Surgery Worries...

[dimple75]

It's nearly 11 pm, still can't get to sleep. I try not to think about it too much but I just find it difficult not to as the table will be turned. This time I won't be preparing someone for theatre. I am the one going to theatre. Tomorrow I will attend preadmission clinic (used to work there) to have my nurse and anaesthetic assessment (know these people).I know that I need to fast from midnight and be at Day procedure Unit (used to work there) by 7 am tuesday for my surgery. I know my gynaecologist, she's the head of the department and I manage her clinic. I know everything seems weird but I have so much faith in them that I would not want anyone else do the job but them.

See my worry is not the surgery itself. my worries include;

1. what if LLETZ procedure won't take all abnormal cells away?

2.would I then go for cone biopsy of cervix or go straight to hysterectomy as I don't need my inners anymore?

3.Importantly, will I have flare ups since I stopped taking prednisolone months ago and was told to stop taking MX week before and week after?

4.Should I push for something/ a dose that will cover me just in case?.

I will be asking the anaesthetist tomorrow. But i think the paranoia will probably kill me first before the surgery and PsA.

The thing is, I never had abnormal papsmear before. Not until I started taking MX. That is why my rheumy is very keen on tapering the dose for that reason. There's not enough evidence that MX directly causes cervical cancer (smoking yes), but won't take any chances.I just find it very coincidental that since I started the job, I now have abnormal reading. Gynae nurse having a gynae problem. What are the odds? Its like the the odds of winning. We get more chance of getting hit by lightning 3 times than winning the lotto.With my luck, I will get hit by lightning first for sure haha.

Papsmear only showed low grade changes. Normally we just watch that as our body most of the times clears the virus. But as Im immunocompromised, they decided to have a look. So I had a colposcopy done (in my clinic) and took 2 biopsies which showed CIN II with HPV effect, reason why I need to have surgery. I know I do not have cancer but am still worried and its only human to feel this way.

So had my biopsies and kept working that day. a very simple procedure we do everyday, women may get cramping, told to take nurofen simple. Not me,24 hours later I ended up in ED (mid Feb) with severe abdo pain. 15 mgs of endone did not knock me out, 5 mg IV morphine helped a little but caused me vomiting.Ultrasound and bloods normal, they figured I just had an inflammatory response, purely unlucky. I got discharged after 2 days then went back to ED for more fluids as I picked up gastro along the way.

So I take this opportunity ladies to SPREAD the words. I know we all hate having it done but PLEASE HAVE REGULAR PAPSMEAR.If we have the 'all clear' then it is something we don;t need to worry about amongst other things we worry about.

I know it is a very long blog but I am being opportunistic here. Im not doing this just for me. If I can PREVENT by information, Iam a happy woman.Thank you so much for your time,all this writing worked, I'm sleepy now. You all take care.Lizaxxx

[fastball]

hope you are alright and that everything goes ok for you on Tuesday. I have PsA and have been on MTX for roughly 6yrs and had all my smears done and they were all clear. So chin up and hopefully all will be sorted.

Chris

[dimple75 in reply to fastball]

Good to hear that you have the all clear for all smears. Thank you for your encouragement.Lizax

[watson3]

Good luck. Having any type of surgery is always a worry. We nurses always worry more. So glad you are able to talk about it here that is a bonus. All the very best for Tuesday.

You blogged some excellent information....thank you.

Carole

[dimple75 in reply to watson3]

Yes we do worry more Carole and can tell you that I am a terrible patient, very non compliant lol. Thanks for the support.Lizax

[Hidden in reply to dimple75]

I AM a terrible patient , hate hospitals especially my own!!

[miss]

Hi hope all goes well for you. I have been there got the tshirt so to speak. ok i was heathy then. Try not to worry take care xx

[dimple75 in reply to miss]

Thank you for your concern.Lizax

[aligator]

hope all goes well on Tuesday, I, too have been there. Thank goodness for regular checks! Love Alison x

[dimple75 in reply to aligator]

Thank you Alison. I am very glad you gilrs have regular smears. We need to do more here in nt, we are just not reaching out enough people I think. Compliance rates down and even I ring them, they say they will come for their follow ups but they dont turn up. We can only do so much for them I just hope they take it seriously as some needs urgent surgeries.Lizax

[Hidden]

I've never been aware (and I do read up about the drugs I take) that MTX can cause cervical cancer? I'm sure you will be fine - it must be pretty weird and nerve wracking to be having all this done by your colleagues but I live in a very small place and I have GP and nurse friends who have had to have things done by their colleagues - and at least you know they are competent and have your best interests at heart. I really am sure you'll be fine - good luck. Tilda x

[dimple75 in reply to Hidden]

Yes saw work colleagues today and Im all set, even have my medicated sponge to keep me extra sanitised pre theatre lol. I came across a couple of links a while ago now but didnt really seem to be legit and reputable sites anyway.Thanks for your concer.Lizax

[Hidden]

I fully understand your dilemma and concerns, having been there, I told my surgeon that whilst I was under he could take the whole lot if required, I thought it was the best way forward for me. On coming round I discovered that indeed he did take everything and have had piece of mind ever since. No more womb, ovaries, cervix, lovely feeling, only have to make sure that I do the breast check each month. Lovely feeling? After all the turmoil beforehand it was a relieve.

Good Luck for Tuesday and your decisions, Take Care. xxx

[dimple75 in reply to Hidden]

Hi George. That would be my last resort. I am having mirena put in tomorrow though so don't need to take pills. The less I take the better. I tried implanon before didnt work bleed for days. I dont want anymore kids, have done my duty to the society lol.Thanks for the concern.Lizax

[Hidden in reply to dimple75]

I Had mirena for five years it was good for me.. no bleeding etc. a trainee.gp cocked up( pardon the pun) the 2nd one and bruised me internally( have tilted or retroverted womb).. put me off, and it had to be removed as it wasnt right.. moved to cerazette after that.. hope this helps, done by a competent person it is

great x

[dimple75 in reply to Hidden]

Hi summer. Im actually pretty good when it comes to training. I let new grads cannulate me and I sign them off, only way to learn and I have been there before. If I train them well it saves me time as they dont need to call me if people want to find veins lol.I watch trainee doctors closely especially working in my area and I glad to say that they're all pretty good. I wont let a GP insert it though, had implanon inserted and she butchered my arm. I actually refer women to family planning here.if there's no need for them to come back to my clinic after 2 consecutive normal smears.x

[Hidden]

Good luck ,I had a womb biopsy whilst taking mtx it was clear( general anaesthetic.. went as nhs patient to local private hospital , anaethesist was lovely I WAS v scared, she came to me after op in my room as did the consultant and he sent me letter saying uterine cuttings were ok to my home address just the same as if I was private patients.. the privacy of a hospital other than the one we work in is essential in my opinion the private one has zero mrsa too,

I am not sure of any link with mtx and gynae cancer. I was having suspect bleeding, whixh can be side effect of mtx.. this was over two years ago x

Hoping it all goes well and IM SURE it will xx.as you know most cervical cancer is actually caused by the human papilloma virus,

[dimple75 in reply to Hidden]

Hi summer. Its good when we are well informed as its not knowing adds to anxiety tremendously. I applaud your docs for what they did and i tell you not everyone's like that.

I did bleed during biopsy and they had to use silver nitrate sticks plus monsels paste to stop the bleeding as stickes were not enough. The cramping that night was incredible. I have suffered debilitating periods for yrs, used to take time off on my heavy days so i know what its like to have period pain.But that was very different. I have a very high tolerance for pain thinking if I can push 4 kgs baby charlotte out hey i can do anything..but I was wrong.

And yes the human papilloma virus..makes me think if all the sex was all worth it lol. as I said to Tilda I came across links that ddnt seem to be legit/reputable. People should be very careful what they read and only seek advice from health professionals and not from Dr. Google. Thanks for your concern.Lizax

[Hidden in reply to dimple75]

hope it goes ok, yes dr Goggle v dangerous, people can misunderstand info. best leave it to the consultants or nurse specialists

[cathie]

I had one of these biopsies many years ago. Lots of smear tests followed - not nice. But thankyou for sharing this.. I think this is one of the best aspects of this forum! I hope everything goes well. XX

[dimple75 in reply to cathie]

Thank you cathie. It feels so good that people can relate to what Im going through.Take care.Lizax

[joan_w]

I know how you feel. I had a cone biopsy some years ago because of abnormal smear results. In 2011 I started getting abnormal results again and my Gynae consultant kept telling me it probably wasn't anything to worry about, it was probably caused by taking MTX.

But you do worry, don't you, especially after 3 smears had come back severely abnormal. I kept being told that they would 'keep an eye on things` and I had smears taken every few months.

Finally, I started to have some bleeding. Not much, but enough to convince me that something really did need to be done. Fortunately the consultant agreed and I had a total hysterectomy last year.

I did not have to come off MTX though.

After the op, I was told that no cancer was found but I did have fibroids, hence the bleeding.

I have to say I am so pleased not to have to worry about it anymore. I also agree with you about having regular smear tests. I hated them but it's only a small amount of unpleasantness for a big reward should they catch something early.

[dimple75 in reply to joan_w]

Thank you for your response. Yes we all hate it and if i come across someone who likes having it done..with GUSTO Id be worried lol.I am glad you had that sorted and just be free of worries.

I spoke to relatives recently from philippines and have encouraged nieces and cousins to have regular check ups. I saw something on the news recently that AIDS and cervical cancer increasing over there and more needs to be done. Its a shame thing, religion comes into it too, catholics dont believe in contraception and also limited access to services. People over there worry about what to have on their next meals and not when to have their smears done.

Thank you for sharing your story and thank you for your concern.Lizax

[allanah]

Just caught your blog, good luck in theatre. I was a theatre manager and anaesthetic manager and was still worried about the anaesthetic,,,crazy! But also don't let them put u in a bed near the phone, if you are like me I got real worried at the her Hb is what!!! Hee Hee, did more work laid there than I did on the floor lol good luck, let us know how u go.

Oh I just had an op and was told to come off my RA drugs, I did flare but they weren't keen to give me steroids as it inhibits your healing process, so just upend my painkillers . Love Axx

[dimple75 in reply to allanah]

Hi there allanah. yap its hard to switch off at times, remember last time I was in sin gapore airport and suddenly we heard this alarm going off that sounded like what we have here in darwin, automatically I got up investigating lol. Now my partner have strict instructions not to tell anyone what I do, though I still screen everyone inside a restaurant once i get in and see who's fragile and more likely to choke lol just can't help it.

I went shopping yesterday and can't remember it..must be the midaz hey..lol

[Dogrose]

I had a LLETZ for CIN 3 cells about 11 years ago, no cause was ever found - I had none of the infections that can lead to it and wasn't on any drugs. I haven't had any recurrence despite all the RA drugs I have been given, hope it all goes well and doesn't return XXX

[dimple75 in reply to Dogrose]

Hi there. Thank you for your response. I hope so too that my doc took all of it out. Abnormal cells are caused by human pappiloma virus.There are over 120 HPV types and more than 30-40 types are transmitted sexually, its just part of life and no point even trying to work out who gave it to us.If undetected it can lead to cervical cancers but that can take 10-15 yrs thats why its crucial that women have papsmear every 2 years.Take care xxx