REPUBLICANS. I'm safer in the UK than at home, despite massive blows to the NHS under a Tory-led initiative to try and privatise and profit-drive healthcare because they're mass-murdering wankfucktards who have no concept of I can't afford it EVEN IF MY LIFE DEPENDS ON IT and therefore assume that poor people just don't care enough...even with those EVIL IDIOTS in charge, I'm BETTER OFF than with YOU.

Without tax-funded women's health centres like Planned Parenthood, many women will not receive Pap smears. They won't be able to afford them, or at least won't see an appreciable cost/benefit ratio to paying to have them as often as they should. They will not detect problems early. They will not have the fucking chance that I think I have...fuck. Fuck fuck fuck. Fucking republicrats. Fucking religious aristocracy trying to punish all us naughty heathens for our normal, human behaviour. Fuck you, yes you--judging me for bringing all this on myself with my youthful indiscriminate actions. If you hadn't told me not to, I probably wouldn't have. I pay my fucking taxes... (descends into incomprehensible mewling)

And Guess what I started reading on Monday?

The Immortal Life of Henrietta Lacks
, by Rebecca Skloot.



Kim said...

I had the same thing (squamous cells and a positive HPV and all that) a couple of years ago. The colposcopy wasn't too bad, actually, though they didn't end up having to do a biopsy. I had the good luck to be seeing a truly great obgyn (when my pap came back irregular, my normal doc was all "go see this guy, he's a specialist") - while my normal doc was not great at reassuring me that it was common and that I would probably be fine, the gyno actually took the time to sit my freaked-out-self down and explain the irregular pap, what every single possibility was (including cancer) and how likely each scenario was (including cancer = not likely at this stage). All this BEFORE taking me into the exam room and having me get all feet-up-in-the-stirrups (which, because it was a nice gyno-only office, were super deluxe and comfy, not like the metal ones you usually see in more multi-use facilities).

Anyway, I was terrified, and had done my internet research, and was nervous and shaky and "what if"-ing, and I was lucky to have a doctor who took care of me. My next pap came back normal, and I've been a-ok ever since.

Let me know if you want to chat about any of it, or if you want more info on my situation. I know sometimes it helps to talk it out, even if it's probably nothing and you're totally fine, hugs and kisses, sunshine and rainbows. :)

PS - my word verification is "scars" - hmmm

Kristen said...

That is very reassuring, darlin. Thanks. It's good to know other real people have gone through it. It's all well and good when you read "one in every twelve paps comes up abnormal, you're probably fine" but to have someone I know say "I was fine" is very nice to hear.

They sent me three letters--on Thursday I received two: "hey there's a problem" which contained some pamphlets, and the "we've changed your appointment by a week" notice. Then Friday I received the original "we've made an appointment for you" letter which contained a map and a printout with a number I could call if I felt like hyperventilating at a trained panic-receptionist. I called it, not because I was freaking, but because the letter said "if you have an IUD use condoms for a week before you come in as we may have to take it out." My IUD is non-hormonal (you remember how unhinged I was in Berkeley? Yeah. I didn't like that either.) and I didn't know if I could get a new one without hormones in this country. It turns out you can--there's 10 different types available from the NHS. I hope they don't need to remove it as the idea of getting a new one fills me with dread. Most painful, helpless feeling..

But anyway, the lady said they probably wouldn't take it out at the first (hopefully only) appointment and would only do so if they needed to do some work in there, so I should only cross that bridge if I have to come to it. But then if they do have to take it out, it'll probably be 6 weeks or so before I could get a new one fitted (or have anything going on in there--oy vey!) so argh. Lame-acious.

It was nice to know that lady is there, though--I honestly think it is her job to answer the phone and calm women down. She picked up on the first ring with a very sweet, helpful voice, and when I said "I have a question regarding colposcopies" she just said "yes...?" as though she couldn't fathom any other reason why I would be calling. Even more interestingly, though, she asked me for my date of birth and hospital number, and after confirming my name asked "did you get your appointment change letter? I had to move it up" indicating that she's been handling me from the beginning. That more than anything was reassuring--knowing that a real person sent the letters who knows my name and wants to ensure that I get there, that it wasn't just some huge faceless machine that read "abnormal" on my sample and spat out an appointment with a random automaton. Even if it was just a receptionist whose memory was jogged by hearing my funny foreign name...I feel like they care.

Cool thing in the UK--for Paps they don't do stirrups. You just lay back on a flat padded table with your knees up and the clinician leans over. No scooch to the edge of the table with your butt cheeks dangling, no holding yourself up with your quads and being told to relax...Downright cozy.

I'm sure I'll get the stirrup treatment for the colposcopy but it's nice to know that under normal circumstances here they don't subject you to the humiliation and discomfort of the female torture table.

Kim said...

I'm glad you're feeling a bit better about it. Feel free to email/gchat/call/text/whatever if you want to chat. When I went for mine, I was so freaked out that I asked a friend to come with me (Will couldn't take off work that day, or I would have made him come). It was totally unnecessary, but it was nice to have someone in the car to talk to me while I drove, keep my mind off the "omigodwhatifit'scancer" feelings...and to have someone to immediately relay all of the doctor's information to once I was done.

Sometimes it just helps to talk to a person, especially at the doctor's office - I'm so glad you had a good receptionist to talk to. It makes all the difference in the world.