A public service announcement

How many of you have seen this report from the CDC? Maybe on your local news (which is where I caught it) or in the paper (if you still read about the world in print form) or from a social media feed perhaps…

The tag line:

“The U.S. Centers for Disease Control and Prevention (CDC) reveals that more than 8 million women in the U.S. skipped cervical cancer screening in the past five years.”

I admit it. Years ago I was one of those women…and I was diagnosed with cervical cancer at age 36.

Quite obviously I am still here so all worked out well, although that statement might be relative depending upon your feelings about reproductive organs such as the uterus. Mine (along with the offending cervix) went away long ago. I did however opt to keep my ovaries. That decision meant that I would not be plunged into menopause 20 years earlier than normal. My surgeon went into the procedure with a caveat from me though: If they look bad, get em out. I will deal with premature menopause if it means I can hang around for a few more years.

I actually wasn’t too worried about retaining those two egg-producers. The cancer diagnosis was carcinoma in situ, Stage 2. The physicians really didn’t suspect that it had spread and I decided to roll with that idea and just be surprised when the anesthesia wore off and I could find out how much of my lady parts were still in place.

I kind of put the cart before the horse here didn’t I. Maybe I should step back and give some background, although I’m not sure how much this post should be about the “this happened then” scenarios and more about the “get off your asses and get checked regularly” tangents. I am going to assume that those reading this post diligently follow through with their care providers and are up to date on all required check-ups. Men, if you are out there as well, and have a female in your life, share the article with them. So I think we’ll skip the tangents this time around.

My story:

I was in the military health care system for a number of years and two pregnancies. After the 2nd delivery, I began slacking on the regular follow through with general exams as well as reproductive exams, pap smears, breast exams… Why? At the time, (1980’s) this system of care was highly impersonal, although some care providers tried as best they could, rather condescending to women in general, formalized to be all about efficiency rather than encouragement of agency or partnership. Take for example the early OB introduction that occurred en masse for newly pregnant enlisted personal or spouses. The process went something like this:

Call a generic hospital number, make contact with an operator, explain that you took a home pregnancy test and it was positive, be asked when your last menstrual period occurred, then find yourself being scheduled for the OB Orientation class 1-2 months hence. 

On assigned date enter a large auditorium type room already filled with 20 or 30 (or more) women, receive a packet of information and find a seat among the herd. Listen to someone, possibly the head RN of the department (?) speak to the way we can all expect to receive care and other information on completing the packet of forms. 

Find the same quizzical and disbelieving looks on the faces of everyone around you as you are thanked for coming, told to call the clinic number given to you to set up your first OB appointment, and that, if truly needed, you could speak to a staff member today with concerns that you didn’t feel could wait.

There is quite a bit of back story surrounding both this pregnancy and my second, but I assume that no one really wants to read of it, besides the fact that I still, almost 30 years later, get pissed off when I think about it. Let’s just say that two wonderful kids resulted and leave it at that. So, the second child was planned to be the last child, and this is where my due diligence began to slip. I would find reasons and excuses to simply not go to, or through, this system for care-although it had improved between pregnancies and I had learned to be much more vocal and demanding as an activist and educator for pregnant and birthing women. I was neither pregnant nor in labor and simply didn’t want to deal with the cattle call mentality for “routine” gynecological care.

Baby #3 came into being and I refused to set foot into the wonderful, new and shiny military clinic and hospital that housed the same system of care. This baby was going to be born at home with a midwife. She was, it was wonderful and there has never been a time that I have set foot inside a military healthcare clinic since.

Three years later, after some trial and error, I was at a routine appointment with a care provider, feet in stirrups, ready for a pap smear. This was the first after almost 8 years of on again, off again care which probably means that I may have had 2 exams during that time. When I was asked to return for a biopsy, I knew. When I was called to come into the office to speak with the physician, I really knew. He was/is a friend of our family and I think it was harder on him to give me the news than it was for me to hear it.

I met with a gynecological oncologist. I actually got to see the cancer on my cervix. He didn’t feel that HPV was the starting agent for this cancer. It happened just because it happened. Of course I did all the what ifs and why didn’t I and if only, but I don’t think that I was really scared. Maybe I was just in denial, or just too stubborn to accept that this wasn’t a big deal. It really seemed simple to me, which of course isn’t an excuse and isn’t the way cervical cancer usually presents. I would have a hysterectomy and that would be that. I listened to, but politely turned down the horrendous options for radiation. Unless cancer cells were detected elsewhere, the only option for me was to get rid of the offending organ and be done with it so that I could go on raising my kids.

I don’t mean to sound flippant, or write this with so little emotion, but I have always looked back to this time as being something very surreal, as a minor inconvenience rather than something greater or possibly more harmful. I don’t remember feeling a lot of emotion. I do remember knowing that I just had to deal with it, like I dealt with most things that came up. Sort of on my own, sort of intellectually and rationally, and definitely with the least stress for my kids. It is a topic that, once surgical recovery was complete, has not been spoken about since. Perhaps-if only for myself, someday I will write about it, all of it, in much greater detail even than this.

The CDC report notes that some women are fearful, some women don’t like the invasive nature of the test, many women don’t have/ or haven’t had health insurance coverage. I will not start on why clinics such as Planned Parenthood need to stay open for this very reason because I think you all know where that could lead and this post is lengthy enough already…

Get the exam. Follow the guidelines for your age group, which for many of you means that this isn’t an annual exam anymore. Think about who you have sex with if you are not in a stable relationship. Talk to your daughters and sons about HPV and the vaccine. Cervical cancer can be dealt with. Cervical cancer that has spread to become uterine cancer, or metastasized to other organs…well I assume you can see what the result may be.

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4 thoughts on “A public service announcement”

    1. I think so as well, but it’s getting women to go that still seems to be an issue–ethnicity and cultural background were also mentioned so education (as always) plays a big part…want to reconsider women’s healthcare specialization 🙂

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  1. They’ve changed the guidelines and now say you can go a few years without a pap (as long as your last one was normal). I don’t buy it. I’m still getting mine annually.

    I remember you sitting Jeff and I down to tell us your diagnosis. I was scared when you said “cancer”. But you were never scared. Or you never showed it. And because of that, I was never worried about you. I knew you’d have your surgery and be fine. There was never a “what if.”

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    1. I always felt your confidence and I think you may have some of my genes that tend to cover up emotions as well…:) I remember Jeff not doing well for a time, and Al of course was way too young. I’ve always wondered how I could have done things differently, better (?) at the time, but I guess that’s one of those what ifs…

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