I'm sorry, Fred...
but this entire post is about the follow-up to my Pap. Feel free to skip if you wish, but living in a household of women, I'm sure this topic isn't completely foreign to you.
Now normally, even *I* wouldn't publicly discuss something like my Pap smear (at least not in detail), but the follow-up to my abnormal Pap was so--well, ABNORMAL that I had to share it with my girls (and Fred, LOL). And this was the most effective way to do so.
To catch everyone up to speed: as a teenager, I had some pre-cancerous stuff going on down there--but, thanks to a unplanned pregnancy, it was caught early and the "bad cells" were simply frozen off. This was over a decade ago (15 years, actually--God, I'm old), and I've had normal Paps ever since. So finding out that my most recent one came back as abnormal kind of threw me off, to say the least.
It was my GP who took the original Pap--but since she doesn't specialize in that area, she referred me to an OB-GYN to take a closer look (no pun intended) when it came back suspicious. As Dr. C and I were chatting and I was getting him up to speed on my history, a nurse brought in the report from my Pap.
"Huh," he said, quickly reviewing it. It was a statement, not a question. Then he looked up at me. "You have a very unusual case here, young lady."
I kind of snorted and thought, "Of COURSE I do." Historically, nothing about me is ever simple or normal (medically and otherwise). Frankly, I'm surprised that I haven't contracted the avian flu, malaria or a flesh-eating bacteria yet.
Anyway, he showed me the report--and here's the deal.
The Pap showed "severe" cell changes. Generally, he said, changes that severe are at best--at BEST!--pre-cancerous--and often, once they've reached that stage, have progessed to actual cancerous.
(That would suck.)
"However," he said, as I nervously started biting my nails, "changes of this nature are virtually always associated with HPV" (as most of you know, a sexually-transmitted virus--one so common that they now say 80% of all sexually active adults will contract it at least once in their lifetime. For most people, it stays in their system for a couple of years before their body sheds it, without causing any issues--but for some, it manifests itself as cervical cancer or genital wars, depending on the strain). "But--" and he pointed to the report--"you tested negative." He paused, seemingly deep in thought. If he'd had a beard, he'd have stroked it contemplatively. "I've never seen this before, and I've been practicing for 25 years."
I had to laugh. Strap yourself in, doc. With me as a patient, it's gonna be a wild ride.
My first question was this: is it possible that it was a false negative and that I DO have HPV, hence the cervical changes?
No, he immediately answered. The test for HPV is cut-and-dried. Either you have it or you don't. It's virtually error-proof. ("That doesn't mean that a false negative hasn't happened to someone, somwhere, at some point," he said. "But I'm essentially ruling that out.") The more likely possibility, he said, is an error in the Pap smear reading. I didn't know this, but he went on to explain that Paps are entirely subjective--it's basically a bunch of people, sitting around in labs, examining the cultures or whatever, and then writing reports on what they see--their personal opinion, basically. (Somehow, I assumed it was a bit more scientific than that.) Still, he said, it would be highly unusual to "accidentally" label a sample as "severe"--that's a fairly hard mistake to make, since cell changes that drastic would be pretty damn obvious.
The third option, of course, is that both reports are right--I am HPV negative AND I happen to have these cervical, um, issues. (I don't even want to use the C-word, although frankly--and this might sound weird--but even with the worst-case scenario, I'm not all that worried. Cervical cancer is an incredibly curable and treatable form of the disease if caught early, as mine would be.)
So he took a biopsy, with the results due next week. He said he'd call as soon as they came in. "If it comes back that the Pap reading was correct, I'll be shocked," he told me, and then reiterated that it's virtually impossible to have this combination of no HPV/severe cervical changes.
LOL. $50 says I end up in a freakin' medical journal. ;)