Saturday, January 14, 2017

Amanda's Story - Guest Blog Post by Amanda Tanay

Amanda and I became friends several years ago, when we were diagnosed with cervical cancer right around the same time. She is such an amazing person, and has gotten me through some really rough times. I love her more than words could say, and I am so grateful for her ongoing love and support.


Amanda


The moment you’re told there’s even a possibility you have cancer, the entire world seems to break apart and fall at your feet. At least that’s how I felt while sitting in my gynecologist’s office in July 2014. I’d been there less than a year prior (October 2013) after a few occurrences of bleeding after intercourse. At that appointment my doctor told me she felt I had a sensitive cervix due to hormonal changes, but she “ran some tests” to be on the safe side.

But by July 2014 I was questioning my body more and more. The bleeding after intercourse had become more frequent and I was suddenly dealing with watery discharge as well. It was more than I was willing to deal with and had hoped to discuss with my doctor changing my birth control pills in order to fix whatever “hormonal changes” were causing these problems. But when she did an internal exam the look of worry on her face and the mention of how easily I bled during the exam caused a million alarms to sound in my brain.
She wanted me to have a colposcopy (an exam where they more closely examine the cervix) and biopsy to see what we were dealing with, but the word cancer was mentioned as a possibility. She wanted me to come back later in the afternoon or the following day, but I begged her to do it immediately. Twenty minutes later I was holding a nurses hand as a lie with my feet in stirrups, tears flowing from my eyes, and my doctor poking and prodding at my cervix. When the exam and biopsy were complete, she told me she’d call me in a few days with the results.

That appointment was probably about an hour, but the memory of it flutters quickly through my mind because it was merely the first of many that followed with more doctors. But I remember during that hour asking how I could possibly have cancer when I’d had a clear pap exam last October. That’s when she told me I hadn’t had a pap exam in October when I’d visited with my first concerns of bleeding after intercourse. My last pap test had been two years prior and was clear, which was why she had only swabbed for the possibility of infection at my previous exam.

I was dumbfounded, and still am today, by the fact that I didn’t receive a pap test after discussing my bleeding, one of the few symptoms of cervical cancer. It upsets me to know that the bleeding I experienced in 2013 was more than likely an early symptom that progressed farther and farther until my July 2014 appointment which led to a phone call approximately five days later telling me I had cervical cancer and should make an appointment with a gynecologic oncologist immediately.

Of course I am most angry with my gynecologist who’d known my history of having HPV and abnormal pap tests off and on since 2007. A woman whose job it was to examine women daily and make choices to help them stay healthy. This was the woman who delivered my beautiful daughter in 2009. The woman who also treated other female family members. When I went to her in 2013 with a symptom of cervical cancer and the knowledge of HPV and past abnormal pap tests sat in black and white in my file, she made a professional choice not to do a pap test. A choice that allowed my cancer to progress. A choice that caused me to undergo a radical hysterectomy at the age of 34 as well as the five rounds of chemotherapy and 28 rounds of external radiation that followed.

And as angry as I am with my gynecologist, I’m also upset with myself for not asking the right questions during that first exam. I assumed that during my internal exam that when she swabbed me it was for a pap test. I never asked her what tests she was running. I never asked her if the bleeding could be associated with any previous issues I’d had. There was not a thought in my mind at all that I could suddenly have cervical cancer caused by the HPV that I’d pushed to the back of my mind after quite a few previous clear pap tests.
Two years later I am healthy with no evidence of disease (NED as we cancer survivors call it). I’ve been told I should consider filing a law suit against my gynecologist for not doing the appropriate test when I’d first complained of a symptom. But then I think to myself, what would that do? Sure, I could use the money, but what’s done is done and nothing can change the fact that I had cancer. I can no longer have children, but I am blessed to have my daughter. I have anxiety issues and the thought of cancer returning terrifies me, but I am alive.


It’s because of my doctor’s mistake that one of the most important things I tell women when it comes to my cancer journey is to be your own best advocate. No one else knows your body as well as you. If something doesn’t feel right, make an appointment and talk to your doctor about it. Make sure the appropriate tests are done for every possibility based on your symptoms. And if they’re not, find another doctor. Don’t wait until things get worse. When it comes to cancer, the earlier it’s caught the better the chance of survival. Refuse to become a statistic.

Friday, January 13, 2017

Sex Is Scary **GRAPHIC CONTENT**

My sex life is dysfunctional. I know the reasons behind this, but I have not yet been able to conquer the problem.

First, when I was 19, I was raped by a bouncer in the parking lot behind a night club. I didn't tell anyone for years what had happened. I was in the club, very drunk (and very under age), and I had  gotten separated from my friends. As I walked past, this bouncer grabbed my arm, and led me out a side door. I figured that I was getting kicked out of the club for underage drinking. Instead, we wound up in the employee parking lot. He took me to his truck, pushed me inside, and raped me. When it was over, he led me back inside, and walked away. He never said a word to me the entire time.

Then, when I was around 33, I started having pelvic pain, which eventually led to my diagnosis of cervical cancer. The pain was actually not related to the cancer at all - I think it was just my body's way of alerting me that something was wrong, and I fortunately kept pursuing the matter with several different types of doctors, until I was finally diagnosed.

So I have PTSD, both from the rape and from the cancer. And I still have pelvic pain. My vagina is like a no fly zone. Sex is painful for me, and causes bleeding. As a result, my husband and I don't have sex frequently at all. I feel horrible for him. We are still newlyweds, and we should be doing what newlyweds do. But instead I make excuses, and we don't have sex, and we miss out on the intimacy of making love with the love of our lives.

Another issue I have faced is basically a distrust of my vagina. In my mind, it goes something like this: I had sex, and got HPV, an STI. The HPV gave me cervical cancer. Therefore, I got cancer from having sex, and that makes sex dangerous.

During my oncology check up yesterday, I had a long conversation about this with my doctor. He did a very thorough pelvic exam in addition to my Pap smear, to make sure that my vagina was fine from a physiological standpoint. He said that everything looked good. The pain is kind of a self-fulfilling prophesy: I expect sex to be painful, so I tense up, which does in fact cause it to hurt. The bleeding is more of a chafing issue than anything else. We discussed several options to improve my situation:


  • Using a dilator. Dilators are mostly used by women who have had brachytherapy, or internal radiation, which shrinks and stiffens the vaginal vault. His opinion is that a dilator is not necessary at this point, as my vagina is in good shape.
  • Lube and foreplay. My oncologist thinks that engaging in extended foreplay would quell my anxiety enough that my vaginal muscles will relax, and penetration will not only be possible, but enjoyable. Lubricants will help facilitate the relaxation, as well as stop the chafing that causes the bleeding. Lube is especially helpful for women who have had their ovaries removed during their hysterectomy, which causes menopause, and makes dryness a major issue. Fortunately, I still have my ovaries, and am not in menopause. My vaginal dryness is, like everything else, centered around my anxiety.


My husband and I have decided to go with the second option, using lube, and aiming for 15 to 20 minutes of foreplay before attempting penetration. We also agree that if standard intercourse is not possible, there are other things we can do sexually, like digital penetration or oral sex.

The most important part is the intimacy that comes from making love. If one partner avoids sex, it has a tendency to make the other partner feel like they are unattractive to their mate. This is totally not the case at all - my husband is the handsomest, most sexy man on the planet, and I love him more than anything. I would do anything to make him happy.

I know that other women deal with these types of issues after treatment for cervical cancer, many to a much greater degree than I do, especially those who have had internal radiation. I know it's hard, but my advice to you would be to use lots of lube, set the mood, spend a good amount of time leading up to the main event, and remember that sex can be a whole lot more than just penis-vagina penetration.

xoxo Jennie

Thursday, January 12, 2017

The Oncology Check Up

Today I go see my oncologist for my 4 month check up. Even though I'm a little over 2 1/2 years NED (no evidence of disease), I still see him every 4 months for a vault smear, and the occasional HPV test. As a general rule, I'm totally fine with seeing him every 4 months. It just means I know with more frequency that the cancer has not come back.

But then there is the anxiety surrounding the visit. I haven't been sleeping very much for the past week, most likely because my brain is screaming "Cancer! Danger, Will Robinson, CANCER!!!!!" This is completely illogical, because I have been NED since my hysterectomy on 6/16/2014, with no questions at all during any of my follow up appointments. But I've learned that my brain is not always rational when faced with the prospect of cancer.

Even though my chances of a recurrence are ridiculously low (something like 5 - 10%), each visit to my oncologist provokes a deep fear that he will find SOMETHING. Since I no longer have a cervix, a recurrence would most likely be vaginal or vulvar. I should probably spend some time checking myself for anything out of the ordinary, but I don't.

Confession time - ever since my diagnosis (April 2014), I have steadfastly refused to put my fingers in or around my vagina. The main reason is because my anatomy has changed. Instead of a cervix, I have a cuff, or a doctor-built pseudo-cervix. Because tissue from my vagina was removed during my hysterectomy for testing, my vaginal canal is shorter than it used to be. Gone is the vagina I spent 34 years knowing well, and I am honestly terrified to introduce myself to my new vagina.

So today I will head off to my oncologist, he'll do the smear, and the whole thing will be over in about 5 minutes. Seriously. 5 days of stressing for 5 minutes of examination.

And then comes the waiting game. If all is well, I'll get a letter in the mail, possibly as long as a month after today's visit (my onc's office is slightly technologically challenged). If, god forbid, there were to be bad news, I'll get a phone call. So I'll keep stressing for about a week or so, then figure the path reports have come back normal, and just wait for my letter.

I deal with my anxiety with medication, and I feel no shame or guilt about that. Valium is my friend. I also exercise and meditate (don't laugh, but I do Chakra meditation focusing on my pelvic area and sex organs to bring as much good juju as I can).

How do you deal with the anxiety of oncology check ups? How frequently do you see your oncologist? And how far out are you in your journey?

xoxo Jennie

Wednesday, January 11, 2017

Honoring Melissa McGroerty Fisher

For those of you who have not read all the previous blog posts, Melissa McGroerty Fisher was a wonderful woman I met through an online community for women with Gyn cancers. We hit it off immediately, and became cancer besties. Sadly, Melissa lost her life to metastatic cervical cancer. You can read previous entries about Melissa herehere, and here.

Melissa McGroerty Fisher



On November 17, 2015, my dear friend Melissa McGroerty Fisher passed away from metastatic cervical cancer. Exactly one year later, I drove down to Hilton Head, SC, with her husband Ed, her parents Elaine and Tom, and two of her best friends, Colleen and Amy.









We arrived to beautiful weather. In the early evening, while it was still light out, we went to Tower Beach, Melissa’s happy place. Ed read a beautiful statement, opened the small urn of ashes, and let them float into the breeze.



It was amazing– Melissa’s ashes dancing on the wind, with the sun shining through. It was a truly fitting send off for a woman who was not of this earth. She was so beautiful, both physically and spiritually, that she could not be bound to this place.

We spent the rest of the weekend reminiscing about Melissa, telling stories, and visiting her favorite places on Hilton Head.

And if you are at Tower Beach, on the right day, with the right light, you can see Melissa’s spirit dancing across the waves.


I will always love and miss Melissa. Every morning when I wake up, I speak to her, and I say, “I live this day for you.”

Tuesday, January 10, 2017

What Is HPV?


HPV is human papillomavirus. It is the most common sexually transmitted infection, and affects both males and females alike. HPV is asymptomatic, meaning those who are infected with it have no idea that they carry HPV.

There are over a hundred strands of HPV. The vast majority of them are harmless. However, high-risk HPV strains include HPV 16 and 18, which cause about 70% of cervical cancers. Other high-risk HPV viruses include 31, 33, 45, 52, 58, and a few others. Low-risk HPV strains, such as HPV 6 and 11, cause about 90% of genital warts, which rarely develop into cancer. Genital warts can look like bumps or growths.

HPV TESTING
(from healio.com)

Screening for HPV is usually carried out by a Pap smear or by liquid-based cytology to detect abnormal cells. When abnormal cells are detected, a colposcopic inspection is recommended. During this procedure, biopsies are performed and abnormal cells removed via cauterizing loop or, more commonly, by cryotherapy.

HPV TREATMENT
(from healio.com)

Although there is no current treatment for HPV, the two HPV vaccines (Cervarix, GlaxoSmithKline and Gardasil, Merck) provide protection from infection with HPV types 16 and 18 — the cause of 70% of cervical cancer.
According to the CDC, “Condom use may reduce the risk for genital HPV infection.” However, when compared with other sexually transmitted infections, condom use provides a lesser degree of protection because HPV can also be transmitted via exposure to infected skin or mucosal surfaces not protected by condom use.

IS HPV PERMANENT?
(from healio.com)

In most girls, HPV infection is temporary and does not have a significant long-term effect. Within 1 year, 70% of HPV infections are cured; 90% are cured within 2 years. Yet, in 5% to 10% of women, HPV infection persists. These patients are at a significant risk for precancerous lesions of the cervix, which may lead to invasive cervical cancer within 10 to 15 years.
On rare occasions, mothers with genital HPV can pass on the virus to their baby during delivery, and the baby may develop recurrent respiratory papillomatosis. This is a condition in which warts grow on the throat and is referred to as juvenile-onset recurrent respiratory papillomatosis in older children.

CONNECTION TO OTHER CANCERS?
(from healio.com)

Data suggest HPV is also linked to lung and throat cancers.


HOW DO YOU PREVENT HPV?
(from healio.com)

Vaccination

One way to avoid HPV is to get vaccinated. The vaccines are given in three injections throughout the course of 6 months.

According to CDC, all boys and girls should get vaccinated at the age of 11 or 12 years. Vaccines are recommended for males through age 21 years, and for females through age 26 years, if they were not vaccinated when they were younger.


The HPV vaccine is also recommended for men who have sex with men, as well as men and women with compromised immune systems, including people living with HIV/AIDS, through age 26 years.