For 30 years I was never concerned about my cervix. I trusted it to do its thing, just like I trusted my gallbladder to create bile and my appendix to not explode, and in return I partook in regular gynecological preventive care. In college I had an abnormal Pap smear, followed by a colposcopy that came back positive for HPV. The doctor riddled off statistics and recommended adopting a healthy lifestyle so my body could erase the virus. I got the Gardasil vaccine to protect myself from additional strains of HPV and lived a (fairly) healthy life.I was young and assumed I was invincible.
It wasn’t until pregnancy that I really understood the job of the cervix. It’s actually kind of a big deal, acting as the barrier that would keep my unborn child safe. It’s strong and resilient. And vulnerable, as I learned during a post-miscarriage D&E. My former obstetrician informed me that my cervix suffered a minor cut since the barricade had never been opened by childbirth before.
Once my next pregnancy hit the 40 week mark the former OB had me come in, on two occasions, for a quick “membrane sweeping.” Ladies, this is a great way to test if you’re tough enough for natural childbirth. If you can handle your doctor shoving two fingers through a blueberry-sized opening and sweeping them around then you’ll be all set. For me, the searing pain made me question my plans to hold off on the epidural for as long as possible.
Childbirth is when your cervix does its Oscar worthy work, shape-shifting from a closed tunnel to a bagel-sized opening to allow for your bundle of joy’s big head to pass through. And then it slowly shrinks back to almost normal. It’s a sci-fi miracle if you ask me. Seven weeks later my lady bits suffered another blow – there was some residual birth matter that needed to be removed. The doctor insisted it would be an easy procedure to do in the office without sedation. The Valium she prescribed should have been fair warning that it wasn’t going to be pleasant. Performing a D&E on a new mom whose hormones are raging from breastfeeding and still in perineal pain is an act or torture.
During the decade between college and the present I never had another abnormal Pap smear. In my mind I was in the clear. At this year’s annual exam the only question I had for my new gynecologist was about advancements in prenatal testing. I never considered there’d be a bigger issue to deal with.
The Pap smear came back abnormal.
My doctor gave me the option to have a colposcopy done or to wait a year and retest. I opted for the colposcopy since I tend to be on the losing end of chance and risk. The earliest appointment was 6 weeks away so it felt like a year anyway. The doctor took samples from two sites – one on the outside of the cervix and one going into the uterus. It’s an uncomfortable procedure but honestly not terrible (as long as the snipping tool is sharp enough and the doctor doesn’t try a couple times before using a new one). She ran through the possible scenarios and promised I’d hear back in a week.
It’s never good when an unknown number calls you after 5pm. It was my doctor, calling during her vacation. The pathology report came back positive for pre-cancerous cells on the outer region of the cervix. The next step would depend on whether the cells were low grade or high grade and my plans for future children. She promised to call me back once she heard back from the pathologist with more details. “It’s important to remember this isn’t cancer.”
The next morning UNKNOWN called back. The pathologist confirmed the sample was high grade, much to my doctor’s surprise. The good news was that the baddie cells seemed to be shallow. There’d be a 1% chance that the procedure (Loop Electrosurgical Excision Procedure or LEEP) would cause any issues during pregnancy. Also, it’s important to remember this isn’t cancer.
I had the option of being sedated or awake for the procedure depending on my pain and anxiety level. My pain rating is from zero to labor pains and my anxiety rating is from zero to non-sedated postpartum cleanup. Also, the anesthesiologist only visits their practice once a month so it would delay this ordeal even more.