Saturday, April 07, 2007

More Drama! Of a Non-Sexy Sort, Though.

I went to the doctor today for a “consult.” That is, for the results of my colposcopy (cervical biopsy).

I was sitting in the exam room, reading Elle, when Dr. Smith burst in: “This is the exact same thing that I told the other women I just saw; I should have just made a recording,” Dr. Smith said by way of greeting.

What? But I didn’t get a chance to ask because she plowed on: “Now what you have is a mild dysplasia. There are a few levels: mild, moderate, and severe. And cancer,” she added after a moment.

She handed me a piece of paper. After the words moderate dysplasia and severe dysplasia read the words carcinoma in situ. Carcinoma. But OK, that wasn’t me. I was Mild. Right.

I hadn’t expected the colposcopy would find anything at all, as a matter of fact. Mild dysplasia? This was a surprise. “All this means is that you should have a Pap smear every three months, we just want to monitor you,” said the doctor. “Are you in a committed relationship with someone you’re absolutely sure you’re going to marry?”

I thought about my rather hectic social life. “Um, no…”

“You should think about getting Gardasil.”

Gardasil is the Human Papilloma Virus (HPV) vaccine, recently approved by the FDA. According to Web MD, (among others, no doubt), some types of HPV are now thought to be responsible for the majority of cervical cancers. “How old are you?”

“I’m 33 – aren’t I too old…?”

“It doesn’t mean the vaccine won’t benefit you,” Dr Smith lectured. “Only that you’re not in the age group that the drug can be advertised to. There’s no reason that the vaccine wouldn’t be effective. But because it’s off label [meaning she could legally prescribe it for me, but the FDA had not approved the drug for someone in my situation – that situation being that I am 33], I doubt your insurance will cover it. Here--”

She handed me a form letter titled HPV Facts. The vaccine, which consists of three shots, was $450! Good grief.

I don’t really have $450. Then I had a thought: My mother! Surely the words mild dysplasia –a bona fide condition, however non-threatening, ought to leech a little sympathy out of her. She would loan me the money. I relaxed.

Then when I got home I looked up dysplasia on the Internet, possibly not the most reliable of sources. Again, according to
Web MD, dysplasia is the appearance of “not normal” cells in the cervix, which can lead to the growth of cancer cells. Ooooh.And it turns out that most dysplasia is indeed caused by HPV, which, according to Dr. Smith, I should get the vaccine for. So am I someone with mild dysplasia but no HPV infection? Or does she mean I should get the vaccine when my dysplasia clears up on its own, as it sometimes does? I will have to look into this. And call my insurance company. Not to mention borrow $450 from my mother, which means I will have to bring up the topic of sex with her. The very idea makes me cringe. Even now, if I am watching TV at my parents’ place and my dad enters the room during a sex scene, I want to hide behind the sofa. “I’m too old for this,” my dad will announce jovially, and I will squirm. When, my sister, who at the time had been married for over two years, announced that she was pregnant, I thought, “This means Mom and Dad will know she has sex! Ack!”

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