Stress and Anxiety Ruled My Life, and I Paid for it with Pieces of My Cervix
*Warning: explicit descriptions of medical procedure ahead*
I’ve been thinking about writing this for a while now, not only to get this information out there, but to help me work through it as well. Earlier this year in March 2019, I had a LEEP (Loop Electrosurgical Excision Procedure). This is an outpatient procedure, done in your gynecologist’s office, where they use a hot looped wire to slice off parts of your cervix that have abnormal cell growth from HPV. It is the gold standard of care for higher level abnormal cell growth on the cervix. I had only heard of this procedure because I work in women’s healthcare — I am a pelvic floor physical therapist. I had seen in my practice a few women who got a LEEP and were never the same afterwards. That’s all I knew about LEEPs when I was told I needed to get one. Needless to say, I was terrified.
I want to tell my story in full, from the beginning, because I want anyone else going through a similar situation to know they are not alone. This isn’t just a story about my LEEP though, it’s a story about my ongoing battle with stress and anxiety.
I’m going to take you back to 2016, when I graduated from Physical Therapy (PT) school. I was the absolute definition of bright-eyed and bushy-tailed. I had landed what seemed to be my dream job right out of PT school. I was going to work in an outpatient women’s health physical therapy clinic helping prenatal and postpartum women. I was ecstatic!
However, the work was hard for many reasons. I saw 2–3 patients an hour, which for women’s health, is a lot. I would get about 20 minutes with each patient and then send them off to work the rest of their hour-long appointment with a PT aide. For me, these 20 minutes were not enough to listen to the patient, address their concerns, think critically about what was going on with them, and provide good treatment. I became a mindless zombie, churning out patient after patient, trying to get through the day without breaking down.
I felt like I wasn’t able to do my job to the best of my ability and was a slave to my schedule. I began to develop much higher anxiety than I had ever felt before. I started having trouble sleeping. I was distant with my boyfriend. I was in a constant state of dread and I never wanted to go to work. But I kept on. I thought, ”This is adult life. I’ll get used to it eventually”.
Fast forward to June 2017. It was time for my annual well-woman visit, which I never missed, even though nothing was ever wrong. Thank goodness for the Type-A in me. I went, got a little pap smear, and went on with my day. I didn’t even think twice about it.
Until, I got a phone call. I saw my OBGYN’s name flash across my phone screen and knew something was up — my doctor NEVER called me. This couldn’t be good.
She said the words in a calm, but emotionless tone, “Anna, your pap results came back abnormal”. I was stunned, I never thought I would ever hear those words. I had never slept around, I was always safe, I was in a very serious relationship with my boyfriend at the time, so what happened? My doctor said we should do something called a colposcopy, which she explained is a biopsy of the cervix of the areas that were abnormal. We scheduled it for the next week. I didn’t ask her any questions.
As soon as I hung up the phone, Googling commenced. “Abnormal cells on cervix”. “HPV”. “Cervical Cancer”. “What to expect during a colposcopy”. I went deep into the rabbit hole.
I tried not to panic. I wasn’t successful.
The next week, I went in for my colposcopy. My doctor explained the procedure very thoroughly. She told me that she was going to take a few samples from my cervix, send it off to the lab and see what type of cells they were. If the cells were a low-level abnormal, we wouldn’t have to do any other procedures because the body can usually heal that type of HPV on its own. If they were higher level abnormal, we would need to do a LEEP to take them out.
The colposcopy felt like my doctor was taking a little tiny hole puncher to my cervix. It wasn’t painful, but it didn’t feel great. The hole-punchy sound was worse than the actual sensation of it. She took 3 or 4 samples, I think. It was very quick.
After she was done, I asked her how this could have happened? I had had the HPV shots and was in a monogamous relationship. She told me HPV can lay dormant for years and she couldn’t be sure how I got it, just that it was very common and my body should be able to heal on its own if it was low level. However, she told me that in order for my body to be able to heal itself, I had to manage my stress better. Stress, she told me, affects the immune system negatively and doesn’t allow it to do its job effectively.
I laughed. I tell my patients this all the time! I see the negative effects stress has on women’s pelvic floor and other muscles, I know about how stress affects the body! Also, how was I not going to be stressed? Quit my job? Please. I brushed it off.
I felt normal again the next day and went back to work. A week later, my doctor called. She said, “They are abnormal cells, but they are low level, they should heal on their own. You have to have pap smears every 6 months until they come back normal”. I was happy! We celebrated! This is great news!
My boyfriend sat me down when he got home that night and got very serious. “I think you should start going to therapy”. Huh. Therapy, for my anxiety and stress. Again, I laughed at myself. It’s what I tell so many of my patients, and I never thought to do it myself. I didn’t think I needed it.
So, I went to therapy for the first time. I felt INCREDIBLE. Wow, an objective person to listen to me and help me work through why I was feeling so anxious and stressed. Someone to validate my feelings. Someone who could sympathize with me, but then give me strategies to help me get through it.
I will never forget my first therapist because she helped me realize that I needed to leave my job. The things that were creating my stress and anxiety were things that could not be changed. I had to make the change myself.
In August 2018 I decided, wisely or unwisely, that I would leave my job, get married, and start my new business, all basically at the same time. Hey, if you’re going to take the leap, might as well take all the leaps!
I left my job and felt almost instantaneously that a weight had been lifted off my shoulders. I was good now, so I thought. I was happy, newly married, and just sort of stopped going to therapy. I was fine! Right?
Things with my health were going well. I had been getting pap smears every 6 months, and it seemed like my cervix was starting to heal itself. I had been told it could take a year or two to heal all the way. I also had time to exercise, was sleeping (slightly) better, and I was starting a new business. Things were going great!
Until February 2019. I had gone in for another pap and was feeling confident. It was getting close to the two year mark when things should be all the way healed! Then I got the call…again.
“Anna, your pap results are abnormal again. We should do another colposcopy”.
No! I thought my body was healing itself! I thought I wasn’t stressed anymore after leaving my job! I was angry.
I was angry because I thought I had been doing better with my stress and anxiety. I was angry because I had no way of knowing what was happening in my own body. I was angry because I didn’t want more holes poked in my cervix.
I downplayed it. I was running my own business! I didn’t have time to take a whole day off for this stupid coloposcopy. And besides, last time I had one, it wasn’t that big of a deal. I’d just suck it up. I scheduled my colposcopy between two patients. “No problem,” I thought, “I’ll be fine. I’ll get the colposcopy done and be ready 30 minutes later to see a patient.” Hah. I was so wrong.
The colposcopy was worse the second time. I fucking FELT it. I mean, this was a deep pain I can’t really describe. I was also sad. It felt like my cervix was hurting because it had already had holes punched in it. I was imagining my poor little cervix to look like Swiss cheese at this point. I was crampy, I bled a little. I cried as soon as I got in my car and thought “I can’t see a patient right now”. If I was going to cancel, I needed to call her ASAP because she was probably already on her way. I tried to gather myself as much as possible and called her. With an obviously tearful voice, I tried to explain to her that I had just had a procedure done and didn’t think it was going to affect me this much, but that I had to cancel our appointment. Fortunately, this patient was very understanding, but I felt horrible for having to cancel last minute on her. So, on top of the pain and sadness I was feeling, I also felt guilty for having to cancel a patient like that.
I was beside myself. Why was this one so much worse? What does that mean for my body? Is my cervix ruined? Is it riddled with cancer? Am I going to die? Am I going to be able to have children? My mind went to all the worst places.
I felt better the next day and tried to forget about it. Tried not to cringe every time my phone rang. Tried to focus on the positive things. Tried to let go of my control issues and let my doctor handle things.
Then she called.
“Anna, the cells are abnormal, but are at a higher level than they were before. We need to do a LEEP as soon as possible. A LEEP is an outpatient procedure, I’ll numb the area locally, then take out some small pieces of your cervix that show abnormal growth. You’ll want someone to drive you home after just to be safe. You’ll be on pelvic rest for 6 weeks. I’ll have my nurse schedule you now”.
Fighting back tears.
The nurse came on the line to schedule my appointment. “Uh next week at 10am? Um, sure. Thank you” Click. What just happened.
More Googling ensued. LEEP. Side effects: high chance of miscarriage, early labor, and cerclage, pain, bleeding.
Again, my experience as a pelvic floor PT was not helping me at this point. I had seen at least one patient who had experienced severe pelvic pain after her LEEP. I had also seen several patients who had a cerclage (stitch in their cervix to help keep it closed during pregnancy) and who had to be on strict bed rest for their entire pregnancy. High risk for miscarriages. These images swirled around in my brain and I just kept imagining the worst possible scenario. I felt like I simultaneously knew too much and nothing at all at the same time.
My husband took the day off of work to take me to this appointment. He sat in the waiting room with me and held my hand. I was trying really hard not to cry, I think I looked like a zombie. I was called back. I probably scared all the lovely pregnant ladies who were also in the waiting room with my red eyes and dead face. I felt horrible.
The doctor and the nurse were in there. My doctor explained to me clearly what she would be doing. They were both so very nice to me.
*Warning: very detailed description of my LEEP ahead. If you are squeamish or affected by the idea of this, skip to the end.*
I laid on my back with my feet in the stirrups. My doctor explained to me that she would have to use a larger speculum in order for the LEEP tool to fit in there. She had trouble getting it to stay in because my pelvic floor muscles were clenching. She told me to relax. I laughed, “so this is what it feels like to my patients”. I was proud of myself in that moment for being able to relax my pelvic floor on cue, but that feeling wore off pretty quick.
Since I don’t have any pelvic floor issues, a normal speculum feels slightly uncomfortable, but not terrible. This demon speculum was different. Holy shit. I felt like my vagina was going to tear open. 10 minutes she said, easy peasy.
My doctor said she was going to inject a little lidocaine to a few spots around the cervix, I shouldn’t feel much, just little pinches. I hate needles. I’ve been known to pass out from getting shots or getting blood work done. I tried to take deep breaths and not look at the needle. Pinch, pinch, pinch. “Huh, I guess that wasn’t bad…” But then I started to feel my heart RACING, I was sweating, I was hyperventilating. I was trying to breath deeply to make it go away. My head was hurting. I think I felt kind of nauseous. I wanted to tell my doctor but didn’t feel like I could open my mouth to say words. I was petrified. It felt like an entire eternity passed before the feeling was gone. What just happened? My doctor told me to keep taking deep breaths and that I was doing such a good job. That was just the lidocaine.
She was now painting my cervix with some sort of solution that would light up the abnormal growth areas. This was not painful. I was going to be ok. I was going to be ok.
My doctor informed me there were a few areas she would need to take out. I don’t remember how many exactly, but I think there were three. I nodded or agreed or whatever I could muster at the time. She instructed the nurse to hold this little metal panel flush against my leg, I’m not sure what that was for, but it was attached to the actual tool she’d be using. She told me there would be a loud sound like a vacuum and then a suction sound while she was doing the procedure, this was normal, just the sound the machine makes. She also told me to stay completely still during the procedure and turned on the machine. It was LOUD.
I was now grateful for the nurse holding that little metal thing to my leg, it felt like she was supporting me. I looked up at the ceiling and tried my hardest to be completely still.
And just like that, it happened. Just a “zerp” sound, suction, and a piece of my cervix was dropped into a container. It smelled like burning flesh. I guess it didn’t hurt, per se, but I got a very deep, very weird sensation instead.
She went again. Zerp. Suction. Burnt smell. I looked. Why did I look? The piece of cervix that was dropped into that container was FUCKING HUGE. Looking at a sizeable chunk of me floating in a container made me feel nauseous. She told me she would just be taking off a few top layers of cells from my cervix! That did not look like just a few layers of cells. All I wanted was for it to be over.
Zerp. She painted my cervix again to check that she got everything. She did. It was over. The loud vacuum sound stopped.
My doctor instructed me to keep laying down for a while. I suddenly felt awkward and exposed with my feet still in stirrups so I sat up. I felt lightheaded. I probably shouldn’t have sat up. My doctor explained to me everything that I could expect to happen over the next few weeks. I could expect some discharge that looked like either mustard or coffee grounds. Gross. I was not to exercise or do anything strenuous. If I started cramping or bleeding, I was to stop doing that activity immediately and come back in. I was on complete pelvic rest — no sex, no tampons. I cringed and thought, “I’m going to have to use pads again like a middle schooler.”
I choked out one question, “what is the chance I’ll have to do a LEEP again?”
She said there was a small chance, but that she usually is able to get everything in the first go around.
I felt some relief. More questions came flooding into my head
“Will I have to get a cerclage if I get pregnant? And what about these rates of miscarriages?”
She answered, “What we’ll do if/when you get pregnant is do a cervical check at 12 weeks. If it looks like your cervix is doing ok, then we leave it alone. IF it looks like it’s struggling, we’ll just throw a little stitch in there to help it. But don’t worry about that now. Let’s focus on letting your body heal first.”
Pfft. Telling ME, the world-class worrier, not to worry about something. Please.
I wanted to get the hell out of there.
“Come back and see me in 3 weeks please so we can check on how it’s healing.”
I walked slowly up to the front desk. I barely kept it together as I made eye contact with my husband. I choked out the words, “she wants me to come back in 3 weeks” to the front desk lady. This proved to be challenging for some reason, I don’t remember why, I just remember having to stand there, holding back tears for several minutes while I waited to schedule this stupid appointment. Finally, I put the appointment in my phone. I told the front desk lady to have a good day.
I took my husband’s arm and we walked slowly out. I couldn’t stop the tears from running down my face as soon as we were outside the door. I put my sunglasses on so the parking attendants wouldn’t see me crying.
As soon as I got in the car, I lost it. I felt, for lack of a better word, empty. I felt like someone had taken something from me. I felt sad. I felt really sad. We got home. My lovely husband ordered me some food. I scarfed it down and fell asleep.
I wore huge pads for basically 6 weeks straight. Discharge that LITERALLY looked like mustard and coffee grounds mixed together came out of me in large amounts the first couple weeks. It was pretty alarming.
In the following weeks after my procedure, I continued to feel emptiness. Maybe I was depressed. I couldn’t be sure. I was definitely not right. I can’t explain the feeling other than saying I felt like a part of me had been taken out of my body, which it had been. But like why did I care so much? I couldn’t snap out of it.
I searched the internet for other women having the same reaction to LEEPs that I was having and found a couple articles that were helpful, but everything else out there just talked about how LEEPs are the gold standard and how there weren’t really any side effects. I did feel better when I read those other articles about these women’s experiences with their LEEP, but I was also angry that women weren’t being told that they could feel sad or could have painful sex afterward. I tried to logic my way out of the funk. Telling myself I shouldn’t be sad — the bad cells are gone! I should be happy!
But this wasn’t a sadness I could control. It just lingered. And lingered. And lingered.
It lingered past my 3 week check up with my doc. “It’s healing BEAUTIFULLY” she exclaimed. Great. Come back in 3 more weeks.
It lingered past my 6 week check up. “You are all in the clear. We got clear margins, it’s all out and it healed great! You can exercise and have sex again”. Awesome.
I had no libido. I didn’t have energy. Resuming exercise seemed like an impossible task. I felt…empty, hollow, like somehow I wasn’t a woman anymore because pieces of my cervix had been taken out. Then I felt stupid and dramatic for feeling that way. This procedure is so common, other women have gotten LEEPs before and are doing just fine. Suck it up, Anna, and get over yourself.
It finally dawned on me weeks later. I need to go to therapy again. Why didn’t I think of that sooner? For the second time, I hadn’t realized that I needed therapy when it should have been so obvious.
I found a new therapist who practiced closer to my house. Therapy has been a godsend (again). My therapist specializes in mindfulness-based therapy which basically means I have to learn to acknowledge when something is stressful or anxiety-causing and just let it be there without it affecting me. It’s hard. But it’s easier than living while constantly playing tug-o-war with my anxiety (and losing).
I can’t pinpoint exactly when, but I started to feel like a person again. I don’t know whether that was just my body healing more over time or the therapy or some combination of both — I don’t really care, just as long as it happened.
I had sex again with my husband. The first couple times were, yeah, uncomfortable. I worried it would be like that forever. It wasn’t. I was fortunate in that way. I know from seeing patients in my clinic and from reading other women’s accounts online that sometimes sex stays painful afterwards. (quick note: if sex is painful for you after LEEP, please go see a pelvic floor physical therapist! We are specialized in treating painful sex and we don’t want you to live like that forever!)
I started exercising again. It was hard. I kept at it. I had gained a few pounds since not being able to work out for 6 weeks and to be honest, I still haven’t really lost them.
I’m still worried about what my pap smear is going to say when I get checked again in October. I’m still worried about having to get another LEEP. I’m still worried about my potential future pregnancy. Getting a LEEP was a big deal for me and continues to weigh on my mind. But I feel like I’m as back to normal as I’m going to get and I’m grateful for that.
This was my journey. Everyone’s is different. I wanted to tell my story so that any other woman who felt lost and confused about her LEEP could hopefully find this on the internet and know she’s not alone.
The LEEP is the gold standard for abnormal cervical cells — so please, have one if that’s what your doctor tells you is necessary. You do not want to mess around with cervical cancer, ladies. You just don’t. But just know that there are side effects that may occur. Side effects your doctor may not tell you about. Side effects like low libido, painful sex, feeling depressed, feeling empty, and more and that you are not the only one feeling these things, even if your doctor doesn’t necessarily acknowledge them.
And also, please please please pay attention when your healthcare provider talks to you about stress. The effects stress has on the body are many and they are serious. Find what works for you. I will probably have to go to therapy for the rest of my life to manage my stress and anxiety — I’ve (finally) come to terms with that. Exercising regularly also helps me. But learn from my mistakes. I have no medical or scientific way of proving this, but I just have a feeling that if I had taken steps earlier to manage my stress and anxiety, my body could have been able to fight off the infection on its own. So I guess all I’m saying is, take care of yourself, really. You are worth it.
Links to other helpful articles:
(note: I couldn’t find the one article that had really helped validate my emotional side effects, I will keep looking!)