An important test (Large Loop Excision of the Transformation Z)

Member Name: rlparker23

Product:	Large Loop Excision of the Transformation Z
Date:	26/11/08 (353 review reads)
Rating:

Advantages: Can stop you from getting cancer

Disadvantages: not the most enjoyable of experiances

Can I just apologise for this being a bit on the long side. This review is about the Lletz procedure but I have also included a bit about the tests you would have before hand as I feel they are all related. However please feel free to skip the first part, I won't be offended honestly!

My family's medical history has never been that good. I have family members who have had strokes, heart disease, diabetes, Parkinson's, liver failure (but that was due to alcohol abuse), lupus, cancer... this list goes on. Not happy reading for someone like me who is as terrified of being ill, I mean really ill not just getting a cold.

More recently both my aunties, on my mum's side, have had to have hysterectomies due to having cervical/ovarian cancer. This has obviously caused some concern for the remaining female members of the family, me included. Now I am ashamed to admit that despite the nagging form my mum, at the age of 26 I had never had a smear test. Stupid I know.

The problem is that I am a coward. A big one! I faint at needles, blood (mine or anyone else's), if someone describes something particularly graphic to me etc. Frankly it is embarrassing. You have no idea the trauma GCSE biology caused me and the many, many trips to the nurse after I had passed out. I don't think most people can appreciate just how squeamish I actually am. My fear of the medical profession verges on being a serious phobia and I have no idea why. I have never had a bad or painful experience with any doctor, dentist, nurse etc. My family are very practical Yorkshire farmers who have no problem with blood or medical issues. So I am just a coward.

I think it is important, however embarrassing, to stress my cowardice for two reasons. The first is so you appreciate how major this was/is for me and the second is that if I can do it anyone can!

So back to the point...

Last year I joined a new doctors practice after moving house. During a routine visit to the family planning nurse she was amazed that I had never had a smear, especially with my family history. So she booked me in for one and wouldn't accept any arguments (formidable lady!). When it came to the appointment I dragged my boyfriend along. He thinks I am totally crazy and a big wimp but be comes along anyway. He couldn't believe how much I was shaking with nerves! I must point out that I knew nothing painful was going to happen and that it was no big deal. I can't explain it myself but just being in a doctors makes me nervous.

After the test I just forgot about it until I received my results in the post. There were some changes in a few cells shown so I would have to go back for a second one. Mild panic started setting in. I talked to my flat mate and she said that she had had the same thing on her last smear but the second one had come back fine. Panic levels reduced. So of to the doctors again (boyfriend in tow) for another test.

A few weeks later another dreaded brown envelope (never trust plain brown envelopes lol). They had found more 'changed cells' and I would have to go for a different test called a Coloscopy at the hospital.

Panic levels definitely increased! The letter said the test involved the consultant putting a chemical around your cervix and looking at the cells through a big magnifying glass thing. Ok I know that's not the most technical of descriptions but that is what they do!

At this point I was getting very scared, not by the test itself but by what it might find. The letter I had about my smear test results didn't tell me anything about what 'changes' in the cells they were talking about. I must say my boyfriend was very good. He doesn't understand why I am so terrified of the medical profession and he finds the fact that I am so squeamish hysterically funny. Git. But when faced with a big teary, snotty, gibbering wreck he was great. He even went out and bought me chocolate then sat hugging me on the sofa all night while I stuffed my face with them :-D

The day of my appointment I was surprised by how calm I felt. I had read up on the test and new that nothing was going to happen except they were going to look at my cervix. I could handle that. Plus it was in the local hospital's (Poole in Dorset) gynaecology unit which is in a small separate building so it feels more like a doctors surgery then a hospital. I definitely do not do well in hospitals!

When I was called through I went into an office with my consultant, who was a very nice woman and she was very understanding about my nerves. First of all she talked through my smear test results with me. She had a diagram with 3 pictures of cells at different stages of change. Cell change abnormalities are measures by the Bethesda system the three levels are minor, moderate and severe changes. Minor cell changes don't require treatment as they usually go away by themselves. Moderate and severe can be precancerous and usually need to be treated

This was really helpful as she explained that my results were only stage 1 so this second test was more of a precaution then something to worry too much about. I wish they had put that diagram in with my results letter instead of letting me spend 6 weeks convincing myself I had cancer!

Then she explained what would happen in the test I was about to have. We then went through into the treatment room and I had to go behind a curtain and strip from the waist down. There was a sheet for me to wrap round myself. I found this a bit silly to be honest. I am about to have to lay on a bed, my legs in the air, everything on show, looked at through a bloody magnifying glass etc, but to get undressed you have a screen and a sheet. I think dignity was out the window by that point so not sure how much a sheet would help lol. Still it did provide the useful function of acting like a wall so I couldn't see what was going on.

They did give me the option to watch on a small TV screen but I declined. During the test my cervix bled a little, which apparently is not that uncommon as it is a very delicate area. The consultant said that she could see some cell changes but that the bleeding was making it a bit tricky to see everything (going a bit dizzy just writing this!). Then she said she was going to take a biopsy. Panic levels shot through the roof! She said it would just feel like a small pinch. Then produced the biggest metal contraption I have ever seen. Ok slight exaggeration but considering where she was about to stick it, it looked pretty big to me!

She told me to cough and as I did I felt something. It felt like someone had flicked me very gently and it didn't hurt at all. Now if I say it didn't hurt then it really can't be that bad. I have fainted from a paper cut before! She said that I may experience a small amount of bleeding/discharge as the area the biopsy was taken from healed but that it wouldn't be very heavy so just to wear a normal towel/panty liner. I was also told not to us tampons or have sex for 3-4 days to give it time to heal. At no point did it cause me any pain and the bleeding was very light and only lasted a couple of days as it was such a small area.
I must admit I was very nervous while waiting for the results. I was also very snappy with my boyfriend, but he just ignored me lol. It took about 7 weeks to get my results back. They said that the biopsy had shown further changes in cells so they were going to remove them using a procedure called Lletz. The appointment was for 4 weeks later.

I was very scared and upset. My boyfriend was very supportive but I know he thought I was over reacting. He asked about all the possible outcomes and we discussed worst case scenarios etc. He is very practical and likes to know all possible outcomes etc. He used to be a royal marine and looks at most things like a military operation. To be honest phrases like, "worst case is you have/it develops in to cancer, it will get treated and if you have to have a hysterectomy we have lots of other options if we decide to start a family", are not that comforting! Still I appreciate him trying, I think lol.

His attitude was that it was a tiny area that I'm not going to miss and it's better to get these things sorted straight away. But he also said that he knew that it scared me so if he thought I was being silly it didn't matter. If I was scared then it was important and I could cry on his shoulder all I liked. Which I did :-D

Before, if they wanted to remove dodgy cells they used a laser and simply burnt them off. Now however they do something called Lletz. This uses a thin wire with an electric current running through it to chop off/remove them. This means they can send the removed cells away to be tested. Lletz stands for 'large loop excision of the transformation zone'.

At the appointment I went into the consultant's office again so she could explain what was going to happen. She said that the biopsy had show some cells at level 2 (moderate changes) so it was best to remove them. She also had a plastic cross section of a womb and cervix which she used to show me where the cells were being removed from. Then we went into the treatment room. It was the same routine as before, behind the curtain to undress and get my sheet, the lay on the bed with legs in stirrup things whilst trying to maintain some dignity. Who am I kidding, by this point dignity was the last thing on my mind!

The nurse stuck a big pad to my leg which was wired to the Lletz machine to earth it. The consultant inserts a speculum to hold the cervix open, the same as when you have a smear. They then give you a local anaesthetic. Now my cervix is the last place I wanted to be stabbed with a needle but I can honestly say it wasn't as bad as I had imagined. It was more really uncomfortable then painful but the nurse kept chatting away to me to help distract me. It felt like I had 3 injections but I am not 100% sure and I didn't ask at the time. After the anaesthetic you don't feel anything else, I promise!

A pump/suction device was attached to something down there (again I had declined to watch!) which made quite a lot of noise but in a way it was a nice distraction. I assume it was to remove any blood/fluid. The whole process took about 5-10 minutes. However as I sat up I did go very dizzy. So they made me lay down for a while and gave me a glass of water and a glycerine tablet. Apparently the anaesthetic contains adrenaline which can make you light headed, plus I hadn't eaten anything which didn't help. After about 10 minutes I felt ok again and I got dressed.

The nurse said I would get the results in about 6 weeks and that they would write to me with a follow up appointment in 6 months time. I was also given a piece of paper with some aftercare instructions. It said that after the anaesthetic wore off I would have some period pain like discomfort which I should treat with ibuprofen. It also said I couldn't use tampons for 3-4 weeks but that I should wear panty liners/ pads as I may experience a light water/blood discharge while it was healing. It also said I couldn't have sex for 3-4 weeks. Bugger!

My appointment was at 3:15, at about 4pm I started to get a bit of pain. However this was, like the leaflet had said, just like period pain and wasn't too bad, a couple of Anadin sorted it out. I took another couple at about 9pm as well. After about 9:30 I didn't have any more pain. For the following week I didn't feel any pain/discomfort and any bleeding was minimal. The boyfriend was already sulking about the sex though lol.

I had another 5 weeks to wait for the results. The consultant said that after the Lletz procedure that is usually the end of the matter but I wanted the results in my hand before I relaxed! There aren't really any side affects except that in some cases it may lead to your baby being born slightly early as the cervix is a bit weakened. However, I don't plan on having kids any time soon so that's not an issue for me.

If anyone is reading this that doesn't bother going for smear tests PLEASE go. If I had left it another year or so things could have been much much worse. The statistics for cervical cancer if it is caught late are not good at all. Yes smear tests are unpleasant and a bit embarrassing but they are important. The follow up tests are also not my idea of fun but they are not painful and they are important.

I have written this because I want any fellow wimps or even those who just can't be bothered or put things off to know that the tests are ok. Not painful or scary. Well if you're me they are a bit scary but nothing you can't handle! I apologies for the lack of medical facts/knowledge but there is no way I am reading anymore medical web sites - makes me feel all queasy :-D

I think there are a few things you need to remember if you have to have any of these tests
- they don't hurt!
- they are over quickly
- take your own sanitary towel as theirs are HUGE
- take someone to hold your hand
- they don't hurt!
- try to go in a car with good suspension (bumps are not your friend after this)
- don't drive yourself the adrenalin can make you dizzy
- eat something before hand for the same reason!
- take some ibuprofen with you for later
- they don't hurt!

This was just my experience, and I hope it will help put someone else's mind at ease if they ever have to go through this. I have rated this 5 stars as I think it is so important. If anyone is waiting to have this test please feel free to message me with any questions

I received my results back this week and they are all clear. All the changed cells have been removed. I have a follow up check in January (something to look forward to for the new year!).

I also want to thank my boyfriend who gave me all the support and cuddles I needed XXX

(also on ciao as rachael23)

Summary: Please make sure you go for a smear (if your a woman obviously lol)