#cin3

Abnormal Pap Smear.

Discovery of CIN III HSIL high grade cell changes/severe dysplasia following on from a routine pap smear.

Have you ever been so shocked you didn't know what to do.

Thank god JV was with me on that day.

I was due for a pap smear in May 2018 but in Australia the rules for pap smears changed. Previously a pap smear was recommended every 2 years, but rules and test were changed to a cervical smear every 5 years from the age of 25.

I was 25 in July so it was decided with my GP to put my pap off to avoid having to pay for it myself. I scheduled my pap smear for early Aug 2018.

A pap smear is a quick procedure where a sample of cells is collected to detect cervical cancer early.

I had a phone call late Saturday morning after having my pap smear done the Tuesday prior. Unfortunately I missed this call and had to phone them first thing Monday morning. 

The Doctors office didn’t really give me much indication as to why I needed to come back -  I actually thought I must have had thrush or something pretty basic they wanted to chat about.

JV was driving in the driveway as I was leaving for the appointment and jumped in the car to come with me. I think he must have sensed something wasn’t quite right.

I was explained my pap results and given a copy of the report which indicated high grade cells.

Without a colposcopy (a procedure to examine and biopsy the cervix) they werent able to fully confirm, but indications were I had CIN III HSIL high grade cell changes/severe dysplasia.

CIN III is severly abnormal cells that are found on the surface of the cervix. It is usually caused by the human papilloma virus (HPV). It is not cancer, but very concerning as it may become cancer if not treated.

I was shocked. So shocked I dont think I even cried until we left. It took a hot minute to sink in.

My GP referred me off to see a gynaecological oncologist to have further investigations done.

An appointment was made for about 6 weeks later for a consultation at which point a colposcopy would be performed to investigate these cells further.

I was scared. 

I didn't know what to expect.

I had recently switched jobs from a position I was in for 8 years.

JV was working in a Queensland mine about 18 hours drive away.

We had recently become engaged.

My Dad was due to have open heart surgery.

This wasnt how it was supposed to be. I was young, fit and healthy.

The moral of this story...

Get a pap smear.

If you are due, make an appointment.

If you havent ever had one, make an appointment.

If you’re scared, dont be... cancer is scary. Make an appointment.

Please, make an appointment.

"Why'd you have to go and make things so complicated"

I really need to stop referencing songs.

Warning.

Contains blood & is a lengthy story.

Some of details are hazy or completely forgotten also.

It was an extremely traumatic experience.

Me:

"Get up. I need an ambulance!!!"

JV:

"I can drive you to the hospital quicker than an ambulance can get here"

I won't disclose how long it took JV to drive from our house to the nearest hospital, but yes he was correct.

Lights were left on, doors left open. Im surprised none of the neigbours noticed.

LLETZ discuss what happened a few hours prior...

I'd visited the after hours GP service after my bleeding increased. 

JV had come to work to have his teeth cleaned. I went to the toilet half hour prior to leaving work and by the time I had arrived home I had gone through the pad I was wearing.

When we arrived about 7pm at GP access, I could feel myself bleeding. I couldnt even concertrate enough to give the nurse my correct details, for some reason I tried to give her my mums mobile number instead of my own. JV had to take over and help.

The GP I saw actually happened to be a patient at work and recognised my face.

She examined me and saw that I was bleeding but I seemed to be clotting which was good.

She knew the surgeon who performed my surgery and phoned him personally to advise and discuss my case.

My surgeon thought it was some sort of infection so advised to start me on a course of antibiotics and to phone his rooms first thing in the morning to make a review appointment.

This put my mind at ease.

The GP phoned the local hospital to gain advice on the best antibiotics to give and to alert them that if my bleeding increased I had been advise to present to the emergency department.

I was given antibiotics and was told to go home, rest up and phone the surgeon tomorrow.

I felt a little bit more reassured.

I went home, anxious but knew it would all be sorted tomorrow.

Close to 12am I woke up, heart rate through the roof, sweating. 

I had only been asleep for maybe an hour but I knew something was wrong.

The only way I can describe it was like alarm bells in my body.

I went to go to the toilet but when I stood up I immediately felt something “let go”. Id started to hemorrhage.

I screamed at JV to wake up - he is the world heaviest sleeper.

For someone who is pretty neat, the first time since living where we are I had left a towel on the floor at the foot of the bed. THANK FUCK.

I placed the towel in between my legs, laid myself on the floor and kept screaming at JV I needed an ambulance.

He had by this stage chucked some clothes on and was yelling back at me to get in the car, he knew where we live the nearest ambulance station was around 10 minutes away. Reluctantly I agreed.

I called the ED as we drove out of the driveway and calmly explained what was happening and we were on our way.

I asked JV to talk to me the entire way and not to stop. I can only describe the feeling as tired but I knew I was on the brink of passing out. I told him to ask me what I saw, what my name was, how I was feeling, just anything that would keep me with it.

We arrived at the hospital and the surprise we were already there was apparent.

I dont think they really believed the panic. I was placed in a single room and awaited to be seen a Doctor. The blood just continued to pool around me. Almost 2 hours later a male Doctor came in to assess me.

JV had to step out, he isnt the best with blood or needles.

Between the surprise on the Doctors face and hearing the blood coming out of me... I was began to think I might die.

He tried to stop the bleeding as best he could with gauze and immediately called for the resident gynecologist to come down.

She was delivering a baby - emergency cesarean, so I did have to wait a little bit for her.

When she came down I was busting to wee. That’s all I could think about. 

She helped me go to the toilet in a bed pan and between the blood, clots and wee practically overflowed it. 

I know it sounds stupid with the weight of the situation but also I just wanted to get out of my clothes - they were covered in blood and I was very agitated.

By this stage I was on the borderline for a blood transfusion (I am so thankful for blood donors and had previously donated blood). The Gynecologist called for her intern gyno to come down to assist.

There were no available operating theaters so it was perform what was needed in the ER to stem the bleeding or wait for a OR which could exacerbate my condition.

Things got a little hazy here and I was in the mindset of just save my life.

I was treated with silver nitrate, stitched in several places and packed vaginally with gauze to hold pressure on my cervix/LLETZ procedure site.

She placed a catheter in also as I wouldn't be moving for about 24 hours for any reason.

I was a little uncomfortable after all of this but so thankful I was in the right place to get the care I needed.

I was admitted to the ward at about 6am.

I sent JV straight home to rest and also call the family and let them know what had happened.

They advised me it would be a minimum 24-48 hour admission.

I spent the day resting and managed to eat a little bit of food. I felt a lot of pressure not so much pain as such.

I also forgot to mention earlier I had lost 5kg in 6 days... a sign my body was in distress.

The next day the packing was removed and very minimum to nil blood was noted.

I was anxious but they were more than happy to send me home to recover fully.

A week off work and some bed rest.

Little did we know...

LLETZ talk about it...

I've never fully spoken to most people about my experience after my LLETZ procedure.

She was a wild ride afterwards I tell you. I will go into that story in a separate blog.

LLETZ stands for - large loop excision of the transformation zone.

I had to have this procedure done after high grade cell changes were discovered on my cervix (see one of my previous blogs for more on this).

I chose to have my LLETZ done through a private hospital not through the public system in Australia for a few reasons. There was concerns that with the wait list through the public system that more changes may occur and change the surgery plan. 

The cells were located spread around my entire cervix not on one particular spot which was concerning.

I had a day procedure under general anaesthetic for my LLETZ. 

The surgery involves a small wire loop with an electrical current running through that cuts away the lower part of the cervix and also seals the tissue at the same time. 

Unfortunately my cervix required 3 passes of the ‘loop’ to adequately remove the affected tissue.

I woke up after my procedure feeling quite okay, a little sleepy but good.

I had some bleeding and discharge that started immediately - but this was expected.

My recovery after my LLETZ was... fucked.

It started off fine.

I was only able to use pads after surgery to decrease any irritation to the surgery site/for adequate healing and It was also advised not to have sex, swim or do any exercise for 4 weeks.

This being my first general anaesthetic and first surgery I followed all instructions to the letter.

All was well for around 5 days but quickly went down hill.

The compliactions were discussed prior to having surgery and I happened to be the 1 person per year that had major complications.

I still didn’t realise what to expect. After using tampons for 10 years it was hard to know what volume of blood was normal and what wasnt.

I wouldn’t change having the surgery, it was a given if not treated I would have ended up with cervical cancer in the next 10 years.

I dont want this to scare anyone from having surgery but please look after yourself following surgery, take additional time to recover and listen very closely to your body.

Nachdem sich mein PAP-Abstrich deutlich verschlechtert hatte (von einem IIID1 auf einen IVa), hab ich eine Probeentnahme machen lassen. Hierbei hat sich ein sogenanntes CIN III (eine schwerde Veränderung der oberen Zellschicht am Gebärmutterhals) bestätigt. Dafür ist leider eine OP nötig - ansonsten ist das Risiko bei ca. 30-40%, dass sich daraus ein Gebärmutterhalskrebs entwickelt. Geplant ist das ganze für den 21.07. (die Terminpläne meiner Praxis und die der Kollegin von der ich mich operieren lassen möchte waren etwas schwer in Einklang zu bringen). Bis dahin sollte ich nicht schwanger werden und nach dem Eingriff ist ca. 8 Wochen Enthaltsamkeit angesagt -> schwanger werden / Clomifen verschiebt sich mal mindestens bis September :-/.

Werde in der Zeit wahrscheinlich nicht viel eigenes hier posten, da es nix großartiges zu sagen gibt.

In mir herrscht der typische Kampf Kopf gegen Bauch - ich weiß, es ist besser solche Geschichten vor einer Schwangerschaft zu behandeln, aber es bricht mir dass Herz, es bis September noch nicht einmal versuchen zu können schwanger zu werden. Zieht sich ja KiWu-technisch eh schon alles so lange hin.

I guess I'm just going to sit around shaking and crying until Friday.

I keep trying to find stories of people who had my procedure and were fine after. All I keep finding are horror stories or people who continued to have problems. 

Everyone I've talked to that had something similar had the LEEP and then were fine. I'm getting the Cold Knife Cone and the reasoning is my case is "more serious." How serious? I don't know. I can't keep looking things up online because I'm just going to scare myself more. I won't even know for sure if I'm fine for another 2 weeks. 

Good news: the procedure has a 95% success rate to clear everything up.

Bad News: It could come back easily and there's a 2-4% chance I could die while getting the procedure.