Have a talk with the gyno. They’re the ones who know their way around the lady parts. It was my gyno who did the biopsy.
If you’re not satisfied, don’t just take any doc’s word for it because they’re the doc. Ask lots of questions, and get answers that satisfy YOU.
BTW, the biopsy isn’t painful enough and doesn’t last long enough to justify any anesthesia, even local. At least that was my experience.
Thanks, ThelmaLou! You’re right, I really wasn’t comfortable with the info I’d received, so I’m glad I pushed for the call-back.
…Especially since now I’ve heard from the current head gyno on call (mine isn’t in today) and turns out, the admin had given me mixed up info. The colposcopy/procedures are still on the menu–the doc just wanted to change the day, because as I think I mentioned earlier, Mondays are the days they do their “colposcopy clinic” and my doc felt that this would result in a long and unnecessary wait.
So that makes me feel better (sorta). While I’m disappointed that I can’t just get this over with on Monday, I’m also glad that the clinic’s still doing a thorough job in checking me out.
Good for you. 
I honestly have a low tolerance for pain. I’m always the patient who needs extra novocaine at the dentist, etc. I would imagine that it’s not always necessary, and I would have endured without it, but when given the choice, I took the doc up on lidocaine. It came in the form of a needle directly into my lady bits, which was horrifying enough, but it made the rest of the procedure more comfortable.
Because I’m sure everyone’s on tenterhooks waiting for info on my girly bits, here’s the latest update. Warning, more TMI, slightly icky, but c’mon, if you’ve read this far, you know this isn’t about cotton candy and rainbows.
So I went in for the procedure on Tuesday, which was supposed to be a colposcopy, a cervical biopsy, an endocervical curettage, and an endometrial biopsy. But when I got there, I was told that they weren’t able to do the colposcopy after all–they only do that on Mondays. (To refresh your memory, the clinic folks were the ones who’d cancelled on me back in early January, telling me that it was better for me to do it not during their “colposcopy clinic” Mondays. Like, get it together, people!!!)
Anyway, the doc said she was able to do the curettage (ECC) and the endometrial biopsy (EMB), they’d just reschedule the colposcopy for the next clinic date. I was annoyed because I’m tired of the miscommunications and I just want to get everything taken care of at once.
Both my sisters went with me, btw, but just one was in the room during the procedures. Lucky her! I chose the one who hadn’t been there for the sonogram. (She got the worse deal… the sonogram was nice and clean; this was… not.)
I was very uneasy about the whole thing and regretting not having chosen the conscious sedative (twilight) option. I’d taken two ibuprofen the day before, and three an hour before my appointment, plus 3mg of Ativan.
(“Funny” thing: like the total nimrod I am, I ran out of my regular prescription of Xanax that very day because I’d been so distracted about this whole thing that I’d forgotten to get a refill. So I had to double up on Ativan–for me, 1 Ativan is equivalent to only 1/2 Xanax–and take an extra to actually get some calming effect. I should mention that Ativan is only my “In Case of Emergency” drug, while Xanax is a regular med for panic disorder.)
Anyhoo. If the 600mg of ibuprofen helped, that was scary, because HOLY SHIT that mofo speculum and the dilating the cervix were unbelievably painful. Especially when the doc had to turn it to navigate a bit… I broke out into a sweat, lemme tell you, and felt like groaning but didn’t because I’m shy like that. That’s when my sister rushed over to stand over me and pat my hair. I guess that’s the closest I’ll ever come to a labor-like experience. (Which is probably why this was as painful as it was… apparently those of us who haven’t had kids have less flexible cervixes… not surprisingly.)
About four minutes in, the doc said: “Okaaay, I see a polyp here that’s either inside your cervix or peeking out from the end of your uterus.” This took me aback, since neither my pap test nor the ultrasound saw any polyp. Doc said she’d need to get a piece of it out for testing, of course, so it meant more poking around. I was barely able to speak at this point but just sorta grunted an “okay.”
Note: The doc and her assistant were very nice, btw. They kept telling me how amazing I was doing and that they could tell I was in pain but was being calmer than 95% of the other women they see. I have a feeling they use that line on everyone–probably a trick of the trade to boost confidence!–but it was nice to hear anyway. 
They congratulated me afterward too, saying I was really cooperative and so on. I half expected them to give me a lollipop!
What really astonished me was that the pain level (I’d put it at an 8 / 10, maybe lessening to a 7 as I got more used to it) remained pretty much status quo even though I kept expecting a tearing or ripping feeling (when they removed the polyp section), a scraping feeling (during the curettage) and another tear during the EMB. But nope–after about ten minutes of the same type of pain, the doc suddenly said “Okay, cough” and thanks to some pretty good diaphragm muscles (hey, I used to be a singer) I pretty much shot the speculum out of me through brute force.
And that was it. I asked, bewildered, “Wait… you mean you did the ECC and the EMB already?!” Doc was all, “Yup!” So weird, I totally felt none of it. I guess I was so concentrated on the speculum pain that nothing else registered.
I just lay there for a few minutes to get my bearings while they cleaned me up a tiny bit. (Sorry to be even more TMI than this whole post has been, but the floor looked like a friggin’ crime scene. I think all the blood I hadn’t shed during my five-month “no period” period decided to come out and say hi.)
Doc said she thinks she got a good sampling of the endometrium as well as the polyp–which she thinks might have been responsible for what had appeared to be thickening of the endometrial lining. Also she said what she saw of the cervix looked normal and while I have the appointment for the colposcopy, it might not be necessary.
I’m having no bad effects a couple days later, although I did sleep most of yesterday (sheer emotional exhaustion) and am still bleeding a bit, nothing out of the ordinary for a regular period. I was slightly sore for maybe a half-hour after the procedure, but not even to the point where I felt I needed to take ibuprofen or anything. No discomfort since.
So “all” that’s left is for me to wait for the biopsy results, which my doc expects by late next week. I’m hoping for the best, especially since if the polyp was reaching from the uterus to the cervix, that might explain the AGC (I think?) and most polyps are benign. I think the highest likelihood I’ve seen is 5%, for post-menopausal women w/abnormal uterine bleeding. But there’s still the endo lining to worry about. And the cervix, after the colposcopy. (Cervical cancer odds for me are very low, but not nonexistent.)
Oh… and I guess even if the polyp is benign, they’ll want to remove it, which will be a proper operation (hopeful with sedative rather than general). But we’ll cross that bridge if we get to it… first gotta deal with the anxious waiting for the results.
I know the way I’ve described this clinic it sounds like it’s run by idiots, but aside from the scheduling oddities and communication mishaps (which I’m willing to cop to a 20% possibility were my misunderstanding), the doctors, nurse practitioners and assistants have all been amazing.
Okay that’s the latest and longest update yet. Until I get the biopsy results. For anyone who may be reading this and is wondering whether this stuff is painful… well, two folks here called it nothing more than a thirty-second pinch, mazel tov to them. For me, it was decidedly way the hell more than a pinch, and it lasted a good 10 minutes–but bear in mind that for me it was the speculum that was the issue, together with the dilation of my barren, under-utilized, stiff old cervix. If you don’t have issues with pap tests, and if you’ve had kids, I’m guessing things would be much easier.
If anyone thinks of questions that I should be asking at this point, or information I should find out, please do let me know. I’d be grateful to hear any advice! Other than trying not to obsess during the wait. Thanks again for everyone and sorry for the blood stuff. And big big thanks yet again to everyone for helping me through this process thus far.
Thanks for the informative update! Wishing you the best results.
As far as waiting for biopsy results goes - usual pathology turnaround for “routine” ECC/EMB specimens is 24 hours, so there likely isn’t any good reason for telling choie that the biopsy report won’t be available until “late next week”. Patients in my experience often get told things like that by their doc’s office, either on the off chance that some special testing or consultation might be needed that would delay matters, or because “late next week” is when the patient’s next office visit is scheduled, or maybe because they can’t be arsed to process the report for the patient in a timely manner.
Anyway, if you don’t want to wait, raise a little hell and you should get your results this week.
Continued best wishes.
EEK! Glad (for you) that that part is over.
I had uterine polyps removed last year, and it was under full, general anesthesia. Wouldn’t have it any other way. I had had trouble with anesthesia when I had the lumpectomy, and acting on SDMB advice, I went into this one telling everyone/anyone who would listen (including the janitor and the snack bar people). So the anesthesiologist put a patch behind my ear and the anesthesia was no problem.
51 years?:smack:
::::cringing::::: here at the experience of having all that done in-office without sedation. I was having some oddball bleeding issues in my early 30s, and the doctor tried to do an endometrial biopsy in the office, but was unable to. I already had a D&C scheduled for a couple weeks later so that solved that problem.
I too was nulliparous at that point, which I’m sure didn’t help.
I’m glad to hear that things seem to be OK overall. Hopefully if they do want to remove the polyp it can be done just as part of a sedation procedure.
Best wishes. Things like this usually turn out okay. Way too early to worry about it.
Bet you’re glad THAT’S over! Keep us posted.
Thanks everyone, as always, for your good wishes, shared experiences and knowledge.
The doc called me yesterday with the results, which were a mixed bag–something I knew in my gut the longer it took for her to get to the point. After all, telling me, “All the biopsies and labs came back benign” takes about three seconds.
Faster than she told me: The endoceverical curettage and polyp were benign; the endometrial biopsy came back as complex hyperplasia without atypia. While this is better than with “atypia,” by which they mean “cells that are fucked up and are precancerous,” it still is problematic and I need more follow-up investigation.
Mainly because, as I’m sure the more experienced here already know, endometrial biopsies only suck out a few spots of the lining. It’s possible and not at all unheard of for there to be atypical or even actual cancerous cells hidden farther up or just elsewhere in the endometrium.
So the next step is surgery: a hysteroscopy and D&C. They’ll also perform the colposcopy at the same time, and while they’re at it, depending on my consultation with yet another frickin’ gyno next week, an IUD implantation. The latter is recommended to fix the issue behind the hyperplasia: too much damn estrogen.
(Gotta admit there’s some extreme irony in having what most people use as a birth control device at my age, especially since my never having kids was one of my several risk factors for hyperplasia in the first place. Kinda like how not breastfeeding is a risk factor for breast cancer. At dark times like this I really feel like a failure of a woman.)
The possible results, as I understand them:
This levels the playing field against my abundance of estrogen and helps reduce the hyperplasia as the cycle normalizes and sheds the excess lining the way it should’ve done all along.
Then I’d be on a “watch carefully” regimen, meaning biopsies every six months to see if the hyperplasia regresses as it should, or whether things stay the same or worsen. The aim is to have two negative biopsies in a row, which would then put me on an annual biopsy schedule. Yay.
The more aggressive treatment is, of course, hysterectomy–just yank that shit out altogether.
If, on the other hand, they do find atypia after all, that puts me in the precancerous territory and strongly indicates a hysterectomy is in order. Some people go with hormone treatment and ‘watch & wait’ but given the significantly increased risk for cancer I wouldn’t dare do that. Something like 25% of the time, turns out there’s cancer anyway that still wasn’t found but is only discovered after the hysterectomy.
If they find cancer, I’d obviously get a hysterectomy and likely more of the fun cancer-related treatments as deemed necessary.
So there’s the news. This is depressing as hell. At every stage things have been worse than expected, so I’m frankly expecting the D&C to show up with atypia or worse. I don’t know what percentage of subsequent results do show that the first biopsy was wrong, but I’m betting the odds are against me.
Honestly at this point I’m going to ask my gyno if I should just get a hysterectomy anyway, even without the D&C. Why not just get rid of everything that I’m not using? Was never any earthly good to me anyway. I’d probably want to do a whole shebang–ovaries too–because why hang around waiting for that shoe to drop?
Anyway that’s the latest. I’m feeling kinda pessimistic just in case it wasn’t kinda clear. Trying to figure out my options. Thanks again for your help everyone.