How it begins:
A routine Pap smear. You go every year so that you can keep getting refills for your birth control prescription. You’ve had Paps a few times before, and this time is the same as all the rest.
A few weeks later:
A call from the doctor that says your Pap results were abnormal, and that they have diagnosed you with HPV. The high-risk kind. The cancer-causing kind.
You’ll have to come in, as soon as your schedule permits, for a colposcopy. Take two or three Advil an hour before your appointment.
Colposcopy: a procedure for closely examining your cervix, vagina, and vulva for signs of disease using a colposcope, which is similar to a microscope.
You read online that some women have immense pain during and bleeding after the procedure. Others report only mild discomfort. You’re sure that you will fall into the former group. That’s just how life has been going lately.
You only need to undress from the waist down. The procedure takes place in a normal examination room, like where you’d go for a Pap. You sit in the seat and inch your butt towards the edge, resting your feet in the stirrups. You stare at the ceiling and hear metallic clangs that raise the hair on your arms as your doctor prepares to examine you.
There is really only a mild discomfort, a normal feeling for having the inside of your body examined. You wait for the doctor to say that everything looks fine, but she doesn’t. Instead she says she sees a few abnormal areas, and decides to take a biopsy to be sent to the lab. In fact she takes two biopsies, in two different spots.
That is not what you were expecting.
A few weeks after that:
Your doctor calls and says that one of the biopsies returned low-risk cervical dysplasia, while the other returned higher-risk results. These are known as CIN I and CIN III.
Cervical dysplasia: healthy cells in the cervix undergo abnormal changes and indicate the possibility of the development of cancer.
CIN: Cervical Intraepithelial Neoplasia, the diagnosis of a biopsy after it is sent to the lab and classified as showing dysplasia.
CIN I: mild dysplasia.
CIN II: moderate dysplasia.
CIN III: severe dysplasia.
She recommends a LEEP procedure as soon as possible. They don’t like to wait more than two months when CIN III is involved. They will leave the CIN I alone, and see if it goes away.
LEEP procedure: Loop Electrosurgical Excision Procedure, it uses a wire loop heated by an electrical current to remove cells and tissue.
You don’t consider not doing the procedure. You have trouble reconciling the idea of pre-cancer with your own body.
You have to wait until after your next period, so in three weeks you return to the doctor. You walk into a room similar to last time, still just a regular examination room, but now there is a large, medical-looking machine next to the examination chair.
Your doctor puts a solution on your cervix to clean it, then uses the colposcope to locate the part of your cervix she is removing. She numbs you with novocaine.
The LEEP machine hums to life and you can’t see exactly what’s going on, as it’s happening low down and between your own legs. The doctor and nurse each ask you multiple times if you’re doing okay or if you feel anything, but the entire procedure is startlingly pain-free. The only thing that makes you nervous is the smell of burning that lightly fills the air.
After it’s over, you ask how much they took out. Your doctor shows you what she removed from inside of you, floating in a clear liquid in a small plastic jar. It’s pink and red, about the width of a quarter but very thin. It looks porous, and strangely alive. You look for any sign that it is bad, diseased, infected, but see nothing.
Your doctor says that some bleeding afterwards is normal, although this doesn’t start for you until a few days after your procedure. It’s like a light period, and lasts nearly a week. The bleeding worries you, and you are relieved when it stops.
Another phone call:
Although you didn’t know exactly why what they took out of you was being sent to a lab, you know you’re waiting for “results.” These results turn out to be whether or not they had gotten everything out, whether or not you had “clear margins.”
A month post-LEEP:
You go in for another appointment but you can’t even really remember what it’s for. It turns out to be nothing more than a quick check-up that you’re healing okay.
Thankfully, you are. Good news in the examination room comes as a surprise.
The only thing to do is wait. You have a Pap smear scheduled for five months away, and until then you’ll know nothing new. What you’re really hoping for is that your next Pap comes back normal. That would mean your HPV is cleared, or at least dormant. You’re not sure what that means for your risk of cancer. Can the CIN I they left inside of you still be dangerous even after you’ve cleared the virus?
That’s something you try not to think about; what is still inside of you. It may be low-risk, not severe, whatever you want to call it. But it’s always in the back of your mind.
Wait. It’s all you can do.