I hope the last week has treated you well and that you enjoyed the long weekend!
Today I want to talk about a more serious issue – The Pap Test. I have spoken about anxiety here before, so I have touched on serious issues before, but this time it’s a physical issue.
I am 28 years old (29 in November) and I recently had my first smear test. You would be correct in thinking that this is a little bit old for a first smear test as the NHS start offering smear tests to women when they hit the age of 25. I was offered one when I was 25… and 26… and 27 and I always found a reason not to pick up the phone and arrange the appointment. It was just never convenient with work or social commitments or 100 other things. It’s also not an exciting prospect so it was something I was willing to delay. I remember my mum having to go for one when I was a lot younger and saying how unpleasant it was.
This year a letter came through with a pre-arranged appointment. I couldn’t really get out of it and I was sort of relieved that they had made the appointment for me because I knew I should go and if it was left to me to make the appointment I would procrastinate again.
I was nervous when they day came. I had also scheduled in to see the registrar for us to give notice of our wedding in the morning which did ease my mind for a while.
The nurse took me in to the room, whilst my other half waited in the waiting room, and she could not have put me more at ease. She explained exactly what was going to happen and what they were looking for.
I’m going to go into some detail here so if you want to skip down feel free but I feel like it’s something that a lot of young women just aren’t told. Older women just tell them it’s not very pleasant and that’s where it ends.
You lie on a bed and you have to be nude from the waist down. Some women prefer to wear a skirt because they can just remove their underwear and leave their skirt on and feel a little less exposed. You have to lie with your knees apart and try to relax as best you can. It’s obviously not easy to relax given the situation but it is much more uncomfortable if you tense up. The nurse then puts a speculum (posh name for a tool used to, basically, hold you open) into your vagina. These are plastic these days so they’re not too cold or too savage looking compared to the metal ones of years gone by. Once that’s in, the nurse uses a little brush to collect cells from your cervix. I really don’t remember feeling much when the nurse was doing this and I certainly wouldn’t describe the feeling as painful.
Once the nurse has collected a sample of cells from your cervix, you are free to go. The cells are sent to a laboratory where they are tested for any abnormalities.
I left the surgery feeling relieved. The test itself had not been as bad as I had feared and I was pleased that I was doing the right thing in terms of looking after my health.
A week or so later I received a letter in the mail containing my results. I opened the envelope and the first thing that dropped out was a pamphlet that had a title something like “So you’ve had an abnormal smear result”. My heart sank, because I had thought that my results would come back clear. I read the letter and it said that they had found some abnormal cells and that I needed to have a further appointment so they could see how abnormal they were and whether or not they were, or could potentially be, cancerous.
The NHS were good, they had already booked in an appointment for me to go to the hospital to have the procedure called a Colposcopy. In layman’s terms, this is a procedure where a specialist uses a microscope and a very strong light to look into your cervix and look at the cells. It’s quite similar, for the patient at least, to the smear test although this time they have you in the stirrups (the same stirrups that Ross gets tangled up in in Friends).
After the smear test, I felt like I was ok to handle this and I wasn’t too worried. Until the technician looked up at me and said she was concerned that my cells might be more abnormal than they initially thought.
I should take a moment to explain the different “levels” of abnormality that can occur in your cervical cells.
- CIN 1 – this is the lowest grade abnormality. These cells usually go back to being normal on their own without treatment after 12 months.
- CIN 2 – The medium severity. These cells have a high chance of actually becoming worse and changing to the next level of intensity.
- CIN 3 – The highest severity. These cells are extremely likely to become cancerous.
The specialist said that she wanted to take a biopsy of my cervix so that they could be 100% sure how severe the abnormality was. I was a bit shaken but I didn’t feel too bad about it. The biopsy was definitely the most painful part and also the most difficult to describe. It also induced period pains and stomach cramps – something I haven’t experienced for about 4 odd years now.
When I left the hospital, it hit me. I could have precancerous cells. I should have come earlier. If I had come sooner this could have been dealt with. I hadn’t had any concrete information and I was going to have to wait 4-6 weeks for results but I was still upset. It sounds crazy but a lot of things go through your mind. And I was scared. I had decided that if I had CIN 2 I would have the cells removed. I didn’t want to risk them going cancerous. The treatment didn’t sound pleasant – a laser is used to effectively burn off the abnormal cells.
1 week later I got a letter through from the hospital and I was convinced I was going to read the C word. Why else would they have sent a letter so fast unless it was something that needed urgent attention? It wasn’t. It was a letter explaining that I had had a biopsy and that I would be receiving results in 4-6 weeks. Thank you for that.
3 weeks later I got another letter through from the hospital and I couldn’t bring myself to open it. I felt a bit like Schroedinger’s cat. I had cancer and I didn’t have cancer all at the same time and I wasn’t sure if I wanted to know the truth. My fiancé opened the letter. I was CIN 1. I was so relieved I thought he was pulling my leg to start with.
I have to go back again for another Pap test in 12 months to make sure that the cells have gone back to normal. I’m not quite sure what happens if they haven’t but I guess we will cross that bridge when we come to it.
So why am I telling you all this? Because I now realise how important the Pap test is. I should have gone when I first got the appointment through when I was 25. These things aren’t meant to be an inconvenience. They could save your life. If I had had precancerous cells when I was 25 and had left them for 3 years I could be telling a very different story now.
I was lucky.
Don’t be lucky. Be smart. Have a pap test.
For more information about Cervical Screening, check out the NHS Choices website.
Stay Safe, Be Smart