Surreal and yet so real...

I've been meaning to write this down for a while now, but have been too chicken. I know theoretically that it is good to talk with others and to write when one goes through a difficult situation, but that doesn't make it easy. However, some of my friends have done just that recently and have given me the little encouragement push I need. So, before I chicken out again, here's what's been going on the last few years. (Heads up, I'm going to be honest, so this may be TMI at some points.)

August 2010: I went in for my annual Pap and check-up to renew my birth control. My doctor informed me of the new federal guidelines for someone my age without any abnormal paps or HPV positive testing and told me that I didn't need to have the test done this year. I told her that my mother had cervical cancer when she was very young, and that I wasn't going to risk it. A few minutes exposed to the world was worth it to me. A week later, the results came back, Atypical Squamous cells of unknown significance, HPV negative.

I immediately began to freak out. My doctor calmed me down and explained that this could very easily be a simple infection, and given that I had a really bad yeast infection a few months prior, it was likely nothing to be concerned about. She gave me a list of symptoms to be aware of, and I felt a little bit okay.

One of the symptoms to watch for was unusual bleeding. I noticed that for the next month I would bleed after sex. It wasn't much, and I had noticed it on and off before, but there wasn't any pain so I didn't think much of it, but I called the office and they suggested I come back in.

September 2010: I went in for another exam. The doctor took a new sample and examined it in the office for the presence of any bacterial/fungal infections. She didn't see anything unusual, but suspected that there was a Gardnerella infection. Being a natural bacteria in the body, it may have simply gotten out of control during the previous yeast infections. She sent a sample off to the lab just to be sure. The lab test however only looks for bacteria that are STDs and my doctor told me that it was a precaution that was in the "best practice" but that she was expecting a negative result. (In fact, she told me that if it came back positive, she'd be having a talk with Philip, a talk that included baseball bats.) The tests were negative as expected, and Philip's knees remained safe. We went ahead and started a course of antibiotics for the Gardnerella.

Halloween 2010: Some idiot decided not to look before turning left and slammed into my car. Sally the Sexy Saturn was DOA. I felt fine for a few hours, but that night my back began to hurt like I had just been hit my a giant SUV... Oh wait, I had. I went the chiropractor the next day. There were some disks that were out of line, and my right hip's range of motion was almost not existent. The Wednesday after the accident, Philip lost his job at GameStop.

Fast forward a little bit...

Late March/Early April: Philip got hired at RadioShack! During his first week of training, I had my repeat pap. The doctor said that cervix was inflamed and friable. It bled from just a cotton swab. She sent off the new pap specimen and put me on a vaginal antibiotic cream. This was to serve two purposes, 1-kill any infection that may be present, and 2- help to strengthen the cervix. A little over a week later, the new results came in. They were the exact same. Atypical, unknown, no HPV. Because of my family history, she wanted me to have a colposcopy with a possible biopsy. We still didn't have insurance yet so she told me about the Alliance for Women and Children and that they could approve me for federal coverage for the procedure.

May 13: I went in for the colposcopy. Philip came with me as I was scared to death. The nurse was very reassuring and told me that this new doctor would have probably waited another year before doing the colposcopy, but that because I went through the Alliance, he had to do it, but he most likely wouldn't take any biopsies. The colposcopy is essentially the same as a vaginal exam for a pap, except that he uses a microscope type machine to magnify the cervix.

During the procedure, he talked with Philip about taking Latin and his time at ACU. You can't go more than ten feet without finding someone who went to ACU around here. And he told me that he was going to take three biopsies, 6, 9, and 12 o'clock. My heart sank, but I just focused on the conversation between him and Philip about ACU's ministry programs. After the biopsies were done, he told us that he saw a section of leukoplakia. Watching him draw the diagram, it looked like it covered over half the cervix. He told me that I did not have "woman-eating cancer" and that the results would likely be in on Wednesday. He also had taken a swab to check for bacteria, just like they had done in September.

May 19: I got the call from the office while in class. Dr. B. explained to me that they had found grade three cervical dysplasia and that they needed to schedule a LEEP where he uses an electric scalpel to remove the bad cells. Someone from his office would call me to schedule the appointment. That was it. I immediately called Philip, but he was at work so I left a message for him to call me back and called my mother. I was freaking out. All I kept thinking of was that this had left my mother where she couldn't have any more kids. "I'm just 24, why is this happening?"

My mom tried to be comforting, but she was crying herself. She kept apologizing for giving this to me, which even at the time sounded strange to me. Almost like she gave me a Chucky doll, but this was the real psycho-killer toy. Even then, I didn't, and still don't blame her, or think it's her fault. There are far worse genetic gifts that I could have gotten.

Philip called me back within minutes. He was great. He kept telling me that we can get through this, and that it's good news. He was expecting cancer, so yeah, this was good news.

June 3: This was to be the "big day." My LEEP was scheduled for that morning. I went in and peed in the little cup. They took my blood pressure and walked me through the consent forms. Philip was in the car finishing a call, but got into the office before the room was even ready. I got in, got undressed, wrapped myself in the paper and sat on the table. And sat. And sat.... Dr. B. had gotten held up at the hospital delivering a baby. When he got in he told us it was a little girl.

We then started talking about the test results and what everything meant. We had so many questions. Poor guy probably felt like he was being interrogated on Law & Order or something. Anyways, while Dr. B. was explaining something to Philip (I honestly can't remember what), the nurse held up this little plastic tray with two red lines. "What is that?" I mouthed to her. "Pregnancy test." I look her dead in the eye and forget everything I know about manners and decorum, "Are you fucking kidding me?" She just shook her head.

That got Dr. B.'s attention. It was a weak positive, but a positive none the less. He told us that it might be a false positive, but that we could not do the procedure if I were pregnant as it would cause a miscarriage. Therefore, I needed to go get a blood test, and if that was negative, we could reschedule. Otherwise, we would just have to keep a close eye on it, and do the procedure in nine months. We went to the health department (BTW- $4 blood serum pregnancy tests, if you ever need). The test came back negative. I was not pregnant.

Part of me was relieved, but a large part was disappointed. I kept thinking, that this could have been my chance, that maybe we would have a baby. I think Philip had even gotten a little excited. The false positive may have been what is called a "chemical pregnancy" which is a very early miscarriage. There's no real way to know for sure without the doctor seeing it happen, or watching the HCG levels change. Sometimes I think that it doesn't really matter, after all if I hadn't been having the procedure, I would have never now. Other times I think it's silly to think about because we don't even know if that is the case or not. Then sometimes I think that I could have been pregnant. On the Fourth of July, I got really upset thinking about how far along I might have been. Then I got mad at myself for being so silly.

I think that's something about ambiguous loss: You can read about it all you want, but once it's there in your face, no amount of research matters. It could be something to mourn, or it might not be and you can't even decide for yourself if it should or not. It's an emotional mess.

However, one thing was sure. We were not ready to give up our chance at having children. That Monday, I dropped the results off at the doctor's office. Later that day I called them and said that I wanted to talk with Dr. B. about fertility after the LEEP before we rescheduled. A few days later the main nurse called to answer my questions.

There are risks to my fertility after the procedure. My cervix could narrow so that sperm would have difficulty entering the uterus. If I were to get pregnant, my cervix could become incompetent ("incompetent cervix" is still funny to Philip, I don't know why). She assured me that Dr. B. would very careful and would watch for signs of incompetence and that if it were to happen, it could be fixed with a simple purse stitch to keep the cervix closed. I felt much more at ease and we rescheduled the appointment.

June 24: After a long week at KDK camp, I went in that Friday morning for the LEEP. Dr. B. went over a lot of the fertility questions again and talked us through the procedure. He wanted to get it all at once, but also wanted to conserve as much cervical tissue as possible. He showed us the "Deep D" and "Shallow D" tools and told us that he would use the shallow D to help maintain as much tissue as possible.

He got started with the lytacaine with epinephrin. My heart started racing like crazy, which they had told me to expect, and I started to shiver. The nurse kept telling me to take deep breaths, so I focused on my breathing like I learned in yoga. Philip kept asking if I was okay and making little jokes to make me giggle. I told him not to make me laugh so that I wouldn't move too much. The procedure itself was rather quick and I didn't really feel anything. I  did feel some of the cautery when he was stopping the bleeding, but it only hurt for a second. I had one little bleeder that didn't want to quit, so he had the nurse watch it for a few minutes. It stopped on its own. They went to have me sit up, but I got pretty light-headed so I had to stay laying down for a little while and then they sat me up slowly. Philip went over to see the parts of cervix in the little jars. I was not that curious. The nurse talked to use while she cleaned up and then I was free to go.

Recovery hasn't been too bad. I had some pretty bad cramping for a few days, but I didn't have to use the Codeine they gave me, Advil was enough. Through out the following two weeks, I've had some occasional cramps that might get pretty bad, but nothing horrible. I had started the antibiotics the Thursday before the LEEP and by now, I'm sure every bacteria in my body is dead and my digestive system is none too happy.

I haven't gotten the pathology results yet, so I still don't know if they got it all. I go in to the doctor tomorrow to make sure that my cervix is healing properly.

I'm sure that this is way too much information for some people, but I want to get this story out there. If I had not pushed to have that pap in August, and if I had not pushed to retest, and to go for colposcopy, this probably wouldn't have been found before it became "woman-eating cancer." My last pap was Atypical Squamous cells of undermined significance, HPV negative. According to the federal guidelines, I shouldn't have had another pap for another two years. And then, maybe they'd repeat in six months, and after those six months, maybe they'd do the colposcopy, and by then, this would be a totally different story.