A Smear Campaign

Good morning and happy hump day! For those that don’t already know, this is Cervical Cancer Prevention Week in the UK. The week aims to raise awareness of cervical cancer and the importance of smear tests. I am rather passionate about women taking up the offer of their smear tests as feel prevention is always better than cure. My mum is a smear test screener (she looks at them down the microscope and checks the cells) so have learnt a lot about the subject from her.

What Is A Smear Test?

A smear test is offered free by the NHS every three years to women between the ages of 25 and 49 and every five years from the age of 50 and 64. You will receive a letter from your GP inviting you to make an appointment for your smear test when it is due. The appointment will take about fifteen minutes, however, the procedure is over in under five minutes.

When you arrive the nurse will ask you some basic information and also about your periods – when your last one was, if you have had any irregular bleeding etc. You will be told about the procedure and asked to sign a consent form. You will then be asked to go behind a curtain and undress from the waist down, and then lay on the bed.

The nurse will then join you and ask you to bend your legs and keeping your feet together, lower your knees towards the bed. If, like me, you have mobility issues such as arthritis, please let the nurse know. They are always very helpful and accommodating with me!

The picture above on the left is the speculum. They are either made of plastic or metal ad are used to open up your vaginal canal. This isn’t generally uncomfortable unless you are very tense. It can be a bit cold, but a kind nurse will normally warm a metal one under the tap before using it!

The nurse will try and ‘visualise’ the cervix – that is, have a look and see if they can see any abnormalities in the first instance. Then will then use a small brush, and wipe it around the cervix to collect the cells. This will be popped into a test tube and sent to the hospital to be screened. The nurse will then remove the speculum and you will be able to get dressed.

The Results

The brush which has your cervical cells on will be sent to the hospital where it will be screened. The idea of a smear test is not to detect cancer, although it will do if it is present. A smear test is designed to identify changes in the cells in your cervix which could develop into cancer, therefore a preventative measure.

HPV screening is coming in in the UK and in some areas your smear will be initially checked for the HPV virus. If that isn’t present, you will be sent a negative result and asked to return in three/five years. If the HPV virus is present, your cells will be put onto a slide and sent to screeners who will look at it through a microscope and check for abnormalities.

There are three levels of abnormal cells that can detected before it turns into cancer, and this is the aim of the program – to detect these changes and treat before it gets that severe. Depending on the level of these cells will depend on what treatment needs doing and you may be invited for a smear test sooner than your usual recall time to ensure treatment is successful. You will be contacted by your doctors surgery in the event of an abnormal result.

“I had my first smear aged 25 and had stage 3 pre cancerous cells, basically the next step was cancer. I had them removed and had several colnoscopies which involved a camera up the foof but on my last one got the all clear.. They are so important”

COLPOSCOPY – A colposcopy is a simple procedure used to look at the cervix, the lower part of the womb at the top of the vagina. It’s often done if cervical screening finds abnormal cells in your cervix.

Facts & Figures

TWO WOMEN LOSE THEIR LIVES TO CERVICAL CANCER EVERY WEEK IN THE UK

9 WOMEN ARE DIAGNOSED WITH CERVICAL CANCER IN THE UK EVERY WEEK

I posted a series of polls and posed questions on my Instagram about women’s uptake and experiences of smear tests and the HPV vaccine. 

Statistics suggest that 4 in 5 women currently have their smear test when it is offered. The women who answered my survey were slightly above this rate which is encouraging, although there was still 18% of women who hadn’t had one in the previous three years.

“Never had one! I’m scared if I am honest”

75% OF CERVICAL CANCER DIAGNOSIS CAN BE PREVENTED WITH CERVICAL SCREENING (SMEAR TESTS)

The latest government statistics suggest that 83.9% of teenage girls in year 9 take up both doses of the HPV vaccine. This national statistic is higher than the results from my poll, in which 75% of people offered the vaccine had taken up the offer.

“I always have my smear. The NHS don’t offer anything free that isn’t necessary. Also, all women should have them as a basic form of self care”

The HPV Vaccine

HPV – Human Papillomavirus

HPV is a virus that around 80% of us will have at some point. It is passed through skin to skin contact, and in most cases our immune system will get rid of it.

There are over 200 different types of HPV, around 40 of which affect the genital regions of men and women. Of these, around 13 are linked to cancer and known as high risk. HPV can lie dormant in your system for years so you may not know who you caught it from or when you caught it.

The HPV vaccine is now offered to teenage girls in the UK. It helps protect against two strains of the high risk HPV virus which can cause cancer, and two strains of the HPV virus which can cause genital warts.

FAQ

Does a smear test hurt?

Not usually! It can be a little bit uncomfortable, but should not be painful. Please alert the nurse if you do encounter a high level of pain while having the test as soon as you can. You may experience a little bleeding after the test, I generally wear a panty liner just in case.

“It made me bleed. Was painful but not too much that it put me off. Peace of mind knowing”

What symptoms should I see a GP about?

Symptoms including bleeding after sex and between periods should always be reported to a doctor. They may decide to do a smear test before you are due, just in case.

I had the HPV vaccine and still got HPV. What is the point?

The HPV vaccine currently only protects against two of the high risk HPV strains and two other strains of HPV. Being vaccinated against some of these strains is definitely better than none at all, and scientists are working on the other strains to offer better protection for women.

I am so embarrassed, what can I do?

Remember that nurses are trained to do these tests, and do multiple ones of them a week. For them it is very normal and routine. Explaining to the nurse that you are worried/embarrassed can definitely help, and they will be able to reassure you.

When is the best time to book my smear test?

You should aim to book your smear test for around two weeks after the start of your period, mid cycle. However, a smear test can be booked at any time of the month.

I had her HPV vaccine, does that mean I don’t need a smear test?

YOU STILL NEED A SMEAR TEST EVEN IF YOU HAVE HAD THE HPV VACCINE. This information does not seem to be getting out there,so any girls think they no longer need a smear test after having the vaccine. However, as explained, the vaccine currently only covers two of the 13 high risk HPV strains, so smear tests are still very important.

I have had a fistula and seton in place, and am worried it will hurt more?

This was a question raised on my Instagram stories following my polls. I am not sure of the answer to this but wanted to say – it is still vital to have your smear test so speak to your practice/IBD nurse who will be able to give you more information.

Smear For Smear Campaign (Jo’s Cervical Cancer Trust)

Jo’s Cervical Cancer Trust is the only UK charity dedicated to women, their families and friends affected by cervical cancer and cervical abnormalities. They aim to support, raise awareness and provide information.

Check out their website here

The Smear for Smear Campaign this week will see women all over social media posting pictures with their lipstick smeared. You can join in and don’t forget o include the hashtags #smearforsmear and #ccpw

I want to thank Jo’s Cervical Cancer Trust for the great information available on their website. I have also been sent some fantastic leaflets through the post, and am happy to send some on to anybody who would like to read or who has a method of distributing it, feel free to contact me at thespooniemummy@hotmail.com

When did you last have a smear test? I would love to hear about your experiences, feel free to comment below of you have any advice or questions and I will endeavour to reply to everyone.

A Day In The Life – Flexible Sigmoidoscopy

Happy hump-day one and all.  Apologies for the radio silence but after getting out of hospital and resting and then a big appointment on Monday I have been focusing on my health a little.

Firstly, if you follow me on social media you will have seen that just under two weeks ago I had another incident with my knee locking.  This happens due to the degeneration in the joint and unfortunately ended up in a late night visit to A and E (thanks lovely Dad) and three nights under the care of Ward 205 in the Royal Derby hospital (thanks fab staff).  Knee was once again straightened in theatre and I am being followed up with my fantastic orthopaedic doctor to see what we can do next.

On Monday I was scheduled for a flexible sigmoidoscopy camera test to check out my rectum and remaining large bowel as I have been having some pain, trouble passing the mucous which is normal from the remaining bowel as it is still working and some infrequent, but heavy bleeding from my bottom.  I decided to take you through what happens during one of these tests in another day in the life style as I did for my first Stelara appointment, as I think knowing what happens can be reassuring to those facing similar tests.

Monday 19th February

7.30am Wake up a little later than planned so have to start getting ready straight away.  Ste laughs as I put on make-up – he says you are going to have a camera up your bum, they won’t be looking at your face!  Charming, but he makes me laugh which I am pleased about as I am feeling a little sick and it must be nerves.  I just out the basics on as I am not going to go overboard for the hospital and know I won’t be feeling up to much later.  Today I am having a flexible sigmoidoscopy.

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7.50am Complete nightmare as Ste gets his wire caught on something as he is getting up and rips the needle out of his port.  Run downstairs to grab all the sterile stuff he needs so he can sort himself out.  Need to keep an extra eye on his temperature etc now today, looking for any signs of infection.  Very scary but he is ok apart from being a little sore.

8am Just checked the letter and realise I have to be there for 9.30am not 9am as I first thought so have a little more time than we thought.  Try to eat some breakfast cereal but only manage a couple of mouthfuls due to my nausea.  Take some extra anti sickness.  Because my large bowel is no longer connected to the rest of my digestive system  I have no prior prep for the test to do at home.

9.05am The taxi collects us to take us to hospital.  As I am being sedated I am not allowed to drive home.

9.25am Sign in at the endoscopy unit and we sit and wait.

9.45am  I am called through by a nurse to got through all the paperwork.  He is absolutely lovely and talks about his wife, who also has an ileostomy due to Hirschsprung’s disease.  I then say goodbye to Ste and he goes off for a wander while I am led through to get changed.

10.05am  I get changed into the gorgeous blue shorts (one size, hole in bum area for easy access) and gown, then go through to a little room with a bed and a bathroom attached.

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10.15am Enema time.  To clear the normally occurring mucous out of my rectum and large bowel, I am given an enema.  It is quite painful, which normally isn’t the case.  Within five minutes I am running to the bathroom.  Sitting on the toilet I start to feel very hot and faint.  This is so unpleasant and reminds me of the torturous trips to the bathroom I had prior to my ileostomy.  When I finally get up I see the toilet bowl is full of blood, clots and a couple of large, hard clumps of mucous. I go and lay down for ten minutes and am feeling slightly less faint.  I return to the toilet and check that there is nothing more to come out, get myself decent and call the nurse back.

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I feel terrible!

10.50  I am taken into the scope room by the doctor after he has gone through the consent forms.  These can be pretty scary, with talk of perforating the bowel and infection as possible risks from this type of test.  The risks are very low though, but they have to make you aware of them.  The doctor pops a cannula in the back of my hand (a children’s one as they are small veins) and I lay on my left hand side.  There are three nurses in the room with us and they all introduce themselves.  They use a children’s scope as from previous MRI’s my doctor knows I have strictures, so wants to lessen the risk of pain and the probe getting stuck behind them.  The sedation is put through my cannula and the procedure starts.  It is intensely painful and even with my high pain threshold and the sedation, I struggle to keep my cool.  The doctor is very good and explains that from what he can see, he knows it is sore and is going to go no further.  He asks if he can take some biopsies as if not, I will possibly need to be brought back to do them anyway and I agree and hang on for another couple of minutes.

11.45  I am taken through to recovery and my BP and heart rate is monitored.  I am then given a cup of tea and some biscuits.  Once I have had those I am able to go out to meet back up with Ste and wait for the results.  I just want to reassure anyone having this test that it normally does not hurt, I actually had my last one with no sedation and it was uncomfortable but fine.  The pain I experienced today was due to the problems I am having in that area.

11.55  I go back into the room with the first nurse I saw who confirms I have haemorrhaging proctitis (inflammation of the rectum which is bleeding).  Above this there is normal bowel mucous and when washed away the doctor couldn’t see visible signs of inflammation but it was ‘oozing blood’.  The biopsies were taken to check for microscopic inflammation as well as being taken from the rectum.  The report will be passed to my gastro doctor and once the biopsy results are returned to her, we will see what can be done to sort this.

12.30  A taxi home and I go straight to bed.  I feel completely washed out from the enema, pain and the sedation.

5pm Ste wakes me up and gets me to have something to eat and a drink.  He has been trying to wake me for an hour but I was out for the count!

7pm I go upstairs, have a quick shower and bag change and get back into bed.  Once Ste has showered, he joins me and we both read until we go to sleep.  Cuddling up to him in bed after a long and tough day always make me feel better and I am so grateful for him being there for me today.

Check out this post from Rocking2Stomas about her experience of a flexible sigmoidoscopy ‘Lights, Camera…Oh No Not Again?’