Tuesday, 30 September 2014

cervical screening: the honest truth


As I sit here for the second time in 6 months, trying not to move on the sofa in fear of making the situation worse, I thought maybe I should share my story. As a twenty-seven year old woman I have had my fair share of female-related woes, culminating in what I want to talk about today. Although I know I have a few male readers out there, the majority of you guys are girls (!) and I feel its important for women to be aware of the trials and tribulations we face in terms of cervical health. 

Just as a heads up, I wanted to share my smear/cervical cancer screening story with you. An opportunity for you to bail out now if you are not interested!

When I was 25 and living in Cardiff doing my teacher training, I had my first smear test. They used to begin cervical cancer screening at 20 in Wales, but as of last year they have moved in line with the UK recommended age of 25. If you want any more information about who gets invited for screening, please see here. Anyway, off I went to my GP surgery and saw the nurse for my first ever smear test. What I expected: a mortifying, degrading experience that would be really painful and embarrassing. What I experienced: a completely lovely nurse who put me at ease and talked through each stage with me clearly. No, I wouldn't choose to spend every twenty minutes like this, but I survived! It was a little uncomfortable at worst, but with some deep breathing and relaxation techniques it was totally manageable. No 'pain' as I'd expected. The only thing I wasn't prepared for was the feeling afterwards. I will be completely honest with you - I left feeling a little emotionally off balance, and oddly a bit violated. I think this is entirely a personal thing, as I know lots of women who didn't experience this at all. My Mum had breast cancer just a few years prior to this (she fought it and is now many years in remission, go her!) so I think I was a little emotional and overwhelmed by the whole screening-for-cancer thing. The human body is a funny thing. You can find out more about the emotional aspect of screening here

A few weeks later I got my results back. All ok. Phew! 

A year later, when back registered with a doctor in Surrey, I was recalled for another smear test. I think this was due to moving from the Welsh health authority to the English health authority. Despite the screening process being 3 yearly, I thought there was no harm in going back for another smear - after all, the outcome is so important. Again, I saw the nurse and had another smear. All ok, again a bit emotional afterwards, but fine. This time my results came back showing 'mild abnormalities', or low grade dyskaryosis or CIN1 - apparently the case in about 5% of cases and this does not mean you have cervical cancer. I have to be honest and say that I can't remember how the sequence of events went after that, but I think I had another smear 6 months later and then was referred to the colposcopy clinic at my local hospital. 

Now, a colposcopy is like an upgraded smear (my very non-medical definition!). According to the Cancer Research UK information site on cervical cancer (seriously so useful and user-friendly, check it out here) a colposcopy is "a close examination of your cervix. A colposcope is basically a magnifying glass. It doesn't go inside your vagina. The doctor or specialist nurse uses it to look more closely at the abnormal areas on your cervix and may take samples of them (biopsies) to send to the lab". I have now had three colposcopies over the past 18 months. It can be a little more scary as you usually have to go to hospital, but takes little longer than a smear and is again completely explained by a specialist who is able to answer any questions you may have. I took my Mum with me to the first one, who made sure to ask all the questions I didn't even think of - would any treatment, if needed, effect fertility? What if the results come back inconclusive? How does treatment work? Will she suffer any after effects? Thank god for Mums! 

My first colposcopy was absolutely fine. The procedure itself was straightforward - this time my legs were in stirrups (which is a little mortifying at first - just remember they see this countless times each and every day!) and I had a doctor and a medical student (just my luck!) examining me, as well as two nurses on hand who made me feel completely at ease. The results came back a few weeks later showing mild abnormalities and I was asked to come back for another colposcopy in 12 months time. The reason for such a long wait (and yes, I was shocked... 12 months?! But don't fear...) is that for most people, abnormal cells will go back to normal by themselves. But in some cases they don't, and a further examination 12 months later will check for this. 

Onto my second and third colposcopies. The second I had back in March of this year, and the procedure was exactly the same as the first but this time biopsies were taken and the after effects were somewhat different. The day after the procedure I started to bleed quite heavily, and by the evening was bleeding so heavily I was really quite concerned and called NHS Direct (or the 111 service as it's now called, for when you need medical help fast, but its not a 999 emergency). They told me to rest as much as possible, and if the bleeding continued to make an emergency appointment with my GP the next day. The morning came round and I was quite literally flooding when I stood up for long periods of time (sorry, gross I know) so quickly made it to my GP who sent me straight away to A&E. In A&E I was seen, after an almost three hour wait, by the on call gynae doctor who cauterised the bleeding with silver nitrate (used after taking biopsies in a colposcopy and can be a little painful, and can leave you with cramps) and I was sent on my way. Back home, more lying down, and the next day more bleeding. I waited another 24 hours before going back into hospital to be seen again in A&E, who took me to see the consultant who originally performed my colposcopy who finally was able to stop the bleeding and the next day I returned to normal. Phew! After all this, the results from the biopsies came back inconclusive. I was invited back in six months time for a third colposcopy. I was also diagnosed with high-grade HPV which can increase the risk of cervical cancer developing, but I was reassured to be told that HPV is very common and most people will have the virus at some point in their lives. Obviously the higher-grade HPV you have, the more concerning it is so my next colposcopy would be checking on that.

Yesterday I had my third colposcopy and today I am off work resting... and you guessed it, more bleeding. The consultant informed me that I am an unusual case (always reassuring!) as my cervix was bleeding even before the biopsies were taken - something relating to the pill apparently, but nothing to worry about. Naturally, I am a little concerned so will be booking an appointment with my GP to discuss this. Anyway, I am resting, trying not to move too much in the hope that it can heal and I don't need to go back to hospital. We'll see.

I'm sharing this for a few reasons. First, I was inspired by people like Hayley who have shared their experience, in an attempt to challenge the myths surrounding smears and screening. I love that people are being honest and coming forward to dispel rumours that so many of us hear about smear tests - 'they are so painful', 'it must mean I have cancer', 'I was made to feel really embarrassed', and 'I must be too sexually active' etc etc. I think we are all learning that is quite simply not the case.

Second, I wanted to share with you what happened to me after my second colposcopy as I was really quite terrified. When you start bleeding uncontrollably, it can be a really scary experience especially when the source isn't visible and you've just been dealing with the big C word. I genuinely thought that this reaction was a sign that I had cervical cancer. No, I'm not trying to scare you into thinking all colposcopies are like this - they're not. But I hadn't heard of any women having particularly negative experiences or negative after effects. I totally agree that we should all promote cancer awareness and cancer screening awareness, but lets not forget that sometimes this can be really shit and quite scary. I'm not trying to scare-monger, but simply say 'you're not alone, and you'll be fine'. Sharing negative experiences can be just as useful as sharing the positive. 

And finally, I just wanted to show that every experience is different. I have had friends who have had colposcopies and subsequent treatment and they have been completely fine, no complications or anything. In fact, most people I know have had entirely positive experiences, but we are not robots. We are built differently and people have different emotional and physical responses. 

Because lets get back to the root of this - cervical screening is to screen for cancer. I've seen the effect cancer can have on an individual and it's not pleasant. I wouldn't wish that on anyone. If we are informed, aware and most importantly spreading the word, I believe more women (and men!) can protect themselves and be aware of the early signs. So if you're putting off booking in for your smear, remember it's nothing to be afraid of. I can assure you the potential consequences of putting it off could be far worse!

If you want to find out more about cervical screening in the UK, check out the NHS site here. They have a great downloadable PDF brochure which gives you all sorts of information about the process - the what's, why's and when's. 

The Cancer Research UK site also has loads of great information on:
After treatment 
(particularly some great stuff on bleeding, the emotional effects and how to get back to normal)

I'd love to hear from you. Did you find this useful? Have you had a similar (or completely different) experience?
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7 comments

  1. This is such a useful post, I know so many people are scared of smear tests. I had mine done by my doctor, and it was honestly so quick and pain free as you say (not exactly comfortable, but hey!).
    Also I know you mentioned about bleeding before the biopsies were taken and it being related to the pill, well it sounds to me like this is 'cervical erosion'. I'm by no means a doctor, but I was told I had this and that it was a side effect of the pill. (I'll let you google it rather than explain the symptoms here!) I have since swapped to the implant and have noticed barely any bleeding in comparison (although I know the implant is very different for each woman). Just thought I'd share (perhaps TMI, but oh well!) Hopefully it might help :)
    Ceri x

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  2. Great post, and really useful information. Something to make you smile - when I went for either my first or second smear test they/I put my legs in stirrups and whilst the nurse was examining/prodding me one of the stirrups came lose, and flew off so hard I ended up kicking the poor lady in the head!!!! I felt so terrible, so did she, and we both collapsed in fits of giggles!!

    Hope your results are all ok,
    Rosie xx

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  3. Oh goodness what a trial! Hope you're on the mend and get to the bottom of the bleeding, that sounds absolutely horrid. I've had my smear and found it absolutely fine but then, I've had a coil inserted and I'm fairly good at being on top of sexual health screens etc so the whole situation wasn't that alien. I think a lot of the fear is about the unknown involved but it is so important to know your body and get things checked. Great post
    xxx


    Chambray & Curls /

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  4. Very honest account of what can happen, well done! :)
    I've had treatment to remove abnormal cells and recovered quickly, but have never been concerned about going for a smear, I know some friends who haven't been for YEARS.

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  5. This was such an informative post, I think us girls just put it off because it's embarrassing but it's so important we go for smears, I haven't started yet because I'm only 22 but as soon as I get my letter I'll be making my appointment. This was such a helpful post to younger girls too and it will really help raise awareness and the importance of smears.

    Love Beth @ BethBlogsBeauty
    xx

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  6. A very insightful post and I think it's actually very important to discuss subjects that can be quite awkward to some people. At 20, I've never had to have one and I do think that they really ought to lower the age because these things can happen at any age. You're right, the reason smear tests are done is to check for cancer so there are no excuses not to go, despite how awkward or uncomfortable the experience may be.

    Lucy
    She's So Lucy

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  7. I'm in Wales so I got the letter when I was 20 (I'm 21 1/2 now!) but I still haven't got round to booking one... I will now after reading this post! Thanks for sharing this really important advice! xx

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