Don’t Fear The Smear….

In the UK we as woman are offered a cervical screening test or a smear test every 3 years between the ages of 25-49 and every 5 years between the age of 50-64.  This is a free health check, we don’t have to pay a penny.  Woman who live in America don’t have this service offered to them free, they have to pay hundreds of dollars.  In the UK therefore you would think us woman would take the full advantage of a free service that could potentially save our lives.  This is not always the case, many woman still refuse a smear.

I can only speak from personal experience of the reasons why I myself ” Feared the smear”

I had my first smear at the age of 25, I went along to the practice nurse with very little knowledge of what the test entailed, the internet wasn’t such ”a thing” back in 2004, it did exist, but we didn’t have access to it via phones, therefore I went along very naively, with very little thought of what was being tested for.  The first smear test I had was normal, the second one was normal, then somewhere between the ages of 30 and 36 the whole Jade Goody story broke and my knowledge of cervical cancer and cervical changes began to grow and I became more aware of the dangers.  I am the kind of person who has a slightly ostrich style approach to certain things in life, I will bury my head in the sand if I become afraid.  This fear I had developed made me ignore the letters inviting me for a test, so from the age of 30 I ignored every letter that came through my letterbox, I totally buried my head in the sand and had myself convinced it would never happen to me.

In 2015 I began a new relationship, I can say now after 3 years that this was when I met my soul mate.  Anyway after a year of seeing each other the topic of children came up and we both decided that we wanted a family in the near future, so we began trying for a child.  During this period of time I had noticed that after intercourse I would spot bleed from time to time, not every time but occasionally.  I knew something wasn’t just right but again I buried my head in the sand and went on about my every day life.  I sadly suffered a miscarriage in February 2017, this was an extremely low point in my life but that blog post is for another day.  I guess after the miscarriage I began to think more of how life could change in a day, we were not in control, especially with health related issues, sure we could eat healthy and look after our bodies but we need to be especially concerned when we notice change.  I couldn’t have done anything to stop the miscarriage, I had no reason as to why it happened, all the hospital would say was, something wasn’t just right, so it was natures way of dealing with it.  It was something I had no control over. 

Time went on and the concern and worry I began to develop about my health  became so great it was consuming my every thought.  I spoke with my Mum about my concerns and her answer was “book a smear, to put your mind at ease”  So in the July of 2017 I rang my medical practice and booked a smear test.  I went along very reluctantly that morning, trying my best to find an excuse not to go.  The test itself takes minutes and is a little uncomfortable but not painful at all.  The nurse had a good look and said that she couldn’t see any cause for concern with the naked eye.  The naked eye cannot see cervical cell change.  I left that day reasonably content, thinking to myself well if I had something wrong down there, surely she would have been able to tell.  I was told to call for my results in about three weeks time, so I carefully took note of the date and set myself a reminder when to call.

Three weeks passed and I very nervously dialed the health center results line.  “hello results line, how can I help?” I gave my name, address and date of birth and I heard the receptionist key the details into her computer as I carefully listened at the other side of the phone, “umm Julie, the practice nurse wants to talk with you, your smear has come back abnormal, please don’t worry” at that point my heart sank, I heard the words she was saying but I wasn’t taking them in, I couldn’t take them in, because that would mean what she had just said was true.  The receptionist said the nurse would call me after she had finished her clinic to discuss my results.  I was in work at the time, total panic set in, what did abnormal cells mean? was it cancer? was I going to die?  The nurse phoned me after about an hour, she explained that I had CIN3 the highest grade cervical change, I felt physically sick, she told me over the phone not to worry and that these changes could be fixed and that we had detected them on time. This didn’t ease my panic at all, I went home that day and done exactly what the nurse told me not to do, I began to Google.  Every possible worse case scenario is documented and detailed on the internet.  It’s the same as labour, every horrific labour under the sun is documented with every gory detail possible on the internet, you rarely read of a good labour, because people are more likely to write about bad experiences than good ones, they make better reading.

The next day I received a letter in the post with an appointment to go to the colposcopy clinic in three weeks time for an examination.  Three weeks? After zero sleep the night before and the worry and stress I had suffered in two days, waiting three weeks would have finished me.  I spoke with my Mum and she suggested I try to book a private appointment.  Mum rang the very next day and was able to book me an appointment for the following day.  I woke the morning of the appointment full of dread, took a shower as normal and got ready, at this point I had myself convinced that I had left it too late and that the abnormalities had turned into cancer.  I went to the hospital that day like a death row inmate making their final walk to the execution chamber.

The waiting room of the hospital was reasonably empty that day, I sat very nervously reading posters that were placed on notice boards around the room.  One said McMillan the other said “coping with cancer”.  I was a mess, trying to hold it together and not  break down, thankfully Mum was with me to keep me sane.  I was called for by a doctor who seemed to be around my age, he was very down to earth, pleasant, not stuffy at all.  He welcomed me into his office and made me feel at ease very quickly.  Firstly he sat me down and he said “before we begin I want to tell you, I don’t bullshit, I say it like it is” I thought oh my God what is coming next.  He then drew a diagram of the cervix and explained the stages of cervical change.  They are categorised into CIN1, CIN2 and CIN3, if the changes have gone beyond this, then it is classed as cancer but is highly treatable.  He explained that my smear test had picked up CIN3, high-grade changes, however he was going to take a look and decide the severity himself.  In order to decide what treatment I needed he had to carry out a procedure called a colposcopy.  This procedure involves the patient stripping off their clothes from the waist down, laying down on a special chair with padded leg supports. A speculum is then inserted into the vagina and it is gently opened, a microscope with a light is then used to look at your cervix and special liquids are then applied to the cervix, in order to highlight areas of cell change.  The consultant and I decided that if their was cell change that needed removed he would go ahead and complete the procedure and the examination all at once. 

I lay down on the chair, two nurses stood by me.  One at my head and one at my feet.  They were very friendly, they chatted and made small talk as the doctor scrubbed his hands and got ready for the procedure.  He began, he explained that he would inject my cervix to freeze it and that adrenaline would also be injected into the cervix, I believe this is used to stop the body going into shock.  He explained that I might feel my heart race and my breathing become rapid, but not to panic and take deep breaths.  I was then warned that the needle was coming and to take a deep breath.  I won’t lie and say it is painless, I felt pain but nothing unbearable.  He then began to cut away the affected area of the cervix, this is done with a hot wire, that cauterises the wound straight away.  I asked the doctor how it looked and he told me that to him it was CIN3 but the biopsy would tell the full extent.  I was given a home care information sheet and sent home to wait on the biopsy results.  I left the clinic that day feeling very positive and extremely thankful.

The weeks passed again, and in between getting the procedure done and receiving the results I managed to pick up an infection, nothing a course of antibiotics couldn’t cure.  The doctor rang with my biopsy results around four weeks after my procedure.  He confirmed that I had CIN2 on the outer part of the cervix but I had slightly different cells inside the cervix that were high-grade.  He was confident that he had removed them all successfully.  Cervical cell abnormalities are caused by a virus that grows exceptionally well on the cervix.  The virus is passed by sexual contact but can lay dormant in your system for a very long time before it causes cell change, or in some cases your immune system can fight it off before it causes change.  Cell change takes place very slowly, this is why it is so important that us woman go for regular smears.  We can prevent cervical cancer developing by attending a five minute examination.  Please ladies forget about embarrassment, these nurses and doctors carry out this type of examination daily, and trust me once they have seen one they have probably seen them all.  I personally will be forever in their radar and I will be attending regular six monthly smears for quite some time.  I don’t mind this at all as long as they keep me healthy.  So in closing I urge you, if you are overdue a smear book it, if you have never had one, book it, if you feel their is something just not right down below, book it.  Don’t make excuses and never, ever, ever fear the smear, it could save your life.



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