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When a smear test doesn't go as you'd hoped.

June 3, 2017

Smear tests - they're part of every woman's life and they're not only worrying and potentially anxiety inducing, but they're also not spoken of very much. Is it that we won't feel comfortable speaking about what happens inside our vaginas or that we don't want to hear about it?

I wanted to write and tell you about my experience with having an abnormal smear test and the journey following that, a journey that I'm still on. 

 

I had my first smear in my early twenties. It was uncomfortable but not anywhere near as scary as my overactive imagination had me believe. Fast forward to a week after my most recent test in April, and on the last day of my holiday I received a text message confirming a hospital appointment. The letter explaining about my severely abnormal cells was waiting when I got home. For the most rational of us, that could mean fear and dealing with the unknown. For those of us that jump to the worst conclusions, it's downright terrifying.


I'm not going to act like this is something rare to experience. Thousands of women go through it every day across the world and usually it's nothing to worry about. However, the last thing you should say to anyone going through this is that they're overreacting, being irrational, or that it absolutely will be nothing to worry about. If you are going through it, it's fine to worry, it's normal. Find someone who will acknowledge your fear and help you research and calm your nerves (nurses are great for this too and are only at the end of the phone if you need some reassurance).

The colposcopy appointment was nervewracking. J and I sat down before, looked through lots of forums and read up about the science of it all. For me, one of the scariest things was not knowing what was going on in my own body, the body I lived in day in and day out, and yet had no control over. Knowing about timelines and what was actually happening to my cells calmed my nerves a lot as it gave me perspective and reality of it all. The colposcopy itself was very straightforward and totally painless. If you find smears or gyno explorations uncomfortable (I definitely do!) then you'll have the same with this. The only difference is that at the end they take a small biopsy. I should say at this point that every single health professional I've dealt with as part of this has been amazing. They deal with nervous women every day and are really fantastic at making you feel cared for and less anxious (yay for the NHS!). When you have the exam they'll let you know straight away what they find and, if you want, you can see it on the screen as they look. I didn't want to see it at first but eventually did look. Warning: it looks massive on the screen, your cervix is not that big and neither are the abnormalities...keep reminding yourself that it's not! They'll put some iodine on the area and then a dye that shows the affected cells as it turns white. This part was pretty scary for me as most of the area turned white (again, reminder of how small the area actually is off screen, it's all perspective!). Ultimately the best news from it all is that it wasn't cancer and is very treatable to prevent it from becoming that. I was told straight away that I would need a loop diathermy (LLETZ) in a few weeks and they made the appointment with me then and there, followed by a letter with the biopsy results.

A weight was lifted but once I turned to Dr Google I became worried again about the next step. We all know that Dr Google is the worst place to go for health advice but we can't help ourselves. Can I turn you at this point to Jo's Cervical Cancer Trust. It's a website with an amazing forum full of women who have been through the same thing. Women who are nervous and afraid just like the rest of us. Once I started talking to friends about it all I realised even more so that I wasn't the only one. In fact, a couple of my very close friends had been through something very similar.

My letter came through and I was told I had CIN3. To explain, this is the highest of the scale of cell abnormalities and means that these are found throughout the thickness of the cervix, as opposed to just on the surface. To clarify, it doesn't mean that it will turn into cancer. If left untreated it could, but, even if it did, it would take years. Smears are there to stop this from happening and that's exactly why it's so important to have them. The night before my LLETZ treatment I got home from work and burst into tears. I'm pretty good at hiding my anxiety from most people by getting on with life and generally just telling everyone everything is fine. It all hit me at once. The idea of a doctor going somewhere quite intimately and burning off cells was truly terrifying for me. The increased chance of having a baby prematurely in the future made me afraid of the whole process (it's less than 3%...not 10% or 50% as I'd read online). Even the fact that I was having my coil removed and that I had to, once again, choose which birth control I wanted. I was putting my body and the most intimate parts of it through a lot and it really was quite scary for me.

The day of the procedure I went to work as normal in the morning. I was anxious and didn't stop fidgeting until I left, then walked the whole way to the hospital to calm my nerves. J met me there (he's been part of this whole journey with me) and as usual, the hospital staff were amazing. The doctor talked me through the whole process again, answered questions, and the nurse took me behind the curtain. The all too familiar bed, leg stirrups, microscope and screen were waiting for me, and I got myself into position. The reality is that it did hurt a little when I had the local anaesthetic and the noise of the suction and wire loop weren't exactly calming. The hospital fire alarm going off through the whole thing didn't help either but when your legs are spread and there is a doctor in front of you peering down a speculum there's not much you can do. It's uncomfortable, it's invasive and it's not particularly nice but I can promise you that it's over quickly and is carried out with your dignity and best health interests in the forefront of the doctors mind. On a scale of 1-10 the pain was about a 3 and the uncomfortableness (is that a word?!) was about a 7. It's totally bearable and even with my anxiety and almost fainting part way through, it really wasn't as bad as I'd thought it would be. The doctor had to take 2 sections as the abnormal cells were quite widespread, but there wasn't anything to worry about and he was confident that he got it all.

In 6 weeks I'll get a letter with the results of the cells they took and in 6 months another smear test and colposcopy. Until then I have to take it easy for a while - no exercise and sex for 4 weeks and no baths or swimming. I'll also have to have my coil refitted (if that's what I want again) and watch for any kind of infection.

Ultimately I'm now safe in the knowledge that we live in a time where smears are available to prevent us from having to deal with a lot worse and for that I'm incredibly grateful. If you're worried about the smear test or anything following it, please try not to be. I know that might sound like rubbish advice because I thought the same, but once you've spoken to doctors and friends who've been through it, they can reassure you that the fear is totally reasonable and also that you'll be ok. So many women go through the same thing and the most important thing to keep in mind is that it's preventative, the abnormal CIN cells are not cancer, and they may have never been. 

 

- Sara

 

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