RAINN and Sexography - pt. 1

O-N-E-L-E-S-S I Wanna Be One Less One Less
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I'll warn you. This first one is a long one, probably because it informs rather a lot of my current sexuality, and this whole month-long blogging theme is sexuality. This entry leads because what is described here has been the foremost informant of my sexuality to now. Please see previous post for context!

Two weeks after I started dating the boy who would become my husband, I got what turned out to be two ingrown hairs... down there. I, of course, promptly freaked out. I high-tailed it with my roommate to the campus Gynecological office. I had my exam ("These are ingrown hairs."), had your basic swabs, just in case, and left, hugging my roommate and probably eating something fatty in celebration on the way home. (Shout-out to Leah, too, who stayed with me the night before my appointment, and even offered to take a look at the problem area because I was so. freaked. out. I said no, only out of pity for her.)

Skip ahead one week, and I got a call from the GYN office telling me I had some BV ("Huh?" "Bacterial vaginosis." "... Oh that's what that feeling is.") that they wanted to treat. Went in ("80% of women get it at some point," and "your bodies are probably just adjusting to one another."), got an antibiotic and went on my merry way.

Two weeks later, I didn't feel any better. Went back in and came out with a different, stronger antibiotic. Got a rash. Still didn't feel better. Went on a third antibiotic. Got pityriasis, which seems a little suspicious in retrospect (there is a theory that it is triggered by the emergence of a virus). Went back in. By this time, my nurse practitioner was getting just about as frustrated as I was, though she was probably suffering from less severe (or no) hypochondria, unlike yours truly. She was poking around on my fourth visit in as many weeks, when all of a sudden I heard, "Huh. I see something just under your cervix." "I didn't know there was an 'under the cervix.'" "Do you mind if I get a colleague of mine in here to take a look?" "Uh... no?"

Skip ahead a few days, and I was having my first colposcopy and vaginal biopsy. What turned out to be two phase III precancerous vaginal lesions and phase II precancerous cervical lesions would have to be removed via a partial vaginectomy (good old fashioned scalpel) and LEEP procedure (a laser surgery). The lesions in my vagina had literally been hiding under the lip of my cervix, making them almost invisible during a routine pelvic exam, and also making a nice little home where bacteria could hide from antibiotics. Not only had the first three visits at NYU's office missed them, but my regular GYN in Atlanta hadn't found them two months before, when they were almost certainly there.

What would have been frightening and shameful on its own I experienced in the beginning of a romantic and sexual relationship. My future husband was with me through three rounds of non-oral antibiotics (ew), two rounds of biopsies (no sex for two weeks afterward), and a shitload of crying and moaning, as well as an HIV test, just for shits and giggles. After all that, there was the surgery one week before his birthday (performed by a gynecological oncologist who is one of the U.S.'s foremost experts on fertility after or during cancer, interestingly enough) and no sex for four weeks after that.

Shall we say that easing back into sex and sexuality both during and after the biopsy and surgical experiences was... thorny? We went through a few fights because I was literally afraid of his penis and what it, or others like it, could do and/or had done to my reproductive system. (Graphic? Yes. True? Also yes.) Once I got used to the idea that maybe sex wouldn't send me to hell, I had never been inhibited, but after this diagnosis, I became semi-frigid. As a 22-year-old guy at the time, I can't blame my future hubby for his occasional, fleeting frustration. His actions as a whole during this string of illness and events (whether it was his penis that caused it or not - LOL - we'll never know) were the first big demonstrations to me that this was a really Good Man. And as all good Southerners know, thanks to Flannery O'Connor, that kind of man is Hard to Find. Obviously, we got through it and it made us stronger. We were married exactly three years, three months and three days after my outpatient surgery. (Though it's not like we planned that...)

I saw my gynecological oncologist for the last time in May 2007, having biopsies on suspicious sites every three to four months up 'til then. I'd like to add, on a personal note, I had to have been one of the least "important" cases my GYN-ONC had, but he always treated me and listened to me as though I were terribly important. After my outpatient surgery, when my mom had to drive me from the Bronx to Manhattan, he gave her his cell and home phone numbers in case we got lost on the way to her hotel (I'm the navigator, between me and my mom, and I was hopped up on morphine) or I needed anything that night.

I finally graduated to a "regular" OB-GYN in October, and I can't tell you how good it felt to hear her say, "Okay, you don't have to see me for a year." (And then to hear her say, "After the stuff you've had to do in the last few years, you deserve a year off.") And I'll admit, only on this, my semi-anonymous blog (although, not, because? how many picture of me are there on here?), that our "maritals" improved since my switch back into the "normal" gynecological world.

This is a long post, and I'll wrap it up with this: What do I wish I had known before heading into all that?

1. I wish I had known more about HPV. I don't consider my pre-Ken self promiscuous, but it never occurred to me and I was never taught that condoms don't give 100% protection against HPV, which is what causes most precancerous conditions of the female reproductive system (except the uterus and ovaries, obviously - think of what comes into contact with someone's skin: that's what's susceptible). And even when you and a long term, monogamous partner have STD tests before you stop using condoms (when the gal is has the Pill or Norplant or an IUD, etc.) that one or both of you may be infected with one or more strains of HPV.

2. I wish I had known that proper nutrition, i.e., not being underweight for a prolonged period of time, could suppress development of such precancerous lesions. (I don't know about genital warts, also an HPV symptom, since I've never presented with them.) Taking care of your immune system in general, and one way is via good nutrition, can also take care of your sexual immune system.

3. I wish I had known that there is no HPV test for men. I have no idea whether it was my husband or my first partner or someone else who passed on the infection that led to precancerous lesions in my body, and probably other women's bodies. At least half of sexually active people will contract HPV during their lives. I can't help but think that part of that high figure is due to the fact that there's no screening for men.

4. Speaking of "at least half," I wish I had known that this disease was so widespread. Part of the sexual inhibition which followed my diagnosis was due to feeling dirty, to feeling like a point of contagion, to feeling, quite frankly, like a slut. Only several months after my surgery did I learn that I have aunts, friends' mothers, friends, cousins and professors who have all had LEEP procedure, cryosurgery and other dysplasia- and lesion-removal procedures as far back as the 1960's.

What do I know now?

1. I know that any daughter I have will be vaccinated against any HPV strain possible.

2. I know that I'll try my best, when necessary, to share my story. Not only so lives can be saved (I probably won't make much of a difference at that), but so that women can feel less isolated in themselves and about their experiences with cervical dysplasia, vaginal lesions, genital warts, or any other symptom of HPV infection and its consequences.

3. I know that no matter what frustrations I get from my husband's behavior about stupid "male" hangups, I never have to doubt his support during the tough times of life. I feel so lucky for knowing that right from the get-go. I already knew the answer to "in sickness and in health," although it was at a non-lethal level.

4. I know that there are moms who read this blog, specifically moms of daughters. Please, please get your daughter vaccinated when she turns nine, or sometime after that when you feel she can handle the truth about what the vaccine prevents. Please don't let her go into her first sexual relationship, whether that's with a boyfriend or with her husband on her wedding night, without protection from a potentially deadly infection that her partner probably doesn't know he has. HPV may not always kill via cervical or vaginal or vulvar cancer, but there's always a chance. Even when it doesn't kill or even threaten life, it can leave all kinds of literal and non-literal scars. Please. Talk to your daughter, and give her the choice to be vaccinated.

Thank you, moms.