This can't be happening. Not again. Not now.
I sat straight up, sweat dripping from my forehead, startled by what had become a recurring nightmare. I wiped the sleep from my eyes. It's just a dream, I realized as I got out of bed, trying to shake the fear.
It was Friday, April 16, 2004, and that time again. It happened every three months like clockwork, despite my best efforts to ignore it. Most women only make an annual trip to the gynecologist, but not me. As a twenty-nine-year-old cervical cancer survivor, I visited my gynecological oncologist at the change of every season. I hated these appointments—the poking, the prodding. No matter how many times I went, it never got easier. This day marked two years since I had been declared cancer free. I should have been celebrating, but I was actually dreading this appointment even more than usual. My annual exams, like today's, were more extensive than the quarterly checkups. Plus, my doctor took extra precautions, given my cancer history. To treat my cancer, I had opted for a controversial procedure she wouldn't ever have recommended, but now the burden was on her to ensure that my cancer didn't return.
I tried to take my mind off the appointment by focusing on work. I was an assistant district manager for a national retail chain, which is just a polite way of saying district manager-in-training, or as my boss said, "Ain't a district manager yet." I was reading yet another e-mail when I heard the humming of the garage door opening. Mark, my boyfriend of three years, walked in and called up to me, "Honey, I'm home. Are you ready to go?"
"Be right there," I yelled.
"Hurry. We're going to be late!"
I jumped up and raced down the stairs to meet him. "Let me just grab the medicine she prescribed. I'll meet you at the car."
I grabbed the pills and a bottle of water before I headed for the car. As I settled into the passenger seat, Mark asked, "What are those and why are you taking them?"
"One is Lortab for pain, and the other is Valium to help me relax so the procedure will go more smoothly." I added playfully, "That's why you need to drive, mister."
The medicine kicked in about twenty minutes later, as we arrived at the clinic. I reached for Mark's arm and held on as we passed through the doorway. We signed in, sat down, and waited for my name to be called.
Finally, I heard the nurse say, "Michelle Coots?"
Only professional people called me Michelle. My friends and family knew me as Michi, pronounced Mickey, like the mouse.
The nurse directed me to the scale for the usual height and weight measurements. I kicked off my heels and stood against the wall. As usual I measured five feet, seven and a half inches. I always wished I were an inch or two taller, which is why I have to include the half. It's also why I almost always wear heels. I stepped onto the scale: 130 pounds.
The nurse escorted Mark and me into the examination room and continued to take the usual vital statistics. "Dr. C. will be in shortly," she said as she walked out.
I didn't need any instructions; I was a pro and knew the drill. I undressed from the waist down and positioned myself on the examination table with the always flattering white sheet draped over my lower half. The next few minutes seemed like an eternity as I sat half-naked, freezing my buns off, waiting for the doctor. I was beginning to feel like I had downed a bottle of wine. Oh, yeah, the medicine is definitely kicking in now!
When Dr. C. entered the room, she began with the usual battery of questions. "How are you feeling? Has anything changed?" Blah, blah, blah. Then she made her normal plea: "You make me so nervous. I wish you would just get pregnant and let me remove your uterus so we can be sure you're in the clear."
Dr. C. was the third in a string of oncologists that had been in charge of my follow-up care since the dreaded diagnosis two and a half years ago. Each doctor had recommended a hysterectomy, and every time, I had refused. I didn't know if I wanted children, but I knew I was not ready to give up my ability to make that choice. Instead, I had chosen a nontraditional procedure—a radical trachelectomy—to treat the cervical cancer. The doctors had removed a large portion of my cervix, but had left my uterus intact. Dr. C. was not a fan of my chosen course of treatment. She felt the radical trachelectomy was too new, that the overall long-term success rate was too uncertain. This was also the reason my annual checkups involved more than the traditional Pap test. She wanted to track my recovery closely because she was skeptical that my cancer was really gone for good.
"Okay, are you ready, Michelle?"
"Ready as I am going to be," I said, reaching for Mark's hand.
"Slide down a little farther," she instructed, as she made a tent with the white sheet over my knees. Even though I had done this a thousand times, those words always made my stomach queasy. I couldn't think of a more vulnerable or awkward situation than lying with my bare butt exposed to the world, having a near stranger poking around inside my most private and personal spot. Reluctantly, I slid down until I felt the end of the table. I hate this position!
"Okay, this is going to be a little cold and you're going to feel me insert the speculum. Now I am going to open it up. How are you doing?"
"Fine." But not really.
"Okay, I need to numb the area with local anesthetic. Take a deep breath and hold it in. You are going to feel the prick of the needle and a little burning sensation."
As the needle penetrated the base of my uterus, where my cervix used to be, I felt the instant burn of the medicine. I had taken the Lortab, but the pain came anyway. My body tightened, and I clenched Mark's hand as I gasped for another breath.
"Are you still with me?" Dr. C. asked.
"Yeah," I mumbled.
"Remember, deep, slow breaths."
I didn't respond. I was too busy focusing on my breathing so I wouldn't knock her over and flee the room.
"Okay," she said, "two more quick sticks. Now we'll wait a few minutes and give the anesthetic time to take effect."
My head felt fuzzy and my eyes were heavy. Those few minutes felt like hours. Finally Dr. C. checked to ensure that the area inside me was numb. Once she was confident that it was, she proceeded with a wet Pap.
"I want to take an extra step today," she said when she was done with the Pap. "It's called an endocervical curettage, or ECC, and it will help ensure that there's no new cancer present."
She talked me through the procedure as she went, explaining that she was making a small incision at the base of the uterus. Next, she inserted a spoon-shaped tool into the incision. She scraped around the interior walls where the uterus and the upper end of the vaginal canal had been sewn together after my last surgery. I breathed in and gnashed my teeth in a feeble attempt to counter the extreme discomfort. A few blessed moments later, she finished and instructed me to get dressed.
"The results should take about two weeks," she said. "Assuming everything is okay, I shouldn't need to see you for another four months."
An extra month of freedom! I was elated with this news.