Colpo Results!

My biopsy results came back CIN1!! I got a call a week ago, and I breathed a huge sigh of relief. So that means I need a strict 1 year follow-up Pap exam. No more procedures! I am so happy and relieved. Hopefully my abnormality will heal itself by next year. :::fingers crossed:::

Colposcopy

So I went ahead and had my colposcopy this past Friday. Honestly, it wasn't as bad as I thought it would be (gee, where have I heard that before?? Ah yes, the biopsy patients we see on a daily basis at work).

So anyway, despite the constant spotting I had for about 18 days prior to the procedure, the doctor was able to still perform the colposcopy and biopsy. I was really anxious leading up to the procedure. I'll be completely honest. I was more nervous that she wouldn't be able to do the procedure because of the spotting (NuvaRing related since I didn't get a period before I inserted it), and that I'd have to put it off another 2 weeks because I was due for my period the following Monday. 

The vinegar solution she put on my cervix really stung. She said that can happen if the cervix is irritated, and mine looked irritated. She saw hpv changes to my cervix during the colposcopy, so she went ahead with the biopsy. 

{{Back up a little here. This doctor I had for my procedure was awesome. She explained everything to me and it made a lot of sense. I also felt tons better. She explained that the type of abnormality that was on my pap (low grade abnormality) is always caused by hpv. Meaning, I tested positive for hpv. I wasn't thrilled about that, but I felt better after learning that most of the population will get hpv at some point in their life. And also that I could have had it for year, laying dormant, and then something triggered it. There's no way to tell where and when someone got hpv.}}

So moving on. She took a biopsy at 6:00, 12:00 and then an endocervical biopsy. The first 2 biopsies were really painful. It felt like a pinching cramp, and didn't last long. The endocervical biopsy was a little more uncomfortable because they take a sample from inside your cervix. Then one of the biopsy sites wouldn't stop bleeding, so she had to hold pressure on my cervix with a cotton swab to get the bleeding to stop. That was uncomfortable. The whole procedure took about 15-20 minutes maybe, and she said I will get results in 7-10 business days. The results of the biopsy will plan the next course of action - 1 year follow up for CIN1, and a LEEP for CIN2 and 3. 

I ended up having some moderate bleeding with clots over the weekend. I freaked out a little because the doctor said that I would only have a little spotting, probably nothing more than what I've been having. Well, this was definitely more than spotting. So on Saturday I put a call into the on-call doctor just to make sure what was happening was ok. The on-call doctor called me back, and said that moderate bleeding can be normal, as long as I'm not passing large clots. Phew! That's good, but just adds to the annoyance that has been some kind of constant bleeding.

So now I anxiously wait for results...

Unexpected News

"I'm calling about your PAP results. They came back abnormal..."

That was the phone call I got yesterday from my NP. As if dealing with an embedded IUD, and the possibility of pregnancy wasn't enough, I get hit with this. I know abnormal PAP's are fairly common, and that a lot of women have an abnormal PAP at some point, but it's still news I never expected. From what I gathered from our short conversation, there are 4 "levels" of abnormal: Change in cells, low grade, high grade and cancer. Mine was low grade abnormal. Because of that, my NP recommended that I have a colposcopy done. With the colposcopy comes the possibility of a biopsy, and I'm dreading that. The biopsy depends on what is seen during the colposcopy. Someone at work says it hurts a lot. Wonderful, just what I wanted to hear.

She also brought up HPV. Say what!? Isn't that an STD?? She said often times, abnormal PAP's can be caused by HPV. Unfortunately, my HPV results haven't come back yet, so she couldn't tell me if I am positive for that or not. Because I was blindsided by this call, I didn't have enough time to come up with questions. So I consulted Google. From what I read, HPV is the most common virus, and almost every male and female has it at some point in their life. It's most commonly spread by sex, and there are about 40 different strains of HPV. Some cause warts, some don't have any symptoms, and some cause cervical cancer. Also, men can have it too, but they are more like "carriers", and are rarely affected by it. There actually isn't a way to test men to see if they're even carriers. Lucky them.

The other thing is that HPV can lay "dormant" for years. So I could have got this years ago, and then something activated it. Most times HPV doesn't cause symptoms, so there is no way to know if you have it until it causes cell changes in your cervix. It can also correct itself over time. So many times, depending on how abnormal, if you have an abnormal PAP, the doctor may recommend a follow-up PAP in 6 months to see if it's corrected itself. So that's good news.

What makes me nervous is that my NP suggested going straight to the colposcopy instead of a follow-up PAP. Maybe she's just being proactive? I know every practice is different. Maybe if it was just cell changes, it would have just warranted a follow-up and not the colposcopy? Who knows.

So anyway, my "procedure" is on Friday, May 17th in the afternoon. I'm going to leave work at lunch, and have Matt take me, in case I have any discomfort. As I tell the patients that need biopsies, be hopeful and optimistic, but be prepared for the worst. I should follow my own advice.

Oh, and I'm definitely not pregnant .Yes, it was still a thought in my mind, especially since my NP told me that if I didn't get my period when I removed the Ring after the 3rd week, to take a pregnancy test. Well, with this new news, and my procedure a week before I would get my period, I felt a test was necessary. Totally negative. ::Phew::

http://www.cdc.gov/std/hpv/pap/