by J.L. McKenzie

Created on: January 20, 2007   Last Updated: April 18, 2007

Most women have undergone the yearly rite of passage known as the pelvic exam starting when they became sexually active or when they begin menstruating. Either way, no matter how many you've had, it can still feel uncomfortable and intimidating. Add in a PAP smear that comes back abnormal and you can practically feel your blood pressure rising.

There are a few different reasons for an abnormal, or positive, PAP to come back after a pelvic exam and not all of them leave the threat of cancer looming over your head. I've had two abnormal PAP's in my life so far and the first was the scariest and the most relieving. It turns out that the first PAP showed nothing more than a simple bacterial infection, which is a fact I would have appreciated the nurse to tell me over the phone instead of having me drive like a bat out of hell to the office. The second time I had an abnormal PAP was in December of 2006. The routine at that point is to have a sonogram to check for masses in the uterus or on the ovaries. Then you move on to the coloscopy. If you've never had one before you can get a bit nervous waiting in the exam room, looking around at all the new and interesting equipment you don't usually see during a pelvic and wondering how much of it is going to be used on you.

A coloscopy is a very simple procedure where you are placed in the stirrups and a speculum is inserted. Then the doctor smears a vinegar-like substance on your cervix and uses a microscope viewer and a light source to see if any parts of the cervix become illuminated. This indicates abnormal cells. This is when a biopsy is performed, usually with a scalpel and a pair of surgical scissors. This sounds a lot more scary than it actually is. Try your best to relax and not bend the speculum. You will experience a mild cramping sensation and pinching when the biopsy samples are taken. After they take the samples and you can get up out of the stirups do it slowly. Nausea is not uncommon after having that procedure done and throwing up on your doctor like I almost did is not a way to get into their good books.

Now you wait again for the results of the biopsy. It could show that it wasn't cancer at all. It could show that it was just pre-cancerous cells. Or it could show that you indeed have cancer and your doctor will explain to you what stage you are in. I was to have a LEEP procedure as well as a D and C. The LEEP is a procedure done with a laser to essentially burn off the top layer of your cervix which destroys

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