Cervical Cancer Blog Three aka The Cervical Screening

I write this the night before I say goodbye to my cervix. Tomorrow it is being removed via a rather brilliant surgical piece of equipment and a rather brilliant surgical procedure. Whilst I may come across as flippant about this, please rest assured, I am not. I’m writing this to expel some nervous pre-op energy. I’m also writing it to expand upon how lucky I am, something that I have alluded to in previous posts.

I was given the option of having a hysterectomy or something called a trachelectomy (this is the cervix removing operation). This is not an option available for everyone and seems to come down to two things: -

·         The postcode lottery of the NHS and whether there is a hospital or surgeon near the patient that can offer that treatment

·         How early they catch the cancer

Now there are moments where I sit in quiet contemplation and think ‘the universe gave me cancer,’ and then I get angry about it and go ‘the universe gave me cancer, what the actual FUCK!!’ which swings back to quiet contemplation and so on and so forth. Whilst I could hold onto the anger (and so far, there have been moments after the 1^st op where I have been truly furious) I refuse. In the words of seemingly every ten-year old’s favourite Disney princess I have chosen to…let it go. Here, have an obligatory Elsa.

As I need to survive this process with my obnoxious sense of self intact, I need to retain the thought that I have been extremely lucky (which I have been). To elaborate on why, I want to start with a summary of the symptoms of cervical cancer. These are: -

Here is another symptom of cervical cancer: -

It seems that for many nasty things it is very common for symptoms to be in the latter category. It is also very common for cervical cancer to fall into the latter and this is exactly why those screenings are important. By the time some women experience symptoms the outcomes are less positive.

As established, I didn’t attend my screenings when invited and so this is where my luck kicks in. I doubt I would have attended any future ones as (also previously established) my ignorance was driving me to believe that this was never going to happen to me. In usual cases of cervical cancer, once symptoms begin to display, this could be a very different type of blog post to write. As is stands I was lucky and started to develop symptoms in the early stages (not common). This is what made me go ahead and finally, finally, investigate the problem. So now, I won’t have a cervix but I get to keep my life and isn’t that the most wonderful trade off?

In cervical screening awareness week, this is my final push on the importance of attending cervical screenings. All subsequent posts will be on what happened after. Now my intention is not to worry anyone at all. If you are reading the symptom list and you’re thinking, “um…I think I am experiencing some of those” please, please don’t panic. The chances of these symptoms being cancer are slim.

As established in ‘The Biology Lesson,’ the female reproductive system is a very complex piece of machinery. There is a reason the entire medical practice of gynaecology exists. If you are experiencing anything out of the ordinary it could be nothing, it could be something, it could be easily treatable or you may have a different story of your own to tell. Regardless, if you feel something is amiss then go and see someone about it.

I believed so very strongly that I had polyps. When I discussed it with a friend she thought it could be endometriosis. This was after I thought my symptoms were just related to problem periods I used to have, or that my birth control was no longer working out for me or that I was having some very overenthusiastic sexy times. I pray no family members read that last bit. If they do I am telling you now…I don’t even know what a penis is. Promise.

So, I finally booked my screening. This is my experience and my experience alone so I can’t speak on behalf of others but this is how it went.

A 22 Step Guide to Cervical Screening

Step 1: Picked up phone and went into meeting room at work. Spoke to receptionist. Booked appointment. Did this in front of someone who has the misfortune to be both friend and colleague. Feel sorry for this Colliend? Frolleague? She will suffer the many tales of Gerry later to come.

Step 2: Turned up to GP’s and booked self in. Sat in waiting room hoping that no one has anything contagious. Be grateful that I remembered to shave. Wonder how hairy knees still are.

Step 3: Get called in and basically break into a nervous run to get to the room.

Step 4: Be greeted professionally by a nurse because she is a professional and she won’t do anything that isn’t. Discuss the fact that I haven’t attended a smear before. Be gently admonished. State how nervous I am because I have symptoms. Be gently reassured.

Step 4: Step to where the bed thingy is. Have nurse explain what will happen. Receive request to remove everything from below the waist. Request to keep socks on. Request…granted.

Step 5: Nurse pulls curtain across bed for privacy and steps outside. Wonder what the point is as she’s pretty much going to get a good ol’ gander anyways. Struggle to get out of socks and tights. Feel glad that she closed the curtain and is not witnessing a grown adult struggle with her clothes. Struggle to put socks back on. Fold clothes neatly on chair because there is no need to be impolite and messy.

Step 6: Get comfortable on bed. Feel decidedly uncomfortable as there is no candlelight or soft music.

Step 7: Nurse returns. Explains door is locked. Demonstrates ‘the smallest speculum she could find.’ Spend 30 seconds wondering what this implies.

Step 8: Nurse shines spotlight on the area of investigation. Start to wonder if my vagina should have prepared a routine. Would it be a singer? A dancer? Some sort of magic show? Nervously giggle as the situation is just… weird.

Step 9: Get next steps explained – knees up, bring feet to bum and then just drop ‘em to the sides. Proceed to complete steps 1 -2. When needing to proceed with step 3 I just lay there. Told nurse that any second now I will definitely get round to it.

Step 10: Take a deep breath and drop ‘em to the sides.

Step 11: Get told to take another deep breath and drop ‘em some more. Apparently, it’s hard to conduct a smear test if you only move your knees 5 centimetres apart.

Step 12: Feel the urge to make a joke about usually getting dinner before someone’s face gets that close.

Step 13: Make sensible decision to not make that joke.

Step 14: Drop ‘em some more.

Step 15: Enter Sandman. I mean Enter Speculum. Feel amazement at how cold something can possibly be. Wince a bit. Understand that this bit is not fun nor comfy but realise it wasn’t as horrific as I thought.

Step 16: Enter brush. Pull a face as it connects with cervix as this bit feels weird and not entirely good. Feels like she is going to brush forever. Wonder if the nurse thinks she is Bert from Mary Poppins and is going to chim chim cheree until the end of time (as we now know there was a tumour there so it could mean that the discomfort I felt at this point could be related to that – I don’t have a comparison). Look at knees. Realise that they are surprisingly hairy and that I clearly cannot shave them properly.

Step 17: Bleed a bit. Get told that this is very common and is not a sign of anything nefarious.

Step 18: Nurse extracts brush. Realise that at this point less than 5 minutes have passed.

Step 19: Nurse extracts speculum. Minor problem occurs when it decides to wrap itself around my cervix. Wonder how the hell that is biologically possible. Wince a bit more as cervix clearly wants to hold onto speculum. Understand now that my cervix was trying to communicate with me. Speculum extracted.

Step 20: Nurse draws curtain and steps outside to give me dressing privacy. Struggle to get back into tights and socks. Wonder how anyone in the history of mankind has ever managed to successfully put tights on even though it was something I could do that morning.

Step 21: Receive explanation of what happens next – a letter to my home address between 2 – 6 weeks stating results of the smear. Be told that if there is anything to be concerned about it will be received in 2.

Step 22: Walk gleefully out of the surgery stating to the nurse that ‘it wasn’t nearly as bad as I was thinking and that I would never miss it again’ and then rewarded myself with a can of full fat coke.

Here’s Bert. You will not get Bert.

For a lot of women (and more than likely for those reading this) your journey will end here, or more likely, when you receive the letter stating that your results were fine. Good!! Oh, so good! Then you forget about it all and get called up three years later and repeat this process until you no longer need to repeat this process.  

Whilst I can genuinely say that the smear test was the most pleasant part of this entire process so far, I will be honest and say that it isn’t pleasant. It wasn’t as bad as I was imagining it to be but for some women they may have anxiety about this process and so I don’t believe in shaming women who haven’t attended or refuse to downplay their fears or concerns.

My tips for those concerned would be the below: -

·         Book an appointment time that you’ll be most comfortable with. If you feel like you just want to get it over with and a so a morning slot on a Monday is best, then go for it. If you feel like you need to relax into the day, then try and get one for the afternoon.

·         The nurse will probably be female but if that is a concern than double check this with the receptionist when you book. Request a female if that makes you more comfortable.

·         Tell the nurse performing the smear that you are nervous, they will try and re-assure you the best they can.

·         Ask to see the speculum if you feel that may help. Request a small size if you feel intimidated by the larger ones…yep that’s right they come in all sizes!

·         Wear something that you feel comfortable getting in and out of, they should cover you with a sheet anyway but a dress or skirt will provide a bit more discretion.

·         When the nurse is performing the exam, ask her to explain what is going on if that makes you more comfortable, or just make small talk or stare at the ceiling in silence. Whatever works for you.

·         Remember: if you want someone to stop a medical procedure you have the right to ask them to stop and they will do so.

·         If you don’t want to go in alone ask someone you love and trust to go with you. Even if they wait outside the curtain chatting to you, you may find their presence comforting.

It’s a common misconception that cervical screenings are testing for cancer. This isn’t the case. Yes, they can pick up cancer and other problems that may not be presenting themselves yet however the main purpose for them is to pick up problems before they become problems.

In the language of my people (the geekdom) I will present the purpose of cervical screenings in a visual that relates to me.

For the majority of people your cells will remain just that….cells. Normal, healthy cells. Most smears will report that there are no abnormal changes and your cervix is just having a ball down there being nice and lovely. Just like this guy! Smear test has done its job! Yay!

If your cells have eaten after midnight…wait hold on…no. Sorry. If your cells have done something…unusual then they may change. These changes could be mild, moderate or severe but it means that they are no longer the healthy cells that you once had. Kind of like these guys….

…they look like the nice and lovely Gizmo but have started to behave badly.

Good news - these cells will do one of two things: -

·         Revert to being normal, healthy cells. This is quite often the case if they are mild or moderate. It may mean that you are invited back to a screening in a few months’ time to check that this is the case.

·         Be taken out. This is usually the case if the cells are found to be severe. This is a good thing. It means that your cells are abnormal (sometimes pre-cancerous but not always) but it means they are getting taken out before they can do anymore damage or get any worse.

Smear test has done its job!

If. If, you leave these severe changes unchecked they can do something more destructive. Those normal, healthy cells can become pre-cancerous which in turn can become cancerous and then you are dealing with this…

The smear test is a stop gap to sure that your cells are lovely and remain lovely and that they are stopped before they reek damage on your resident home town aka your cervix or other body parts.

(Try finding another blog that will relate cervical cancer to the Gremlins. Good friggin’ luck!)

I shall sign off now, I may not write next week depending on the level of shite I feel but this is far from finished!

Stay tuned.

Cervical Cancer Blog Two aka The Biology Lesson

In my rather creatively titled ‘blog post one’ on cervical cancer (can be found here for the interested) I gave an explanation as to how stupid I have been. In said post I also mentioned that I was lucky. This may seem like an odd word for someone to describe herself as when she has just received a cancer diagnosis but I will elaborate on this in another post soon.  

I also mentioned that I would expand on cervical cancer symptoms because in my case these and ‘luck’ go hand in hand.

But first….

Hehehehe. Ahem. Sorry. But look it has a little smiley face…Ahem. Anyway. Sorry.

I wanted to interrupt my own blog with a quick biology lesson. Back when I was at university I volunteered as a sexual health worker at a youth centre. I still consider it to be one of the most rewarding thing I have ever done. During my training, I learnt a lot about the female and male reproductive organs, more than what information was ever presented at school, so I feel like I knew quite a bit about uteruses and cervixes anyway.

Whilst me and my partner were telling friends and family about my diagnosis we noticed that one thing, or more precisely, one question cropped up from time to time. ‘What is it?’

Now this question was asked by both men and women and one friend mentioned to me that she didn’t know an awful lot about her own biology and her own reproductive organs. This is not her fault, not even a little, and is more indicative about the lack of education we receive on this subject. If we try and encourage women to attend more of their cervical screenings does it stand to reason that we need to also explain the importance of, oh I don’t know, the organ which we are screening?

One of the reasons that women may not attend their screenings could be simply that they don’t know the significance of what is going on down there. So this is biology….Gerry stylee. 

I even drew myself teaching a class using Paint! Look, you continue reading this you've just to deal with the fact that I love Paint.

What is cancer?

I would be surprised if anyone didn’t know what this it. I think children are now aware of what this is. I was thinking back to if there was ever a time where I didn’t know what cancer was. Honestly? I genuinely couldn’t. Maybe this is because there is more exposure now to cancer and people are more open to discussions (a good thing) or maybe, just maybe, it’s because there isn’t a person amongst us who doesn’t know someone who hasn’t been diagnosed.

The NCI (National Cancer Institute) defines cancer as abnormal cells that divide without control and can invade nearby tissue. Cancer cells can also spread to other parts of the body through the blood and lymph systems. Cancer can start almost anywhere in the human body.

Gerry’s explanation of cancer: It’s a fucktard of a disease. Just one day, out of the blue, something inside your body goes directly against what your body is supposed to do. It’s one of those things that just happens. It doesn’t select through age, sex, sexuality, race, whether you are a good person or a shit-head that eats with their mouth open and talks through the good bits in movies. It doesn’t know, it doesn’t care. Cancer doesn’t think. It just exists and, through its own existence, destroys.

Sorry, I can’t make cancer sound fun. It isn’t. Not for the people that have it and not for the people who love someone who has ever had it.

What is a cervix (and all those other bits)?

Here is a lovely diagram of the female reproductive organs. I opted not to use Paint for this as I feel my talents may not represent it all faithfully.

Gerry explanation:-

Ovaries – two of these, egg producing machines. Fun fact – baby girls are born with all the eggs that they will ever have inside their bodies. Males start producing sperm during puberty and pretty much become sperm making machines for a very, very long time. Females have them already stocked but there is a limited supply hence the menopause. When the eggs start running out and the ovaries stop producing hormones to release them; menopause starts. Important. Prone to numerous problems. Can develop cancer.

Fallopian tubes ­– two of these. Acts as the transport system to get the egg from the ovary into the uterus. The egg gets fertilised in the fallopian tube but doesn’t implant there. Important. An egg can implant there. If this happens then there are all sorts of problems. Can develop cancer.

Uterus – one of these…although in some rare and random medical cases apparently there can be two. Huh. Go figure. Supposed to be pear shaped but some women may have different shaped ones which, guess what, can cause problems. In basic terms this is where the baby lives during pregnancy. Important. Prone to many problems. Can develop cancer.

Cervix ­– one of these. Latin for ‘neck’ as it connects the uterus to the vagina. Controls what goes in and out of the uterus (sperm, blood, babies) and is vital in the role of pregnancy and childbirth. Aka stops the baby falling out and then opens massively to make sure the baby can get out. You know in medical shows when women in childbirth have their knees up to their ears and are screaming blue murder and a doctor is yelling ‘she’s ten centimetres dilated…push…push….PUSH!!!!’ yeah they are referring to the cervix. Prone to many problems. Can develop cancer.

Vagina -  one of these. Most people know what this is. Important for periods, childbirth and sexy times. Prone to many problems. Can develop cancer.

As you can see it’s a scary, complex and fascinating world down there. We women have a lot going on!

What is cervical cancer?

I thought I would leave this bit to the professionals. This link does a brilliant job of explaining what cervical cancer is, as well as listing causes, risk factors and how to reduce your risk - https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer.

I need to take a moment also to highlight how wonderful Jo’s Trust is. A lot of the information that I need, that I haven’t necessarily been able to get from nurses or doctors, I have found here so take a moment or two and give it its due.

Gerry’s explanation of cervical cancer: It’s a fucktard of a disease.

Here endeth the biology lesson.

See you soon.

Cervical Cancer Blog One (not a very creative title - sorry!)

Let’s start with this. I have brown hair, brown eyes and cervical cancer. Amongst other many descriptions of me, I am also these two things: -

·         Stupid

·         Lucky

Before I go on I just want you to know that you can also think these of me and I would understand it. Really, I would. So, think it, digest it, but just don’t say it to me. If there is anything at all I have learnt in the past few weeks is that I don’t need anyone telling me what I already know.

But I am stupid and I am lucky.

If I continue to be lucky then my cancer story is going to be short one with a positive ending which, at the time of writing this, it looks like it will be. So, let’s hope my entries on this topic are short. Sadly, I can’t guarantee that they will be sweet.

My reasons for wanting to write all this down are mainly due to the below: -

·       Mainstream cervical cancer stories that are positive are in short supply. The majority that reach main news are either about Jade Goody, women who didn’t get treatment in time or women who died before they even reached cervical screening age. I understand these stories highlight the severity of cervical cancer and bring its own kind of awareness, however, when you have just been diagnosed with cervical cancer, these stories are terrifying.

·       Cervical cancer doesn’t nearly get as much awareness as I would like it to have. Before my diagnosis, it wasn’t really on my radar and neither were the events surrounding it. For instance, I didn’t know that January was the designated month for cervical cancer and contained a Prevention Week concentrating on getting women to attend their smears.  This is extremely important because cervical cancer is a cancer that is preventable through screening. Partly due to a lack of awareness on cervical cancer it took me a long time to realise the symptoms I had were problematic. More on that fun topic later.

·         Sharing stories with women who have gone through similar experiences are a bit of a lifeline right now. I have stumbled upon some blogs written by women just like me (and one in fact who was treated by the very same consultant who is now treating me) and have poured over every single word. This is oddly comforting when the insomnia kicks in and you scour the internet at 3am for anything you can get your greedy, needy eyes on. It may not always be pleasant but the majority outline their own experience and it makes me feel better prepared for what may be coming my way.

·        Writing helps me.

·       I’m hoping if someone finds themselves in a similar situation that they will find this an odd sort of comfort of their own. I’m also hoping that if someone is thinking that they don’t need to attend their cervical screenings, or know of someone who won’t, that this may be the slap upside the head that they need.

That brings me nicely to the first issue at hand and back to the first point. I am stupid.

Cervical cancer is a relatively slow growing cancer which can take up to ten years to fully present itself. So, whilst you are doing things like this….

…and are feeling absolutely wonderful doing so, those cancer cells could already be making their home quite comfortably throughout the cervical tissue. In fact, the first three photos were taken a matter of months before a cancer diagnosis was confirmed. Do I look sick to you? Do I look like I’m in pain? Nope. Because at that point, even though the answer to the first question is yes, the answer to the second was mainly no. I say mainly no but again I’ll get to that and the lack of symptom awareness at a later stage.

The point I’m trying to make is that cervical cancer doesn’t always present itself. For some reason an episode of The Simpsons where Bart is skipping out on lessons comes to mind…

Well at least I have a grasp of human autonomy. But sadly it wasn’t that I popped off my work chair one day grabbing my crotch Michael Jackson style screaming ‘my cervix, my cervix!’

This is why those screenings, that take minutes, are vital because if a medical professional finds abnormal cells they can take them out and often be done with the whole thing.

In an alternate version of this universe there is a version of me, sitting at home without a care in the world. That version of me went to my cervical screenings. This version of me did not. I’m not going to lecture. I don’t respond well to lecturing myself but that is another reason why I wanted to document this. If, like me, you think that attending those screenings are a waste of time because cancer doesn’t happen to people like you (like it was never supposed to happen to me – doh!) then I just want to open your eyes a little. If anyone good comes out of this I hope to act as yours, or someone that you know, terrible warning.

I have a print that says as much on the hallway wall. ‘If you can’t be a good example, be a terrible warning.’ At the time I bought it, I meant you know, don’t eat towelette’s or something. Or, don’t eat out of date ham the night before you’re due to have a thorough pelvic examination. True f*cking story.

This is my first post on the subject. There will be quite a few more.

I just wanted to make sure I had words on a page ready for the start of the Cervical Cancer Prevention Week. The campaign is #smearforsmear and I’m for anything that works but if you know me you also know my views on not hiding the reality of things. So, just in case you wanted a harsh and brutal prompt check out the below photos.

Go. Get. It. Booked. I make a point of not making wishes on the past as making wishes doesn’t change what has happened. But honestly? I wish I had just gone to the screenings.

Stay tuned for more soon.