My Ongoing Reproductive System Drama
So since about Christmas last year, I've been actively trying to get pregnant again. Mr. Song has been falling into the camp of not actively trying (no keeping track of days or asking every month if I've gotten my period) but not objecting to my trying.
In August, after one particularly enjoyable round of my actively trying, I counted days in my head, and thought, "Huh...this might actually be it." A few minutes later, Mr. Song said, "I have a weird feeling I just impregnated you."
We turned out to be prophetic, because two weeks later I was able to confirm that I was, in fact, barely pregnant. So, first order of business. Find a decent OB/Gyn here in South King County. I called about twelve different offices within a thirty minute drive of me and after several days of frustration whittled down my answer based on everything from insurance and billing policies to the Doctor's qualifications to the delivering hospital's accomodations and NICU availabilities to how irritated the resceptionist sounded with me after my game of 20 questions on the phone. Finally decided on a CHI Fransiscan doctor.
I work in the dental field, and have worked with a lot of dentists whose "chairside manner" ranges a lot, and perhaps because of this I'm extremely sensitive about not only my connection with my doctors but their connection with their staff. I had always gotten the vague impression from my previous OB doctors that while they were extremely competant, they also knew it a little too much. I always felt like the questions or objections I had as a first-pregnancy-patient were irritating, and that their staff found both of them a little overbearing. I've worked with that before. I don't want that as my doctor. I changed doctors mid-pregnancy because of this, and found my new doctor pretty much exactly the same way. I despaired a little bit, and decided maybe in this field of delivering infants it's just a playing God thing and they're all basically like that.
Not so this doctor. I was literally blown away by how genuine she came across to me, how unbelievably unsmarmy and how much her own staff seems to adore her. Her nurse jokes and laughs with her in the hall outside my exam room, and that goes a long way in my esteem of a doctor. On top of that she actually seemed to care about ME. She listened, she answered, she admonished about my weight and laughed at my self-depricating sarcasm. I'm officially in love with this doctor, and attempting to come up with a way to still see her when I'm not pregnant. If you live in the area and want a reference, pm me.
So the first visit pretty much went as expected. General physical check up, including pap smear, vaginal ultrasound to look at the gummybear inside, and blood tests. I casually mention a long standing history of abnormal paps--she nods. This is apparently not unusual, which is something I've been told before. After all, in order to get the birth control that doctors hold hostage, you have to have a pap. When mine come back, they're pretty much always "abnormal." The doctor or RPN will shrug, say something to the affect of "This happens all the time, don't be concerned." More or less the impression is given that nothing is off, I'm just not average. Who is, though? See you next year.
A week later, this OB calls me back and says, "You were right...it was abnormal. Have you ever had yourself tested to see what you strain you have?"
Wut? Tested? Strain? Wut?
"Well, typically, an abnormal pap, especially repeated ones, means you have one of nearly 200 strains of HPV. Not generally a big deal, most Americans have one or the other. A very small percentage of them can lead to health complications, though, and it may not be a bad idea to just check and see what strain you have. With your permission, I'm going to have additional testing on that pap done."
I mentally shrug, and feel a little betrayed by my previous GPs and OBs of the last eight years. Would have been nice if SOMEONE had mentioned this before. Ah, well. She doesn't sound too concerned, and no one has before. It's probably no big deal. I give her permission to test further.
At my next appointment, a week later, she informs me what's going on. I have HPV 16. This is one of nine strains that can lead (over the course of years) to cervical cancer, and one of the two most aggressive of the nine. Fortunately, as previously mentioned, this is a very slow process, measured in years, not months. Most women shed their uterine lining before cells can mutate into a problem. But...I'm pregnant, and thirty. So, just to be safe for all concerned, she'd like to do a coloscopy. That's a visual examination with a magnifyer, by the way. Again, don't be concerned, probably nothing wrong.
Yeah, this sounds like it might be worth investigating! I'm a little concerned that again, no one in eight years of abnormal paps has once thought to check. That sounds like enough time for something to happen while nobody with a medical degree cares or even thinks it's worth informing me that I might want to care at some point.
We schedule the coloscopy.
The appointment starts with me a bit nervous. This whole thing sounds like a pelvic examination on steroids, which is something any woman will agree is not particularily comfortable. Beyond that, this one has the potential for my doctor to say something scary afterwards.
She picks up on my jitters right away, and immediately sets about soothing my fears. She explains the procedure in detail, having figured out that I'm one of those people who feels more in control and at ease when I'm overly informed instead of given the basics. She's going to start with a racheting speculum, just like with a pap. Then, instead of taking a sample, she'll use a microscope and just look for visual abnormalities. I'm pregnant, and therefore vascular, and so she won't be doing any biopsies unless she sees something extremely concerning. Nothing to be scared of at all. Just open wide, take a look, and you're done.
About two slightly uncomfortable minutes later..."I'm going to do two biopsies."
Wait, wut? But you said...
"I don't want you to be worried, this is--"
"But this means you see something 'extremely concerning.' Two something 'extremly concerning's."
"Well, yes, but in seven years I've only diagnosed something bad once." She smiles, "You're not that special!" We laugh, but I can't help but feel a knot in my stomach as she procedes to explain in detail what the cervix is shaped like, where the two areas are located, and how a biposy is done, etc. I should have results in about a week.
Six days go by, and impatient, I call. "Are my results in a little early by any chance?" I'm told someone will call. Thanksgiving is in two more days. The next day, I call again. "Are my results in? No one called, even just to say that they weren't...."
I'm told they'll call again. Thanksgiving passes and I impatiently wait another extra day, trying not to be a pest. It has now been nine days, and I call again. "My results should be in by now...can someone at least give me a baseline 'yes' or 'no?' I don't mind discussing details at my next appointment, but I'm going a little crazy waiting to find out if I have cancer or not! Plus...I've had something strange happen, and I'd like to find out if it's normal or not. It didn't happen with my first pregnancy..."
"Uh, your doctor's still on vacation. I'll have someone call you."
A total of two weeks go by with phone silence. My appointment is the next day, and I am so relieved that I'll finally have an answer of some kind that I can hardly wait, and don't pay attention at work all day. Then it happens. My nurse calls, and says, "Dr. X has an appointment tomorrow, we need to re-schedule you." We determine the next day she has open that I'm available is two weeks further into the future.
I have a minor breakdown on the phone. "Can you please tell her that I totally understand she's a busy lady with a life and other patients, but can she PLEASE PLEASE PLEASE call me in the next hour with some kind of answer? I CAN'T wait another two weeks--that's a month and I was told ONE week!"
My nurse is stunned. "No one called you at ALL?"
Still crying a little, I respond that no, I've left three messages, and the closest I've gotten is someone saying she was on vacation. My nurse tells me my records were supposed to be forwarded to a colleague, a doctor So-and-So, who had been left explicit instructions to call me as soon as the results had come in. Rest assured, my doctor will call as soon as she is out of her current exam with another patient.
Ten minutes later, my doctor calls and I have results.
My results are that one biosy came back as "extremely abnormal" but not dangerous, and a not unheard of side effect of HPV 16. Thank goodness. The other biopsy came back with a definitely pre-cancerous lesion, with a 10-20% chance of cancerous cells lurking.
On the whole, my doctor tells me, this is good news. It's very very early, and this won't affect my pregnancy at all. I will still be able to deliver vaginally, and the baby has no chance (beyond the usual possible pregnancy complications) of harming me or itself on the way out. Once I'm recovered from delivery (probably in June, maybe early July) we'll run a plethora of more tests and do surgury as necessary. Likely just a LEEP, I'm told. Not even serious surgery.
Not the best news I could have gotten, but definitely not even close to as bad as it could have been. I feel very, very blessed to have a doctor who took the time to be concerned this time, after eight years of being shrugged at and told that abnormal pap smears are common. Who knows how long this might have continued and how far it might have progressed if I had not gotten pregnant?
God shows his hand in mysterious ways sometimes. I'm greatful He still cares and arranges for the right people to enter my life at the right time (in this case, my unborn child and new OB/GYN) despite how wayword and stubborn I can be as a spiritual daughter. I'm set to have my anatomy ultrasound (that's the one where you find out the sex of your baby) on Christmas Eve. I can't help but feel like it's another indirect message. All will be well, I have a beautiful and special gift for you this year. Merry Christmas, Tyche.
Indeed. Merry Christmas to all of you, as well.
In August, after one particularly enjoyable round of my actively trying, I counted days in my head, and thought, "Huh...this might actually be it." A few minutes later, Mr. Song said, "I have a weird feeling I just impregnated you."
We turned out to be prophetic, because two weeks later I was able to confirm that I was, in fact, barely pregnant. So, first order of business. Find a decent OB/Gyn here in South King County. I called about twelve different offices within a thirty minute drive of me and after several days of frustration whittled down my answer based on everything from insurance and billing policies to the Doctor's qualifications to the delivering hospital's accomodations and NICU availabilities to how irritated the resceptionist sounded with me after my game of 20 questions on the phone. Finally decided on a CHI Fransiscan doctor.
I work in the dental field, and have worked with a lot of dentists whose "chairside manner" ranges a lot, and perhaps because of this I'm extremely sensitive about not only my connection with my doctors but their connection with their staff. I had always gotten the vague impression from my previous OB doctors that while they were extremely competant, they also knew it a little too much. I always felt like the questions or objections I had as a first-pregnancy-patient were irritating, and that their staff found both of them a little overbearing. I've worked with that before. I don't want that as my doctor. I changed doctors mid-pregnancy because of this, and found my new doctor pretty much exactly the same way. I despaired a little bit, and decided maybe in this field of delivering infants it's just a playing God thing and they're all basically like that.
Not so this doctor. I was literally blown away by how genuine she came across to me, how unbelievably unsmarmy and how much her own staff seems to adore her. Her nurse jokes and laughs with her in the hall outside my exam room, and that goes a long way in my esteem of a doctor. On top of that she actually seemed to care about ME. She listened, she answered, she admonished about my weight and laughed at my self-depricating sarcasm. I'm officially in love with this doctor, and attempting to come up with a way to still see her when I'm not pregnant. If you live in the area and want a reference, pm me.
So the first visit pretty much went as expected. General physical check up, including pap smear, vaginal ultrasound to look at the gummybear inside, and blood tests. I casually mention a long standing history of abnormal paps--she nods. This is apparently not unusual, which is something I've been told before. After all, in order to get the birth control that doctors hold hostage, you have to have a pap. When mine come back, they're pretty much always "abnormal." The doctor or RPN will shrug, say something to the affect of "This happens all the time, don't be concerned." More or less the impression is given that nothing is off, I'm just not average. Who is, though? See you next year.
A week later, this OB calls me back and says, "You were right...it was abnormal. Have you ever had yourself tested to see what you strain you have?"
Wut? Tested? Strain? Wut?
"Well, typically, an abnormal pap, especially repeated ones, means you have one of nearly 200 strains of HPV. Not generally a big deal, most Americans have one or the other. A very small percentage of them can lead to health complications, though, and it may not be a bad idea to just check and see what strain you have. With your permission, I'm going to have additional testing on that pap done."
I mentally shrug, and feel a little betrayed by my previous GPs and OBs of the last eight years. Would have been nice if SOMEONE had mentioned this before. Ah, well. She doesn't sound too concerned, and no one has before. It's probably no big deal. I give her permission to test further.
At my next appointment, a week later, she informs me what's going on. I have HPV 16. This is one of nine strains that can lead (over the course of years) to cervical cancer, and one of the two most aggressive of the nine. Fortunately, as previously mentioned, this is a very slow process, measured in years, not months. Most women shed their uterine lining before cells can mutate into a problem. But...I'm pregnant, and thirty. So, just to be safe for all concerned, she'd like to do a coloscopy. That's a visual examination with a magnifyer, by the way. Again, don't be concerned, probably nothing wrong.
Yeah, this sounds like it might be worth investigating! I'm a little concerned that again, no one in eight years of abnormal paps has once thought to check. That sounds like enough time for something to happen while nobody with a medical degree cares or even thinks it's worth informing me that I might want to care at some point.
We schedule the coloscopy.
The appointment starts with me a bit nervous. This whole thing sounds like a pelvic examination on steroids, which is something any woman will agree is not particularily comfortable. Beyond that, this one has the potential for my doctor to say something scary afterwards.
She picks up on my jitters right away, and immediately sets about soothing my fears. She explains the procedure in detail, having figured out that I'm one of those people who feels more in control and at ease when I'm overly informed instead of given the basics. She's going to start with a racheting speculum, just like with a pap. Then, instead of taking a sample, she'll use a microscope and just look for visual abnormalities. I'm pregnant, and therefore vascular, and so she won't be doing any biopsies unless she sees something extremely concerning. Nothing to be scared of at all. Just open wide, take a look, and you're done.
About two slightly uncomfortable minutes later..."I'm going to do two biopsies."
Wait, wut? But you said...
"I don't want you to be worried, this is--"
"But this means you see something 'extremely concerning.' Two something 'extremly concerning's."
"Well, yes, but in seven years I've only diagnosed something bad once." She smiles, "You're not that special!" We laugh, but I can't help but feel a knot in my stomach as she procedes to explain in detail what the cervix is shaped like, where the two areas are located, and how a biposy is done, etc. I should have results in about a week.
Six days go by, and impatient, I call. "Are my results in a little early by any chance?" I'm told someone will call. Thanksgiving is in two more days. The next day, I call again. "Are my results in? No one called, even just to say that they weren't...."
I'm told they'll call again. Thanksgiving passes and I impatiently wait another extra day, trying not to be a pest. It has now been nine days, and I call again. "My results should be in by now...can someone at least give me a baseline 'yes' or 'no?' I don't mind discussing details at my next appointment, but I'm going a little crazy waiting to find out if I have cancer or not! Plus...I've had something strange happen, and I'd like to find out if it's normal or not. It didn't happen with my first pregnancy..."
"Uh, your doctor's still on vacation. I'll have someone call you."
A total of two weeks go by with phone silence. My appointment is the next day, and I am so relieved that I'll finally have an answer of some kind that I can hardly wait, and don't pay attention at work all day. Then it happens. My nurse calls, and says, "Dr. X has an appointment tomorrow, we need to re-schedule you." We determine the next day she has open that I'm available is two weeks further into the future.
I have a minor breakdown on the phone. "Can you please tell her that I totally understand she's a busy lady with a life and other patients, but can she PLEASE PLEASE PLEASE call me in the next hour with some kind of answer? I CAN'T wait another two weeks--that's a month and I was told ONE week!"
My nurse is stunned. "No one called you at ALL?"
Still crying a little, I respond that no, I've left three messages, and the closest I've gotten is someone saying she was on vacation. My nurse tells me my records were supposed to be forwarded to a colleague, a doctor So-and-So, who had been left explicit instructions to call me as soon as the results had come in. Rest assured, my doctor will call as soon as she is out of her current exam with another patient.
Ten minutes later, my doctor calls and I have results.
My results are that one biosy came back as "extremely abnormal" but not dangerous, and a not unheard of side effect of HPV 16. Thank goodness. The other biopsy came back with a definitely pre-cancerous lesion, with a 10-20% chance of cancerous cells lurking.
On the whole, my doctor tells me, this is good news. It's very very early, and this won't affect my pregnancy at all. I will still be able to deliver vaginally, and the baby has no chance (beyond the usual possible pregnancy complications) of harming me or itself on the way out. Once I'm recovered from delivery (probably in June, maybe early July) we'll run a plethora of more tests and do surgury as necessary. Likely just a LEEP, I'm told. Not even serious surgery.
Not the best news I could have gotten, but definitely not even close to as bad as it could have been. I feel very, very blessed to have a doctor who took the time to be concerned this time, after eight years of being shrugged at and told that abnormal pap smears are common. Who knows how long this might have continued and how far it might have progressed if I had not gotten pregnant?
God shows his hand in mysterious ways sometimes. I'm greatful He still cares and arranges for the right people to enter my life at the right time (in this case, my unborn child and new OB/GYN) despite how wayword and stubborn I can be as a spiritual daughter. I'm set to have my anatomy ultrasound (that's the one where you find out the sex of your baby) on Christmas Eve. I can't help but feel like it's another indirect message. All will be well, I have a beautiful and special gift for you this year. Merry Christmas, Tyche.
Indeed. Merry Christmas to all of you, as well.