Dear Editor,
At the age of 29, I sit here five weeks post radical hysterectomy; after having been diagnosed with Stage 1B1 cervical cancer. I’ve just celebrated my third wedding anniversary, and our (my husband’s and I) next step was to start a family.
Let’s start from the beginning. In 2009/2010, or thereabout, I visited a “private” gynaecologist with the complaint of irregular periods – once every 3-4 months, as far as memory serves. I was then gently informed that I had what is called ‘Imbalanced Hormones’ and was written a prescription for Mircogynon (an oral birth control pill).
It sounded odd, as I wasn’t told how contraceptives were going to help me with this kind of issue. However, I accepted and left, because I “paid” and expected him to know what he was doing. It worked! I was happy. I felt normal again. Should I have researched this for myself? Definitely!!! I can make all the excuses why I didn’t, but it worked for what I needed it to, I didn’t see the need. (Please, someone use my experience to not be as naive as I was).
Should he have advised on a time limit to this and possible side effects, including the use of those kinds of pills in excess of five years doubles my chances of developing cervical cancer? (And not limited to) YES!!! Not educated in the slightest way. Of course I blame myself for not knowing nor asking questions. I used the pills for approximately 8-9 years.
Which takes me to my next doctor’s visit. In 2017 (a pretty long gap – but Guyanese don’t visit the doctor unless something is wrong, right?), while still taking the pills, my period came twice in one month. That confused me a bit since the birth control pills are meant to regulate your cycle (as I now understood). I went to the pharmacist and asked for something to stop the bleeding. Thankfully, she advised me to go do an ultrasound instead, to ensure it wasn’t the cause of something more serious.
I subsequently visited Eureka to have my ultrasound done, and found out I had a condition known as PCOS – polycystic ovarian syndrome – where you ovulate a lot less (perhaps this is what caused the imbalanced hormones in the first place? Right. Should doctor number one have picked this up in some way?). Upon advice at home, I sought a second opinion. Of course I’m going to go to a private doctor, this sounds serious! ‘Perhaps I’ll go to a female, I’ll feel more comfortable and they’ll be gentle… but who? I’ll find someone.’
I remember thinking. Here we are at doctor number two, who took me off of the birth control pills and told me to return when my period does. That’s it? I just paid to hear you say come back, whenever? I already don’t like you.
I bounced in there three months after, all happy that progress was made, only to be sent to do all sorts of blood tests and ultrasounds – this was not cheap, but necessary, I reminded myself. But, she didn’t do anything! Did she have to? I suppose not, she’s supposed to know what she’s doing, I’m paying her to. I did all that was required of me, to come back to the conclusion that I had PCOS. (Through no simple way, as I felt as if I was an animal, the way she spoke and interacted) I was placed on Metformin – a known diabetic medication, Metformin likely plays its role in improving ovulation induction in women with PCOS through a variety of actions, including reducing insulin levels and altering the effect of insulin on ovarian androgen. (I only know this because this time I researched). So, I’ve accepted that when I’m ready to have a child, it won’t be easy, I knew that much. I walked away with my meds but with no deadline on when to quit these (guess I haven’t learned my lesson –don’t be like me, ask questions! As many as you feel the need to!) No insight to know whether or not they’re going to work.
My cycle became regular with the use of Metformin, I was happy again. I knew I wasn’t going to go back to doctor number two, the one with the bad attitude and negative vibes. I don’t need that kind of person in my life, definitely not as a doctor, not for something so personal and sensitive.
I lost weight, I ate better, and I used my meds. It was time my husband and I thought of starting a family. I needed a gynaecologist I was comfortable with, happy with. I was out of options, as you hear horror stories when you ask for opinions.
Which takes me to my next doctor’s visit. In May 2018 (still using metformin), after my birthday, I decided to find myself a doctor, seriously this time. I wasn’t getting younger. My cousin recommended her gynaecologist to me, said she was pleased with him during her pregnancy. I have never heard of him, which predominantly influenced the decision of giving him a try.
Day one, I explained my known history to him, and I told him I was there to see if the PCOS was gone, and wondered what my next step was for starting a family (other than the obvious). He advised the discontinuation of the Metformin, and encouraged weight loss. “You’ll ovulate on your own if you lose 10% of your weight.” That’s it? Was it always as simple and non-toxic as that? I was instructed to get undressed behind the wall, for a physical examination. But why? I did. At that point, I was asked one question: “have you ever done a pap smear?” Answer: “No.” He didn’t seem too pleased… I didn’t think I needed to, my sisters are fine, my mother is fine, naturally, and I’m fine. Right? Unfortunately, no.
Upon visual observation, I was told that I had a mass in my cervix and he wanted to do a biopsy to ensure it was non-cancerous. He did say I didn’t have to take his word for it, that I should get a second opinion if I wanted to. Prior to that, I was instructed to return with my husband to discuss this before making arrangements to have a biopsy done. But why? None of the doctors cared whether or not I was there for consultation alone. I guess I finally found someone who cared about a little more than money. Within the following week, the biopsy was performed, and the results were out the next. My husband and I returned to the doctor number three – the God-sent one.
Unfortunately, it’s what we feared – cancer. He advised me of all the possible treatments and operations but admitted that he needed to hand the case over to the oncology department at GPHC, as it was then a case he no longer had control over.
As my husband and I were clueless as to our whereabouts at GPHC, my God-sent gynaecologist volunteered meeting the oncologist gynaecologist with us, (Did he have to care? He no longer had to see me), the one whose care I’d now be in.
After reviewing all tests and results, I was again physically examined. I was sent to do blood tests, a chest x-ray, and a CT scan; to determine whether the cancer had spread, and size of the tumour.
Thankfully, it had not metastasised and was just confined to the cervix – early, but not that early to avoid what had to happen next. I was advised I’d have to have a radical hysterectomy done (a surgical operation done to treat some cancers of the cervix. The surgeon takes out the uterus and the ligaments (tissue fibres) that hold it in place. The cervix and an inch or 2 of the vagina around the cervix are also removed).“But, can’t we take the cervix out and try to have a child, and then we do the hysterectomy?” I asked. I was told this was possible but if I did, and needed radiation after, I’ll no longer be fertile. So, you’re saying I’ll never get to see what my child would have looked like?? Sadly, yes…
The surgery was done successfully. Though I hate to admit it, I was impressed at how everything was handled at the GPHC and the quality of the doctors, and their service. It was a lot of waiting around, but there was progress. The nurses and their attitude however, not so much… but I get it, understaffed and overworked – it’s still no excuse.
While during my recovery still in hospital, my god-sent gynaecologist visited me!!You remembered! You mean there are some nice persons left? I too am shocked by this. As sad as the outcome is, he came into my life at the right time and literally saved my life. What if I wasn’t considering having a child, and just living without a yearly check-up at the gynaecologist unless something was wrong?
Ladies, use my life-threatening scenario, to avoid this happening to you. Ask as many questions as you need to. There are no stupid questions. If you don’t know what to ask, suggest some close relative or friend to go to your doctor’s visit with you.
Most women don’t know the dangers of cervical cancer or the importance of a yearly gynaecological exam (I sincerely did not). That’s why it’s important to share this message. Yearly exams lead to early detection that saves lives!
Yours faithfully,
(Name and address provided)
