Friday, May 1, 2009

before you have a colposcopy

[So, NOW have I had a procedure that nobody else has? Yaya totally had me beat with the sono-hysterogram thing (which, BTW, I have now scheduled!).]

First of all, that claptrap about taking two Advil? Garbage. Listen to me: get someone to drive you to the appointment, and take two VICODIN. Or four. Or, preferrably, try douching with lidocaine. (There's a potential digression here about the fabulous dentist I had as a child who would drip lidocaine instead of injecting it, but I'm going to stay on topic.) Please note that this advice comes from a girl who thought an HSG was painless except for about 90 seconds, and who totally refused morphine (or Vicodin) after her triple-header surgery with the giant incision (and two small ones). (I took ibuprofen and that was plenty.)

Why is this? Simple. I'm actually pretty tough about pap smears (and even ultrasounds, even when they really want to take a look at something that appears to be in another part of your body, such as possibly your head). Imagine they take the little speculum thing and ratchet it up to ALL THE WAY OPEN. I don't know if you're aware, but it has settings. The one they use to get a swab in there for a quick pap smear is nothing.

Then, since they're using a camera to look through the speculum at the cervix, they shove the speculum at all different angles to get a good look at whatever it is they find interesting. Keep in mind that this is a metal object, somewhat sharp (I'm not suggesting it's sharp enough to cut). They then go after the cervix with an assortment of swabs - one with vinegar to make the cells stand in relief (that's supposed to sting, but maybe like rubbing alcohol - nothing to write home about), others to assist in their investigations, and later, some with silver nitrate (to cauterize the wounds!).

By the way, this entire process takes over half an hour - maybe forty-five minutes. The full-on speculum for 45 minutes. Then comes the fun part: they take a sharp object (innocuously called a "curette." Apparently it's supposed to hurt less if they say "cutting instrument" in a different language) and CUT OFF PIECES OF YOUR CERVIX. After one of these, you feel as though you're done, so you'll be rewarded for your suffering. But no - they need to take a further look (more contortion of the speculum) for more areas they might want to attack with sharp objects (in my case, they wanted an assortment!). My doctor wasn't into the communication either, and so I would go from being in pain to being in LOTS of pain, with no warning. After I asked, more firmly than politely, I suspect, for her to tell me what she was doing before she stuck anything else in there, she really did give me more information.

The bottom line was, it doesn't APPEAR that I have cancer, or even carcinoma in situ (bonus!). It's a "low-grade" dysplasia. Generally, the protocol is to wait four months, check again, and hope that it heals itself (because I'm young and "healthy" - hahahahahahahahaha! - so it could just do that). Of course, in my case, it won't, because a year before I had the pap smear that led to this colposcopy, I had another, but less severe, irregular pap smear - i.e., it's getting worse, not better. If in four months it stays the same or gets worse (i.e., carcinoma in situ), then it gets surgically removed (conization or LEEP). I get the biopsy results in two weeks, and then I expect I'll be told to wait four months and have a minor surgery. It's always nice to know when your next surgical milestone is coming. (If I'm really lucky, I can add one for possible fibroids and another one for the endo soon too! I complain that my life is undirected without motherhood, but actually I have an aspiration: human pincushion.)

Also, for those of you who are really doing the math here, one question I asked this morning before I signed the consent form was, "Since I am almost (but not quite) at the end of my cycle, could this procedure cause miscarriage on the insanely remote possibility that I am pregnant?" The doctor didn't want to come out with "absolutely not." I guess, in fairness, sneezing can cause miscarriage if you're unlucky (or IF!). But they do perform the procedure on pregnant women. Given the vanishingly small possibility that I am pregnant, I considered this assurance enough. But my last piece of advice: if you're going to have a colposcopy (because your life lacks sufficient variety with all the shots, scans, and hormone pills), just to remove that worry, do it around CD 7-10.



  1. I had one years ago. It wasn't fun, but I think I only had to have one small biopsy in just one area and it was really fast. Sounds like you were subjected to MUCH more! I did have lots of fun cramping for the rest of the day.

    BTW...loved your comment about my ovaries becoming Miss Congeniality late in the pagent game. I was cracking up!

  2. P.S. Feel better and I'm glad it seems to be "low-grade" even though I wish you didn't have it at all. ((HUGS))

  3. OH MY GOSH! This experience would have scared the crap out of me. WOW it sounded really intense. I am a baby about pain so this procedure will definitley be last on my list. It sounds like you have undergone so much! I hope you get some good results from the biopsy :)
    Many prayers,

  4. Ack!!! I couldn't even handle the HSG - there's no way I could have survived that!! Feel better!

  5. Damn! The nurse who did my colpo was a saint compared to the butcher who tortured you, my poor Misfit! That just sucks. Can't they use the plastic speculum? And do they have to root around in there like they were looking for a lost cuff link? And chop like they usually wield a machete? It's a damn cervix. It's small. It's delicate. It's not about to leap away.

    I had a similar result from my colpo: low-grade dysplasia, that ended with a normal pap three months later. So you can do it!

  6. I had a colposcopy back in Sept, and my repeat pap in February was all normal... but they only took one sample during the procedure!! Wow, glad you got through it ;-) Hope you are feeling better today!

  7. Um wow. That sounds pretty traumatic. I am SO glad they do not think it's cancer though! Good luck and I hope that you're feeling better!!!!

  8. Your description made my legs cross. They couldn't use something stronger for the pain? I know general anesthesia is probably overkill, but even during egg retrievals for IVF, they sedate you. Poking and prodding with sharp things is painful. Pain is not nice. Then again, I suppose it's not the doctor's pain, so no problem.

  9. So apparently...I am NOT the only person who has had this exam, and either I am not living up to my resolution to be as brave as my fellow bloggers, or my doctor is a sadist.

    Also, FYI, for all I complained about 45 minutes of pain, I was fine as soon as it was over - maybe a little sore for half an hour, but I took Aleve every few hours till evening and was A-OK.