Do you know about Co-examination? Michele Part 1

MY MISSION IS TO SHARE MY STORY 

My experience begins in the usual way. Although screening guidelines today seem to be in constant flux, I represent generations of women who have followed the routine of the annual Pap or HPV smear Test.

In 2008, when I was 33, it was time again to take the annual pilgrimage to the gynaecologist. My husband and I decided it was time to try for a baby, and I wanted a doctor I could build a relationship with. A friend loved her doctor, so I made an appointment with her. After a run-through of my and my husband’s sexual and general health history, which was far from exciting, my new doctor advised STD cooperative testing just to be safe. And this is where it got interesting and educational for me.

Co-testing?

She asked what I knew about HPV, and sadly, all I could tell her was that it was an STD and there was a vaccine for it. But I knew I was too old for it, and I had never even heard of STD co-testing, specifically the HPV DNA test. And besides, I was in my 30s and a loving, monogamous marriage. I naively thought STDs are what young, single women in their 20s worry about.

Since I entered my 20s a virgin and came out with just a handful of sexual partners and a glowing, spotless Pap history, I was feeling pretty confident I had no concern for an STD. was someone who had never missed a Pap test, a graduate student at an Ivy League university, getting my doctoral degree in health education, the daughter of a doctor, someone who had always eaten well, been active and knew very well the dos and don’ts of good health. But there I was, learning about an STD and subsequent cancer risk I had to be concerned about. Although the doctor applauded me for my due diligence in getting my annual Pap, she also pointed out that it wasn’t all I could do to protect myself.

The wait for results

I eagerly agreed to co-test and am so grateful to her daily for suggesting and encouraging this. Waiting a week for the results was a walk in the park. When my doctor called, she told me my Pap was normal. I congratulated myself. With so many normal Paps under my belt, I always felt like I was winning some race, beating some record. But then that feeling quickly went up in smoke. She also told me that the HPV Variant Test was positive for strains of High-risk HPV. I was stunned. My mind raced. How could this be? My Paps have always been good. Wouldn’t I know if I was carrying around something as dangerous as high-risk HPV? And my husband?

All I could think of was how much I loved him and how awful I’d feel if I infected him. My doctor said I should tell my husband, and she told me that women don’t always share their HPV status because of the stigma. I was sure my husband would be supportive, but this was also the first time we’d had to deal with something like this and to be honest, I thought it would be awkward.

How would he react?

When I told my husband my HPV Swab Test was not good, his first words were, “I feel so badly. What if I gave this to you?” His second thoughts were, “Isn’t there a vaccine we can get?” and “How do I get tested so we can treat it and get it out of our lives?”

At the time, the vaccine was not approved for men, and even if it had been, he would’ve been too old for it. And this is when we learned that there is no screening for asymptomatic men. This led to us spending many hours learning all we could–that approximately 79 million people are infected with HPV at any given time, that it’s easily transmitted, and that even abstaining from intercourse doesn’t fully protect you. We felt it could be so unfair that the combination of choices, bad luck, and lack of education from our previous lives could have the ability to affect our current lives so drastically.

Six months on

The results of that first round of STD co-testing led us to postpone starting a family, as my doctor told me to return in six months.

Six months later, I was in the same spot –normal Pap, HPV Type Test is positive. I was not fighting this off. We were all stumped by this. All the information out there about reasons you don’t fight it off-poor diet, unhealthy weight, and smoking didn’t apply to me. All my doctor could say was that stress lowers your body’s ability to do its job and that HPV is very common. We were encouraged to keep living our healthy lifestyle and advised that it would probably go away by the next follow-up.

But six months later, at the second follow-up, my co-test showed low-grade ASCUS, and I was still HPV positive Test. I was still not fighting this off. Just the opposite! It was getting worse. My doctor didn’t want to play the waiting game any longer. She referred me to a gynaecologist who specialised in treating STDs. I had to wait three weeks for the appointment with the specialist.

How can we get past this?

Although no one was sure how long I’d been carrying around this unwanted guest, STD Kit testing drew a line, and now we couldn’t wait to get rid of it that we knew it was here. Both my husband and I attended the appointment. She did a colposcopy and noted that a majority of my cervix turned white from the acid solution. This led to a biopsy, and she told us the next steps depending on the results. The scale varied from watchful waiting to total hysterectomy.

You try not to think the worst, but in just 12 short months, we’d gone from co-testing just to be safe to follow-up to low-grade ASCUS to biopsy. It seemed we were pressing on full steam ahead in the wrong direction.

By Michele (Part I)