Abnormal

by Kelly Duthie

I got home one day this week, after a particularly good working day and a very amusing conversation with my boyfriend, to find a letter on my doormat. It was from my local healthcare service telling me I'm severely abnormal. Well, needless to say, I felt this was slightly harsh of them. Admittedly, on my last visit, I arrived looking a little more dishevelled than usual but to go so far as to call me severely abnormal is plain mean.

Upon closer examination of the letter, I realised they weren't referring to me as a whole, but rather the cells of my cervix. Casting my mind back to schoolday Biology lessons, I recalled my cervix as being the lower part of my womb - the bit that opens up to let a baby out. I've always been really good at getting smears done - not the most exciting way of spending five minutes, I admit, but they don't hurt and they're an essential part of remaining healthy. I'd rather spend that time having a small, painless scraping of cells from my cervix done, than putting it off and wondering if everything was okay. I suspected that having abnormal cervix cells may not be a good thing to ignore.

Hurriedly, I called my boyfriend and sought reassurance that everything looked normal last time he'd had a peek and wondered aloud at the possibility that they'd made a mistake. Bolstered by this thought, I followed the instructions outlined in the letter and phoned my GP to make an appointment to discuss my next steps.

Fully expecting to be told they'd made a mistake and sent me the wrong letter, I was slightly alarmed to be asked to come in the next morning. Unfortunately, I couldn't make it and had to arrange an appointment for next week. I hung up on the receptionist trying to extrapolate my promise that I wouldn't spend the ensuing days worrying. Hmm.

Clearly, I wasn't to be told it was a mistake, so I did the next thing I could think of to help me understand - I phoned my sister. My sister has also been told she is severely abnormal (although in her case, I can see why) and would be able to tell me first-hand what I have ahead of me to look forward to.

I love my sister, I really do, but ... she's not exactly renowned for her sensitivity and tact. She asked me to read the letter to her (no problem so far) and homed in on the words "colposcopy" and "biopsy". Apparently, the colposcopy is nothing to worry about, it's just like a smear but the doctor has a giant magnifying glass so he can see your cervix clearly and it's transmitted onto a screen, (great, an IMAX version of my abnormality; I'm seriously considering charging a viewing fee). The gynaecologist then applies an acidic substance to the cervix and the abnormal cells change colour. Unfortunately, the biopsy is "bloody horrible" as they have to stick a needle into your cervix. As she said this, I could see little black dots in front of my eyes and the floor seemed to be bending and looming towards me.

Thankfully, that's just the anaesthetic and she assured me that it means you can't feel the next bit. It's called a Punch Biopsy. Dismissing images of a cartoon boxing glove looming towards my most vulnerable areas, I concentrated hard on the wisdom of my big sister. A small needle takes samples of the abnormal cells (think a pretty shaped biscuit cutter on a flat piece of dough), they're tiny, about the size of a grain of rice each and these are what are sent away to be tested. The whole thing takes all of fifteen or twenty minutes. Hardly a lifetime. All that happens then is I have to wait a week or so for the results and then I get a follow up appointment for treatment. Treatment is actually quicker than the biopsy and examination. It takes about ten minutes, is done under local anaesthetic in most cases (about 80% of cases take place under local and about 20% under general anaesthetic) and the cells are simply burned or scooped away. Not only is it relatively straightforward, but you also get to wear big, baggy paper knickers - and ladies, we all know they're the height of fashion.

Afterwards, I'll have to take it easy, no heavy lifting or strenuous exercise and, to avoid infection, wear sanitary towels for the discharge that follows and avoid sex until it stops.

Anyway, the upshot of all of this is, I've turned into a right nag. I've contacted all my female friends and reminded them of the importance of getting a smear. What shocked me is the number of them who have been putting it off for months. Bloody hell, they're not pleasant (I can think of better ways to spend five minutes, most of which don't involve latex gloves and a medical instrument that uncannily resembles a deformed ice-cream scoop) but the alternative is much worse. I'm not a particularly sensible person but it's not worth neglecting your health. My abnormality can be easily treated but what if I'd put this smear off? It takes ages for pre-cancerous cells to develop into cancer, but cervical cancer is nasty once it gets hold of you and can be very difficult to treat.

So make sure you get your smear when it's due, or remind your partner to go. And if it turns out to be abnormal like mine, not only do I know a great gynaecologist, but I also know where to get some really fancy paper knickers ...