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Personal Perspectives

HPV Detected in a Long-term Relationship

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I am 54 years old and was just told yesterday that my recent colposcopy and biopsy indicate I need cryosurgery.  Apparently a low-grade type of HPV was found.  I was shocked because I tested negative for HPV a couple of years. Soon after my son was born, 20 years ago, I started to have slightly abnormal Paps.  I was told my cervix was “friable” and I had cervicitis.   I had a colposcopy/biopsy in 1994, which was benign.  So this back and forth on the abnormal/normal Paps has gone on for almost 20 years. 

I married my husband when I was 26 and he 24, both of us virgins due to strong Catholic upbringing and “Catholic guilt”.  We have been in a monogamous marriage and faithful for 28 years.  I have been on a crying jag since I heard the news and feel extremely depressed.  I know that my husband would never doubt me, nor I him, but I can’t seem to get past this diagnosis of HPV since it is apparently only transmitted through sexual contact.  It’s like being told you have lung cancer when you have never smoked.  No matter what you say no one believes you.  One might say “get over it “ but this is a big thing to me and I am depressed as well as devastated. 

Your feelings are very normal, as an HPV diagnosis is usually upsetting. It’s normal to wonder “Hmm, what might this say about my partner?” and while we can’t sort that out, keep in mind that 1) HPV is often detected in long-term relationships; 2) there are unexplained cases that seem to defy the convention of sexual transmission; and 3) colposcopy/biopsy are an excellent means of detecting diseases but aren’t specific tests for HPV.  One other important point is that most HPV infections aren’t dangerous and the combination of follow-up exams and, if needed, treatment is typically sufficient to prevent cervical cancer from developing.--ed

 

Sharing My Story

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My Story is a section of the Resource Center’s Web pages where visitors discuss how HPV has affected them personally.

Thanks for the opportunity to tell “my story,” and thanks also to those of you who have shared your experiences.  My OB/GYN told me I had “genital warts” in 1994 after about two abnormal Pap Tests.  He recommended cryosurgery and they were frozen.  I had normal Pap tests for some time until 2002, when a different physician found that I had mild dysplasia. He explained that I could have gotten HPV from any sexual partner, including my very first one.  He also told me about the statistics that say most people have HPV.

I continued to have follow-up Pap tests, and eventually underwent a cold-knife conization following colposcopy (I also had laser vaporization of the affected vaginal area). My Pap remained abnormal so I was referred me to a gynecologic oncologist.  She determined  that I had vaginal cancer--all of this as a result of HPV.  

I am now 38 yrs old and three years cancer free.  I had to undergo five weeks of radiation therapy and also brachytherapy [brachytherapy is a type of radiation therapy that places radioactive material directly into or close to the tumor]. As a result of the radiation I am now going through menopause.   I too, wish that my first doctor would have taken the time to talk with me about how HPV caused my genital warts and that I was one of many people to either have had HPV or been a carrier of HPV.  I am certainly appreciative of the fact that my current OB/GYN cared enough to refer me to a specialist also keeping in mind that I wanted a chance at having another child.  I just wanted to thank ASHA for sharing information.  At least we know that we are not alone.    

--- You have been through quite an ordeal, to say the least, and we very much appreciate hearing your story. The types of HPV that most often cause genital warts are usually not the same that are associated with gynecologic cancers, so it could be that you didn’t have “high risk” HPV at the time the warts were detected or if you did, perhaps no abnormal cells were present yet. One of the most difficult and frustrating aspects of HPV is it’s usually impossible to know exactly how long one might have had the virus before any diagnosis is made. We’re very happy to hear you’re free of cancer for a full three years now! Good luck, take care, and please feel free to keep in touch – ed.

 

HPV and Molluscum

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I was diagnosed with both “low risk” and “high risk” HPV in October of last year. Previously, I had never had an abnormal Pap test. Five months later, I developed genital warts and immediately went to my gynecologist, who prescribed me a take-home cream for the warts.

A short time later I moved and changed doctors. During their initial exam with my new provider, I was told that all of my warts were not associated with HPV. Rather, I now had molluscum contagiosum as well. What joy. Not only did I have both types of HPV, but now I was diagnosed an ADDITIONAL sexually transmitted infection. I must admit this was an extreme hit to my self-confidence. I felt completely disgusted with my body. I was not promiscuous AND I used protection.  

About three months ago I noticed the patch that was molluscum contagiosum had disappeared.Thank God! I am now in the beginning stages of a better, outpatient treatment for the warts. Having the molluscum contagiosum go away was probably the biggest boost to my self-esteem in a year. Without feeling the physical symptoms of them, for once, this whole mess has not been in the forefront of my mind. I don’t need a constant reminder.  Now, as I await the results of my latest Pap, I’m keeping my fingers crossed that the will begin to resolve itself as well.

Most often HPV does self-resolve, so your Pap may return to normal without treatment. For this reason, many women with mild cervical abnormalities are managed with a “watch and wait” approach of frequent Pap tests, rather than immediate treatment. Molluscum contagiosum virus (MCV) can cause small lesions/bumps, and sometimes is confused with warts. MCV is generally a benign infection and symptoms may self-resolve. MCV was once a disease primarily of children, but it has evolved to become a sexually transmitted disease in adults. It is believed to be a member of the pox virus family. Lesions can be removed surgically and/or treated with a chemical agent such as podophyllin, cantharidin, phenol, silver nitrate, trichloracetic acid or iodine. Cryotherapy is an alternative method of removal – ed.

 

Spa Days Get a New Twist: Interview with Jane DeNight, M.S., ARNP

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You walk in and are greeted warmly. With hot tea in hand you’re led to a room that has fluffy pillows and high thread-count sheets.  Immersed in a swirl of calm music, flowers and pastels, you barely notice the exam table and gynecologic stirrups in the corner…

Spa or medical clinic? At SoBe Gyn of South Beach, Florida, the two concepts blend into what the clinic refers to as personalized boutique Jane DeNightgynecology. To learn more about the clinic that pampers patients in a setting more often associated with cold instruments, bright lights and stress, HPV News recently spoke with SoBe Gyn founder Jane DeNight, M.S., ARNP. A fellow of the American Society of Colposcopy and Cervical Pathology, Ms. DeNight’s clinical expertise includes diagnosis and treatment of HPV, abnormal Pap tests, colposcopy, and cervical cancer prevention. She and George Kovacevic, MD, started SoBe GYN in September 2006 with the aim of providing a unique healthcare experience for young, uninsured women in South Beach, Florida.

HPV News: How do you bring a “boutique” experience to health care?
Jane DeNight: It means mixing healthcare with what women like. Women enjoy going to a spa, of course, because it’s serene and tranquil. This environment is soothing and gives women a good chance to unwind and de-stress. We also took a couple concepts from shopping, which of course many women like, so our patients receive shopping bags when they come. They each get a gift with their basic exams and Pap tests. We provide a soothing environment, lots of white linen, comfy and fluffy couches, peaceful music and fresh orchids all over.

This sounds very different from a traditional gynecologic clinic setting.
Yes, clinics are usually much more sterile and not as focused on customer service. We want our patients to feel relaxed, which is why we utilize concepts from the spa. For example, our exam tables have down comforters and Hungarian down pillows, and the stirrups are covered with silk! The women wear chamois robes and spa socks, so it’s a very soothing experience where the woman feels genuinely cared for.

How does the staff dress? Do they wear traditional medical scrubs?
Right now we focus on white: I wear a white lab coat and my assistant Michelle Goodall wears scrubs, but we’re thinking of going with more of a healing outfit, that’s like a Chinese jacket with buttons down the front, and of course white because that promotes cleanliness; it looks clean, feels clean.

Besides spa components, are there other differences a patient might notice with your clinic? You mentioned customer service as a focus…
The cornerstone of our practice is patient education. From the moment they walk in to a warm reception, with “hi, thank you for coming, my name is so and so, would you like some hot tea?” we give them hot tea just like they would receive in a spa. We spend at least 25 minutes doing reviewing their health history and knowledge of cervical caner, HPV, and the Pap test. We teach patients what’s pertinent to their health at their stage of life. Cervical cancer affects young women and can cause loss of fertility. Since we mostly see young reproductive age women, we focus a lot of teaching on the importance of the Pap test and its role in preventing cervical cancer, as well as birth control and STD infections.
That’s very different from what’s going on in many places where the patients are in and out in five minutes. Patient teaching takes up a lot of our time, but  it’s an excellent investment for the patient and us. We feel we provide better service for the patient, better diagnosis and treatment, when we take our time and teach them about what’s important for their age group.

Many people reading this are in health care practice themselves. What are one or two things that will bring a more comfortable atmosphere to a clinic?
Some things don’t cost much money at all, and that’s important to remember. The number one thing is just kindness and empathy, and general good etiquette, which I think is lacking in medicine today. This includes how the patient is received, how well the clinician listens to the patient, thanking them and telling them you appreciate that they chose your facility.
Sobegyn Clinic
Next would be small things, like fresh flowers, a refreshing beverage when they come in, and comfortable seats. Those things don’t have to cost a lot. Women love flowers, they love the color pink, and we use very good exotic wood furniture that wasn’t too expensive but gives a polished look. The other important part is patient education, including verbal, written, and online resources such as HPV News, the ASHA website, and the NCCC website. Knowledge empowers patients and makes them feel more comfortable with their healthcare experience.

You mentioned that you largely work with uninsured patients. How do they afford clinical services?
We once thought about accepting some insurance plans, but after experiencing the exorbitant amount of time and stress we spent filing these claims, we decided not to. The cornerstone of our practice is patient education. When we educate our patients on the facts of the Pap and the statistics of cervical cancer worldwide, they are usually very receptive to paying the $220 annual exam fee which includes the consultation, the lab fee, and the complete gynecological and physical exam and health counseling. We also offer inexpensive options so people can experience this unique approach to healthcare. For example, for urinary tract infections and Vaginitis (yeast, bacterial vaginosis) it costs just $80. For a consultation it is also $80. We also advise women to have their partners share half the cost of birth control.

If a patient is truly unable to pay we offer free referral services to the public health hospital and clinics. We have a very strong referral network. Our typical patients are young reproductive age women and men who work hard and make a decent wage.  Most of them can afford to spend $200-$500 per year for their health. South Beach people often spend more money on less important services such as cable TV, cell phones, dining out, drinks at clubs and bars, hair styling and cuts, and nowadays waxing!

What sort of feedback have you received from your patients?
They often say “I feel like I just went shopping,” and we tell them they have, they’ve been shopping for their body and their health! We’re quite flattered because we get a great response and many people actually ask us if we’ll open clinics in other cities. 

Does your practice also see males?

Yes. Sometimes partners have infections that affect the male so we welcome them, too. Once we get men in, we do some general medicine as well. Men are similar to women in that they appreciate being treated well, with respect and kindness in a soothing environment. So our male population has grown tremendously and they actually feel good about coming to the clinic, a practice that too many men shun.

Visit SoBe Gyn online or contact them at 305.535.9907. For patients in South Florida the clinic offers yearly gynecology exams and Pap tests, birth control, treatment of vaginal infections, and general medicine.

 

This is all so anxiety provoking and stressful

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A little more than a year ago I had my regular annual Pap exam, which resulted in my first abnormal Pap test result. I was told I had a “high-risk” type of HPV, which had caused cell changes in my cervix. I didn’t even know what HPV was until I began to see the commercials for the vaccine! I was amazed at how little support there is for this, and am still upset that the vaccine is only for women ages 9 to 26. I’m 30 and wish I could receive it.

I had another Pap test a month ago, and this one also detected abnormal cells.  I know they say that HPV usually goes away within a few months or maybe a year or two, but this is all so anxiety provoking and stressful. I wish there was more research or ways in how to improve the immune system for those who have mild cervical dysplasia caused by HPV. I am now exercising, taking vitamins and trying to live my life as stress-free as possible, to see if I can get help my body clear HPV.

Stress, anxiety, and even relationship issues are not at all uncommon following abnormal Pap results and a diagnosis of HPV. ASHA has a support forum that might be ideal for you. Free and anonymous, you can log on 24/7 at http://www.ashastd.org/phpbb/index.php. Stop by, and we look forward to connecting with you online! – Ed.

 


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