Monday, 13 June 2016

Cervical Screening, why you should book your smear today...

 Updated: August 2016 - one year post abnormal cell smear results
 Updated: January 2017 - a year and a half post abnormal cell smear results

I originally wrote this post as part of Cervical Screening Awareness Week but have made the decision to keep a rolling record of my own journey for your reference and hopefully it will help even just one person make that all important decision to BOOK YOUR SMEAR!

Imagine a life-saving health check that can detect one of the most silent of killers. Then imagine not having that health check. Seems daft, right? Yet so many of us bury our heads in regards to this test. I'm here today, at the beginning of Cervical Screening Awareness Week (CSAW), chatting personal (which I never thought I would do again), in the hope that I can raise just a little more awareness in regards to Cervical Screening. If I can sway just one of you in the direction of your women's clinic / GP in order to book your smear then it's worth it.

Cervical Screening, Cervical Cancer, CIN 1, CIN2, CIN3, Colposcopy, Lletz, blogger

So many of us are guilty of burying our heads in the sand in regards to a smear test, I've done it too. The letter comes in and you glance at it, tell yourself you'll get around to it when you feel a bit more ready or decide it's not urgent or top of your list and sometimes literally bury the letter under a stack of bills or service provider letters. Sometimes it can sit there for so long you almost forget it's there. Almost. If you're anything like me that letter will play on you and you'll think, numerous times, ''I really should get round to booking that smear''. How many times have you put yours off now?

I'd put mine off a little while but one day I was feeling pro-active and I picked up the phone (after a ridiculous amount of reminder letters and even a mention from my GP), and I finally booked my overdue smear.

Nobody likes a smear test. Nobody enjoys the experience. We're talking about our vaginas, being on display and poked and prodded. It's uncomfortable. Some of us find it excruciatingly embarrassing, which I'm learning is absolutely preposterous. Seriously, the nurse doesn't care whether your legs are shaved, your pedi is in order and your bikini line is freshly done. They simply want to get a sample for testing. Some of us find it more than uncomfortable, I'm in this camp. Because of other health concerns a smear test can prove a little on the painful side, I've learned through the years that a couple of painkillers and a sedative can help with this. If you're extremely anxious about the procedure please do chat to your Dr about how they can help you with this. A good GP will understand and help in any way they can. They want you to have this test too. You can also request the nurse try your procedure with the smallest instrument first. Though this may not work and you may need the test repeated, should you find the procedure sore then it is an avenue you could explore, but speak up. Your nurse needs to be able to hear you, let them know if you feel that you can't cope with the procedure, they will want to help you, trust me.

There are a plethora of articles and blog posts online that offer tips surrounding cervical screening, from what to expect right through to what to wear. If you are like me and need to know the ins and outs of a procedure you're expected to go through then don't be afraid to read up on screening.

There are also many articles on what can happen next.

For so many, a smear will come back clear and that's the last you'll hear for a few years until your time comes around again or you have a particular concern that requires further testing. For so many women, they go for their cervical screening test and it's done and dusted. You get to go about your life as normal and feel good in the fact you've been pro-active about your health.

For some, a smear may come back with an abnormal or inconclusive result. These two terms cover a huge spectrum in cervical screening results but anyone I've spoken to about this have admitted their mind automatically goes to the worst case scenario. I think that's completely understandable. It's worth bearing in mind it could simply mean that not enough of a sample was taken in your first smear and so it needs repeating. In a lot of cases that's the next step, a simple re-screen. Not all that pleasant having to go through it again but being pro-active is it's own reward.

Some of us get the HPV letter. Some of us will have no idea what those letters mean. Again, there are many articles regarding HPV online that can help here. They can explain, in full, that HPV cells can sometimes develop into cancer. Not always, sometimes. This was my experience. I received the HPV letter.

I was invited for a colposcopy. That makes it sound like it was a party of sorts, it definitely was not a party. Though I'd researched the colposcopy procedure online I don't think I was prepared for it in the least. The first thing that threw me personally is that my colposcopy was carried out in an out patient theater. A little more intimidating than a practice nurse's room. Your legs will go into stirrups, mine were padded leather, I don't think that mattered. This procedure is a step up from your smear. It's more uncomfortable on the sliding scale but still, it's hugely important. This is when the colposcopist will inject some dye into your cervical area and look at it through a microscope. For some, this is the end of their discomfort. For others it may mean a punch or cone biopsy may be taken. This was my experience. Sometimes they can offer general anesthetic, not in my case unfortunately but trust me, if I can do it - you can too!

I could absolutely take you through what it felt like to go through that procedure but I think you'll know yourself... it wasn't the best 15 minutes I've had in my life BUT it ended, I had a fantastic team around me who were extremely comforting and afterwards I did feel great about the fact I had been pro-active. Sense a theme? I left to go home and rest up and deal with the aftermath of the procedure. For anyone wondering, you can expect bleeding and bad cramping, no worse than what your usual period will put you through except it possibly might last a little longer. This was my experience.

Then comes a really hard part. Waiting on results.

At that stage I received a discharge notice, along with another lovely invitation to come back in 6 months to have another smear.

And I got on with my life. I was in the lucky camp then. I got to forget about my cervix entirely. It's not something I'd ever thought of before if I'm being honest and I figured I'd thought about it more than enough already and so I pushed it to the very back dark depths of my mind.

But I did go back for my cervical screening. I'd have been seriously daft not to. All I had to do was imagine the consequences if I didn't... That made the decision very easy.

For some, following their 6 month check up smear, they're discharged. I knew that's the camp I'd be in. I felt it.

I was wrong.

It wasn't a smear. It was another colposcopy. It was more biopsies.

Some women will receive a letter or phone call to let them know that their results were not in the clear. At this stage there may be a number of different diagnosis' to be made, all I can speak of is when the letters CIN are mentioned. This was my experience.

So you get to the part of the journey where you're invited back for another colposcopy and something called a LLETZ procedure. If you see the word colposcopy linked to LLETZ and think you're going for the same sort of procedure as before, stop and research because I would hate to think of someone heading for that procedure without knowing exactly what it is. Again, there are articles online that can explain all of this much better than I can. I don't know the ins and outs and the specific names of the instruments used but I do know how it felt for me. That's all I can speak to. For some women this procedure can turn into something a little more, depending on what your colposcopist or surgeon sees and you cope. This was my experience.

At this stage it was explained to me that I had actually been diagnosed as CIN2 all those months ago and during the 6 months I'd been happily forgetting about my cervix, CIN2 had progressed to CIN3. Also referred to as pre cancer cells. At this point it was explained to me how cells progress and I learned where I was on the sliding scale. It was a lot to take in at this point.

This is the part of the post that would usually carry a summation, an ending, a nicely tied bow but, I am here, waiting on my results coming through. I have no update. Not yet.

Imagine if I hadn't had a smear. Imagine if I was still burying that letter under a pile of bills. This has all happened in less than a year. 8 months. How long have you been putting your smear to the back of your mind.........?

Cervical Screening Awareness Week (CSAW) is a national campaign led by Jo's Trust, their website has become one of my frequent haunts in recent weeks. I've found many women in the same boat with stories to share and I've sought comfort in their words. They have a huge amount of information and helpful resources available and they do excellent work.

They remind us of important statistics such as these:

Cervical Screening, Smear Test, Vulval Cancer, Cervical Cancer, CIN, VIN2, VIN3, Colposcopy, Vaginal Biopsy
Choose not to be the one in four. Choose to be pro-active. Choose to go for your smear....

It really could save your life.

And now we've reached the one year point since being diagnosed with CIN in it's beginnings. 

I was asked to come back for another colposcopy and potential treatment.

At this stage it appeared that the Lletz treatment had been successful however there was a new cause for concern. And so I made the journey down for yet another colposcopy. I'm like a pro by this point! If I can go through it repeatedly, YOU can definitely go for a little old smear, right!?
It became apparent rather quickly during the examination that the issue wasn't with my cervix this time around and biopsies had to be taken from the wall of my vagina. Multiple biopsies.

It was suspected that I had VIN3 cells. The vaginal equivilent of cervical pre cancer cells.

Had you ever heard of Vulval Cancer? I hadn't... it was something that hadn't even crossed my mind until my consultant sat me down to explain what that might mean.

I was immediately referred to the only vaginal laser surgeon in Northern Ireland for treatment in November 2016. I. Was. Petrified. What I will say is that the Dr's who look after you know their job and they do it so incredibly well. The nursing staff you are in contact with work exceptionally hard to put you at ease during what can turn out to be a traumatic time. There is a lot of information in regards to the VIN3 laser treatment and should anyone want to go through that please do feel free to get in touch with me. It wasn't one of the most wonderful times of my life but I am entirely grateful to have had the treatment available to me and the team of amazing health care professionals who worked so hard to help me through.

I was lucky. They had caught the cells, many as there were, just before they dropped below the epidermis.

I came home to recuperate.  It took some time.

6 weeks post treatment I had another colposcopy. Seriously, you can just call me Miss Colposcopy now... and we finally had some good news. The treatment had been a success. They were confident that they had lasered all cells involved and healing was apparently trucking alongside their estimated timeline.

And so I have been treated to a few months of not thinking about my cervix or my vagina. Well, residual healing issues aside. I'm entirely grateful and thankful that I went for that initial smear. I can't reiterate that enough. A SMEAR TEST SAVED MY LIFE. That was spelled out to me in no uncertain terms. In regards to VIN cells, they can change silently and quickly. I was ridiculously lucky. Why not give yourself the chance to be ridiculously lucky too!


I'll be back at the hospital for a follow up colposcopy soon. And I absolutely, without a doubt, WILL GO because I deserve the chance. So do you.

I spent this last year and a half chatting about what I was going through in a rolling post on here which I will continue to update and on snapchat (seraemily) and have been overwhelmed by the response of support and the replies telling me smears have been booked. There have also been messages and emails asking for information and advice on the procedures I had that others may now be facing. This is absolutely fine. If I can put just one mind at rest, or help just one person through what I've gone through I will try my damnedest to do so.


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