Sunday, 15 June 2008


My ears have been blocked twice this year, once at Christmas, when I managed to unblock them myself with a bottle of Ear-ex; the second time in March, when they were affecting my singing so badly, I decided to go and have them syringed professionally. The nurse who unblocked them was the same nurse who did the Well Woman clinic; and she reminded me that it had been 8 years since I had last been in for a Pap smear. So, duly chastened, I booked myself in for one of those a week later.

To cut a long story short, it came back 'borderline' which, in the normal course of events (i.e had I not had breast cancer), it would have merely been reported but not investigated, other than by a repeat smear 6 months later. Because I take Tamoxifen, however, my GP decided to refer me to the colposcopy clinic at the hospital, where a beady-eyed consultant gynaecologist, Mr Das (what a wonderful name for a gynae guy!) picked it up. A colposcopy exam, he said, would not give him a 'robust enough' result. So he has booked me in as a day surgical case for a hysteroscopy and ultrasound under general anaesthetic. Talk about one thing leading to another...

It turns out that several of my women friends (none of whom has - or has had -  cancer) have had this procedure, some of them several times, either because it didn't work the first time or because findings were inconclusive. My friend Rosie wrote that both her 'procedures' were managed by an 'overwhelmingly arrogant man in a bow tie, who spoke to my left ear.' At least Mr Das looked me in the eye and said he wasn't worried, and it wasn't urgent. But if he wasn't bloody well worried, why book me in for this procedure in the first place?

My friend, Lindsey, to whom I scurried for some emergency reiki and psyching up last week, tells me it's because doctors these days are so afraid of lawsuits, they have to be ultra careful. My brilliant oncologist, who pulled down the smear result on his screen when I reported these unfortunate events to him, said he wasn't worried at all - even when I said Mr Das had seemed unequivocal in his dislike of Tamoxifen. 'You're doing well on it,' Duncan said. 'But if  Mister-Doctor Das wants to take a look, just let him. ' (Pregnant pause.) 'That's not what you wanted to hear, is it?', he went on. Well no, not exactly.  'If he finds anything,' said Duncan, as positive as ever, 'All I'll do is take you off Tamoxifen for a couple of weeks and monitor your hormone levels. And if you need to come off it, I've got other things I can use.'

Why is Mr Das making such a fuss about Tamoxifen? Because, it seems, from what I can make out as fairly inconclusive (and non robust) studies, there is a minor risk of endometrial cancer from prolonged Tamoxifen use - like 10 years. (I have been taking it for three.) More disoncertingly, those women in the studies who did present with endometrial cancer had it already! 

I've been debating with myself whether or not to have this procedure at all. I've just kicked the hospital visits into touch with my excellent Herceptin-at-home treatment, and now Mr Das has mounted a rear-guard action (terrible pun). Lindsey said any biposy - or curettage in this case 'creates a vacuum which has to be filled.' Well, that's one way of looking at it. I am probably due for a clearing out in that department. I was on  repeated courses of antibiotics after my daughter was born, thanks to a tear and lots of stitching up by 2 surgeons, who stared into my nether regions and said they couldn't 'see the apex'. Why is it always men who go into this field of medicine? You'd expect to find more women in gynaecology and obstetrics these days; but not, it seems, here in Truro. Are there an equal number of women, I wonder, treating men with prostate problems? (Bet the answer is a big fat no.) 

Anyway, if it needs looking at, I guess it should be looked at. On the other hand, if it ain't broke, why fix it? And, of course, I have shied away from going to get things checked before - and look where that got me (hairless and breastless.) 

Best get on with it then.