Surgery

Yippee Ki Yi Ay.
I’m on my way.
Back in the saddle again…

…not exactly. This time I’m back in the stirrups again. This will be my seventh downstairs-region-surgery and I feel like I’m becoming an expert at donning the theatre garb. I’d prefer to be donning the actual-theatre-garb. Reckon the other patients in here would too. We’re lined up in recliner chairs, hairnets and compression knee highs on, politely smiling at the surgeon and anaesthetists who call on us, trying not to think about the fact that very soon, our hoohas will be seen by those very same people.

I don’t like it.

I have set my jaw in resolute forebearance. My exterior is calm and quiet. Only my blood pressure gives anyone any clue that it upsets me to be back here again.  The nurse hums and hahs and goes off to let them know. She’s worried about stroke risk. I’m not, I know it is just a reasonable physiological response to gynae surgery. If you think about it, it’s absolutely ridiculous. I have to suspend my mind, somehow, and not think about the fact that there will be knives in my lady bits, while I am unconscious! Of course my blood pressure is high, that is an alarming thing!!!!

So, off I go. Pretending to be brave again and feeling like a scared kid.
(be gentle with me kind surgeon)

I look forward to being on the other side of it.
How do you cope with pre-op nerves?

 

UPDATE:  They were so lovely and gave me lots of nice medicines to make it all okay. I’m out and delightfully ‘lala-land-y’. Resting in bed for a bit now and no lifting for a good long time.  Shame I couldn’t get them to instruct that there should be no cooking, child ferrying,  washing or otherwise domestic delights for the next six months!  Ha.  Just thought I’d let you know that it all went really well, the surgeon found two more unhealed incisions to repair from the last surgery, so it is good that I agreed to get it done. Should be good as new now! 😉  Happy days. I’m off for a snooze.

 

The Smear Campaign

smearcampaignWhen I embarked on my six month steroid treatment, I was told by numerous people in the medical profession that I couldn’t safely stay on them any longer than that.  As it became clear that the infusions were making a massive difference in my quality of life, I began to wonder why we couldn’t just stay with them.
They’re working!  So why not?”   I asked.  I would be a given serious look and a statement like “No, no, not a good idea long term”.  I was told that they effect bone density, among other things, and of course, you don’t want to have the bones of an eighty year old when you are forty, not if you can avoid it!  In addition, steroids are an immuno-suppressant, which is why they are working for me. One of the things my immune system does is erroneously attack my autonomic nerves.  It’s why I am sick. So suppressing my immunity reduces that misguided malfunction, making me feel better.  It’s just another convoluted body conundrum, my immune system is making me sick… but I still need it.

See, suppressing the immune system isn’t selective. The medication can’t specifically target the part of my immune system that isn’t working properly, it suppresses all of it. And that means that all the work my immune system usually does, battling infections and reducing the impact of other threats to the body, is compromised. I noticed it first in the little things. Small cuts and abrasions that took longer to heal and got infected easily. Eye infections, UTIs, coughs, colds and sore throats that took ages to clear. And then, a phone call from my GP.  Remember I had a smear recently? She said that the results, in combination with my steroid treatment, meant I needed a colposcopy.  So she referred me to the hospital.  I called them after I got my letter, asking if they had a date. The receptionist said that my appointment hadn’t been triaged yet, but based on the wait list I’d be seen next month. Then last week I had a phone call asking if I could come in the next morning.

A colposcopy is the next step after an iffy smear test.  It is a scope used to examine the surface of the cervix to better see the changes noted in the cells at the transformation zone, where the squamous and glandular cells meet.  The doctor uses a combination of acetic acid and iodine to observe changes that are indicative of a problem.  This screening service is so crucial, because it is an early intervention.

anatomical diagram of the colposcopy procedure
Source: www.pixgood.com

I had high grade changes in my smear results (possibly why my GP said, this). The colposcopy doctor found visual evidence of a bloom of pre-cancerous cells and biopsied the tissue for confirmation. She explained that around 80% of women contract a virus called the HPV (Human Papilloma Virus) back when they become sexually active (those stats are the reason behind the vaccination they’re giving all those teenagers).  Normally, the immune system is very efficient at handling the longer term cervical cancer risk posed by this virus. But when your immunity is suppressed, well, it’s much easier for nasty cells to proliferate.

Thankfully, there is an easy fix.

Usually it is a day-stay surgery with a local anaesthetic, a diathermy knife and a deft doctor.  It’s called the LLETZ Procedure (Large Loop Excision of the Transformational Zone) .  My doctor explained that, for me, it will have to be under a general anaesthetic.  That’s because although the previous gynaecological surgery I had was successful (the top and bottom walls of my vagina have held) the side walls have now prolapsed. It’s a bit more of a challenge for the surgeon so they’ll need me to be ‘out’.

So I guess, for me, the presence of those nasty cells was a loud and clear example of exactly why I can’t stay on those steroids.  I get it! And I am so glad that we have a screening service that finds these things before they pose a serious risk to the patient. Only 1:100 patients who present like I have will go on to develop cancer needing further treatment, so I feel safe and in good hands.
And lucky!

In New Zealand our cervical screening programme is free.  All women should be having pap smears at regular intervals.

I know there are a lot of reasons not to do it.  Having pap smears is not nice.  It can hurt and for some women it can be painfully embarrassing. For others it is a difficult reminder of bad past experiences in that region and can trigger traumatic responses.

Please find a way, somehow,  to have your regular smear.
It’s five minutes of unpleasantness that might save your life.

Have you had yours?