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My Deaf Experiences: Cervical Screening and Colposcopy procedures during the COVID-19 Pandemic.

In 2019, Smear Tests were “rebranded” in a new campaign, which was launched by the Government to attempt to help boost the number of women attending screening checks. BBC News stated, the campaign was launched by Public Health England, who decided on updating the terminology “amid concern it may be putting people off”. Women aged between 25 to 49 years are sent an invitation through the post, to attend a Cervical Screening every three years. Whereas, women who are aged 50-64 years, expect a letter of invitation every five years.

According to the NHS, “1 in 4 women skip the cervical screening with the proportion increasing to 1 in 3 among those aged 25 to 29 and to 1 in 2 in some more deprived regions of the UK.”. The survey was carried out by Jo’s Cervical Cancer Trust. Sadly, majority of responses for the lack of attendance included: the feeling of embarrassment because of their body, a lack of understanding regarding how vital it is to attend the appointments and the common misconception amongst women, who believe they do not need to attend, because they are physically healthy. Shockingly, a third of responses shown that women did not have much faith in the procedure and do not think it is beneficial, with regards to reducing their chances of developing cancer.

What is a Cervical Screening and what were my experiences?

The purpose of a Cervical Screening is to check the health of one’s cervix. This is the opening to the womb from the vagina. A small sample of cells are swabbed from the woman’s cervix, and these are tested for HPV (Human Papillomavirus), which can cause cell changes in the cervix. If there are changes within the cervix, this will give the professionals a ‘fighting chance’ to prevent this from developing into Cervical Cancer.

During my appointment, I was slightly nervous, because of the communication barriers that I would face. Due to COVID-19, there were new procedures in place, to prevent the spread of Coronavirus. On arrival, I was met with a nurse who wore a mask. I immediately told her that I was Deaf and reliant on lipreading. We were quite lucky, because the room was big, so there was extra space for the nurse to move the patient’s chair further away from her desk. She gestured me to sit in the chair, lowered her mask, and from a distance, she asked me questions regarding my health and explained the procedure to me.

She drew the curtain and gave me some privacy to undress waist down. She gestured me to lie on an examination bed, which was covered with a large piece of paper towel and she gave me a sheet to cover myself. I laid on my back with my legs bent, with my ankles together and my knees spread apart. The nurse was masked and gestured that she was going to begin the procedure. She gently put a clean plastic cylinder into the opening of the vagina. I know most people are put off by this part of the procedure, but it honestly was not a problem and did not hurt for me. Once this was positioned correctly, the nurse opened it, and was able to view my cervix.

The nurse then took a sample of my cells from my cervix. This did feel a bit uncomfortable, but it did not hurt at all! The sample was then placed into a small plastic container and this was placed into a large bag, which was to be sent away for testing. The procedure was quick and was over in a matter of minutes.

Post Screening Colposcopy Appointment

My results came through the post within a two-week time scale… but they were not what I was hoping for. As an anxious person, reading this letter with no medical professional present to reassure me, was difficult. The letter was an invitation for a Colposcopy appointment at the hospital. The first thing that came into in my head… Cancer.

“Try not to worry Louise! It will be fine”, everyone would tell me. But what people do not understand, is the experience that anxious people go through. My anxiety went through the roof. I often cried during those few weeks, after my results, up to my Colposcopy appointment. When it eventually rolled around the corner, I was so eager to go and just wanted it to be over and done with. The letter stated, that due to COVID, the patient had to go to the appointment alone. Mum spoke to the lady on the phone and explained that I am Deaf and reliant on lipreading, so they luckily made special allowances, and allowed Mum to come with me as communication support (and moral support!).

On arrival in the consultant room, I was met with two masked nurses, we quickly highlighted that I am Deaf and lipread. I felt confused and lost, and constantly found myself looking at Mum every time I heard their muffled speech through their masks. Mum swapped her opaque mask, to a transparent visor, to ensure she could successfully relay information to me. After a short moment, one of the nurses removed her mask and was more than happy to do this, to ensure I understood everything. The other nurse sat in the background quietly and remained masked. The procedure was explained, and we had a brief conversation, with more than a few tears (from me) about my worries. They reassured me not to worry and made me feel calmer. The nurse stated that I had mild abnormal changes within my cervix and this procedure, gave them the opportunity to have a further look.

A Colposcopy is a basic procedure, which is carried out after a Cervical Screening. The patient is invited if the results found abnormal cells within the cervix. The procedure results can show whether the cells are abnormal and whether further treatment should be carried out to remove them.

The nurse gestured me into a larger room with an examination bed. Next to the examination bed, was a light and a small screen. In the room there were four nurses, all wearing masks. Two of the nurses were in the consultation room with me before. One of the nurses informed their colleagues that I was a Deaf lipreader, to make them aware of my communication struggles. Once I was undressed and positioned on the bed, I felt slightly awkward, but I knew how important this procedure was.

One of the nurses removed her mask for me and talked me through what was happening. She told me to try and relax (slightly difficult when you are anxious!) and explained what was happening, step by step. She asked whether I wanted to look at the screen beside me, so I accepted… oh wow, if you are queasy when looking at ‘body insides’, just politely decline! The lady explained what was on the screen and answered my questions. The actual procedure was not painful. There is this common misconception, that these procedures are incredibly painful. Everyone has different experiences, but it was only afterwards, that I experienced mild aches in my lower abdomen. This was pretty much the same as period pains… nothing that a hot water bottle cannot fix!

Why is it important to raise awareness of this?

The reason that I chose to write this post, was because I wanted to raise awareness of the importance of attending your Cervical Screening appointments, do not delay and put it off. The procedure itself takes roughly five minutes, if not, then less! This is the same as the Colposcopy. I can emphasise with women, who are anxious about attending the appointment. The body shape worries, the anxiety of being judged because you have not waxed etc. The nurses are friendly, and they have seen it all! No judgements passed. I cannot emphasise how much they genuinely want to help you, and reduce your chances of getting Cervical Cancer. They are unsung heroes!

In conclusion, the communication barriers are daunting at first, but if you explain your communication needs, they are very accommodating. I advise that you take a close friend of family member with you, someone who you can trust. Book a BSL interpreter, or a Lip-Speaker from ‘Lipspeaker UK’. COVID has restricted a lot of practices, but clear communication is highly important during these procedures, so special allowances can be made, if COVID safety restrictions are followed and maintained in a sensible manner. Be as open and honest as possible with the practitioners and discuss your worries, this helped me massively and took a lot of weight off my shoulders!

To find out more information, visit Jo's Cervical Cancer Trust.

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