Note: I wrote this on my phone about 3 weeks ago, on my commute home from my LEEP procedure. It took me some time to revisit this entry, since a big part of me wanted to forget about it.
As I ride the subway home from the hospital, feet apart to manage the sway, I wonder to myself. Do I feel weak from being nervous, or from having an electrical current shooting through me?
In November, after my annual Pap smear at a gyno’s whom, if my experiences and the many others found on her Yelp and ZocDoc page may be believed, I’m sure is committing medical billing fraud…I found out I have high grade cervical lesions – HSIL. Just a year ago, it was low grade (LSIL). For most people, HPV won’t impact their lives much. It comes and it goes with little harm done. But then there’s people like me, who despite only having two boyfriends ever, gets the “bad strain”. The high risk kind, that may lead to cervical cancer in ten years.
What’s funny but not funny? Gardasil, the HPV vaccine, protects against the high risk strain I have, (type 16). I had a prescription for it 3 years ago, but I was turned away at the hospital’s pharmacy. They said it wasn’t covered by Medicaid, however in hind sight, I wonder about the validity of that. I couldn’t afford the out of pocket expenses of $150 x 3 shots at the time. But now I’ve paid literally thousands because of this virus. Just a colposcopy, the mandatory follow up to an abnormal pap, costs me $5000. And yes, that’s after my insurance paid.
But I don’t want to talk about the financial issues that plague patients and the healthcare system. I want to talk about LEEP, in case someone out there wants to know how my experience went. I couldn’t find much myself before the procedure, past badly written forum posts.
So I had a LEEP procedure today. Still on my way home from it, as I type this on my phone. This is the best explanation I’ve found about it online.
I went to the gynocological oncology department of NYU and, like all my other appointments, waited. For a long time. “Glad I took the rest of the day off,” I told myself. They tested my urine to make sure I wasn’t pregnant, took my vitals, and after more waiting in the exam room with a sheet tied around my hips, the doctor and her nurse walked in.
It’s true that the procedure was about 10-15 minutes in length. I laid back on the table as it raised my hips up 4 feet, my heels in the plastic stirrups. They used a plastic speculum, the color of Peptobismal, with orangey-gold hinges, and a thick plastic tube. I’m not sure if it was really connected to the speculum but they held the two together; it was a small vacuum. Internet tells me the vacuum sucks up ashes that may scatter as she burns away my cervical tissue. Note it’s all plastic, so the doctor and nurse don’t get electrocuted! As for me? The nurse peeled off a 12″ long rectangular white pad and stuck it to my upper thigh. “This will ground you,” she said. Like how you ground your house, or your computer, you get grounded so the electrified metal they stick inside your vagina doesn’t electrocute you! Ha. I make it sound scary, but it’s not. I routinely get a cardiogram at my regular doctor’s for my annual exam, and it’s the same. He sticks a bunch of white pads all over my chest, connected to wires. The current runs from the machine, through my body, and then back to the machine. If you were blind and dead, you’d never know. It’s painless.
Not to say my experience with LEEP was completely painless. I hear it can be, for some. But these things always vary from person to person.
So I was on the table, the speculum was in, and things got started. The doctor flushed the area and swabbed with those giant q-tips you should be familiar with from routine paps. She was cleaning, for better visibility. Today I’m ovulating, so there’s a lot (yes I keep track! It’s fun). Then she swabbed something black, I believe the bottle said “iodine”. More cleaning of the area, this time to prevent infections. Then the nurse held my hand…and a 14″ long needle slide inside me. It kissed my cervix and hurt slightly, but I’d say it was a 3/10 on the pain scale. 10 being the most painful. Getting cauterized on my labia without an anaesthetics, for example, is something I rate an 11/10.
The nurse and doctor worked fast. My IUD, a copper Paragard, was still in place. She used a long, scissor-like tool to shorten the strings then pull it aside so it wasn’t in the way. The nurse handed her the LEEP tool. It was kind of like something a dentist would use…a long, blue stick with a gold, round nub at the end. She touched that to my insides, and I jumped. I screamed. 8/10.
Luckily she’s good and didn’t let it hit anything else when I jumped, but it was close. She then removed my IUD…and I’m cool with that. I’d rather nothing obscures her vision or the electrified baton up my vagina, and maybe that frees a hand for her so she doesn’t burn me painfully again. It barely hurt during removal (1/10), though I recall insertion was a (9/10) when I got it put in. That’s another thing “they say” wouldn’t hurt, and varies from person to person.
There was a high pitched drill sound, very reminiscent of being at a dentist, as she burned away tissue. It no longer hurt at all. Who knows, maybe I needed that extra minute for the anaesthetics to kick in. Maybe digging your nails in to your palm as a distraction is a good technique, or repeatedly thinking in your head, “You’re okay. You’re okay. You’re okay…”
It was over soon. Things got sealed for labs, things were tossed in the red biohazard bin. They let me lay there to regain myself, and the nurse felt my forehead. “You’re not hot, that’s good. Some people get light headed after anything touches their cervix.” They electronically submitted paperwork to a lab, made sure I was alright, asked if I had questions, and left. Apparently if I bleed so much that I need a new pad after an hour, I gotta run to the ER. I’m still on the train ride home, so we’ll see. They said it’s rare.
UPDATE! Conclusion update here; spoilers….everything worked out in 2016 :)