By Cassidy Avery
I can find people who love getting their hair cut (mmmm… someone massaging my scalp), I can find people who love going to the dentist (nice, smooth, clean teeth), but I don’t think I can find anyone who likes going to the gynecologist for their checkup. I know I don’t. It feels so degrading. They make you get weighed (I don’t need to know how overweight I am today, thanks), make you strip and lay under little paper sheets, and then they do all sorts of not so fun things to your lady bits (so sad… my vagina is such a good person, she never did anything to them).
To me, going to the gynecologist was a necessary evil: I had to go to get a prescription for my birth control pill. But recently I’ve been given a crash course in how there is a much more important reason we go and get these tests done.
In November of last year I went to my gynecologist for my annual pap test. A couple weeks later I got called by the nurse and told my results were abnormal. My first instinct was to not worry about it; I’ve had abnormal results in the past (they can have many causes). Ordinarily, they would reschedule me for another pap in six months or a year to double check, but this time was different. The nurse delivering my results told me that the doctor wanted me to come in as soon as possible “for follow-up.”
Instead of asking the nurse what I could expect at this follow-up (people, ask doctors and nurses questions, generally they are nice and don’t mind answering)—I hopped online and promptly started to freak myself out. Was I dying? Why did the doctor want to see me right away? After a lot of research I found that they likely wanted to do a colposcopy, which means they take a closer look at the cervix basically using a magnifying glass, and that if they saw anything that looked strange they would take a small biopsy. So that sounds pretty scary and when I told my mom and my husband what was going on and they both offered to go with me. I decided that I was a tough guy instead, telling them “no, I’m sure it’s fine!” I did not need someone to hold my hand.
I went to the gynecologist again, second time in less than a month.
The nurse that took me back did state that I would be getting a colposcopy and offered me ibuprofen or Tylenol to help with any cramping that I may experience. She seemed very serious about this so I took some Motrin, went into the room, and waited. The doctor came in and discussed with me what they were seeing. The results of the Pap Test did not show HPV (Human Papillomavirus), but they were showing some highly abnormal cells. At this point they wanted to do a colposcopy to see what was going on and possibly take a biopsy.
So they did both.
The colposcopy is very similar in many ways to getting a Pap Test. You are disrobed from the waist down and covered with a paper sheet. When the doctor and nurse are ready, you scooch to the edge of the table and put your feet in stirrups. The doctor inserts a speculum to gently widen the opening of the vagina so the cervix can be observed more easily. They likely will apply a mixture to the cervix using long handled cotton swabs, which will allow any abnormality to stand out and they observe you using their special magnifying tool. If they do see abnormalities, they will probably want to do a biopsy as well. They do the biopsy at the same time as the colposcopy, which is what they decided to do in my case.
For a biopsy, the doctor will either scrape some cells off the cervix, or use a long tool with what I would describe as tiny pinching scissors on the end to pinch off a small sample. They used the second method in my case. The doctor will probably warn you that there will be a little pinch before taking any samples. They use another mixture to help stop any bleeding (they are cutting small pieces out of you. You will bleed).
The doctors mentioned that after the procedure I would continue to have spotting and discharge—I would suggest talking to your doctor about what’s normal. For me there was the yellowish stuff (which they used to highlight the abnormalities), some small brown chunks similar to coffee grounds (which is the stuff that helps you stop bleeding), and also some light spotting. I was told not to have sex or use tampons for a couple weeks while waiting on my results.
When I went in for my follow up a few weeks later, my doctor did another Pap Test. The biopsy results were inconclusive, and they wanted to make sure that the first Pap Test had not shown abnormality because of something irregular in the vagina, as opposed to on the cervix itself. The results of the second Pap Test did show HPV and still were showing the highly abnormal cells. My doctor wanted me to come back for another colposcopy.
The second colposcopy was a much more emotional experience for me. By this point, I was sick of being poked and prodded, and I cried like a baby the whole time, more out of fear than anything else. This time I wished I had agreed when my mother and husband offered to come with me—this whole process was starting to feel pretty scary and lonely.
It was very comforting that my mom came with me a couple weeks later to get my latest results and to discuss my treatment plan.
The doctor came in and sat down with us to let us know that I was showing severe dysplasia—basically some cells on my cervix were really abnormal, a level below cancerous. She said to me that I shouldn’t worry too much because the change from pre-cancerous to cancerous normally takes many years, and that we were going to remove these cells so that they wouldn’t get to that point. She said to me, “This is why we do the Pap Test.” She explained to me that rates of cervical cancer have plummeted in the U.S., but rates of abnormalities below that level have skyrocketed. This is because more and more women are getting tested as they should, and treatment can be given before the abnormalities turn into cancer.
The treatment plan for someone like me was to get a LEEP (Loop Electrosurgical Excision Procedure). Basically, they use a surgical instrument with an electrified wire at the end to shave the problematic cells off the effected part of the cervix. Then the pathology department would review the cells to ensure that they were not worse than tests were showing and also that the edges of the removed cells were normal (indicating that all the abnormal cells had indeed been removed).
From anecdotal stories I’ve heard and things I’ve read online, this procedure can be done with a local anesthetic and in the doctors office; however, my doctor performed my LEEP in the hospital and under general anesthesia. The procedure was outpatient and in my case took less than an hour.
Prior to the procedure, very few people knew what was going on with me. I only told the people that I was closest to or who had the most need to know. My understanding was that the surgery was a very minor, outpatient surgery and I did not want all of my friends and family constantly asking about what was going on. Also, I think part of me was a little ashamed at being sick at all and another part of me did not think it was anyone else’s business.
So my mother and husband both took off time from work and drove me to the hospital. Every single person that I interacted with was super friendly and helpful. They patiently explained every step of the process. I got my first intravenous drip ever, which for someone with a severe fear of needles is a milestone! They put me to sleep and I don’t remember anything until I woke up in recovery.
I was sent home with instructions to rest (no heavy lifting, no vigorous exercise, no sex). My husband lovingly harped on me any time I did anything he considered out of bounds. For example, picking up my 12-lb. cat considered totally OK by the doctors, but my husband is a worrier and, thinking it would be too much, swiftly rejoined “no lifting!” I had some light spotting and discharge, which I was told to expect after the surgery.
Two weeks later, I went back to the doctors to find out my results and to check my healing process. My doctor was able to tell me that they had indeed gotten out all the abnormal cells and that the cells themselves were no worse than originally thought. She told me that I looked like I was healing well and that I could go back to normal activities. I was so relieved that I practically danced across the parking lot to my car.
Even though everything looks good, things will still be different from here on out. For the rest of my life, I will have to be vigilant. I will have to get Pap Tests as often as my doctor tells me to (likely more often than most women). If I decide to get pregnant, I will have make sure my doctors know that I’ve had surgery on my cervix so they can monitor me more closely to stave off any complications. And if any abnormal cells come back, I will have to go through more testing and possibly more surgery.
The process has not been pleasant. All the discomfort and anxiety of a gynecology visit turned up to 11. However, I’m really glad that I went to my doctor like I was supposed to for my annual screening—I’m glad we caught this and were able to treat it. While I may not ever love going to see my gynecologist, at least in the future I will go less reluctantly and with a grateful heart.
Originally, I was considering not telling anyone about what happened to me. It’s personal, right? But I do want to pass along one piece of advice to all the ladies out there: Go to your gynecologist and make sure you’re getting all your tests when you should. Don’t put it off—it’s important. Make sure to talk to your doctor honestly about your body and your sex life. You only get one body, so take good care of it so it lasts you the long haul.[divider] [/divider]
Cassidy lives just outside Washington, D.C., with her awesome husband and two crazy cats. She is currently on sabbatical and trying to figure out what she wants to be when she grows up. his means that most of the time she’s taking personality quizzes and learning to do housewifey things like how to hem cuffs on slacks. She’s a vegetarian bibliophile who likes to cook, devour shows and movies on Netflix, and play video games. In an ideal world where money was no object she would live in Oxford, England, with a bunch of cats and kids, drink hot tea, take long walks, hang out in pubs, read books, and write.[divider] [/divider]
Photo by Bethan Phillips