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Author Topic: Breaking Anal News  (Read 3134 times)

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Offline tednlou2

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Breaking Anal News
« on: October 25, 2013, 05:44:29 PM »
I went to the colorectal doctor today, to have a lump in my anus checked.  He said it was just some kind of hemorrhoid issue.  I have already forgotten what he called it, because we began talking about anal paps.  He was about to write down the medical term, when we got side tracked on anal paps.  I will have to call for the exact term.  He said we will check it again, just to be sure. 

So, I asked about the paps.  He said he didn't know of anyone doing them.  He really was a very good, young doc, but just didn't know who was doing them.  He thought my HIV doc could get it done.  I told them they always say they don't know of anyone and the HIV clinic does not do them, themselves.  He said many colorectal docs don't even want to focus on anal issues, preferring to do things like hernia surgeries and perform robotic surgery.  He is new to this practice.  He has been in the military.  He is board certified.  While other docs are focusing on the other issues, he is doing the anal issues.  I explained there is a real need here for anal paps. 

So,  he asked his assistant.  She called and asked someone, who told her no.  She was persistent and called this another nurse, who said she knows how to do them and they have the equipment to do them.  So, we go back into the room.  He says he has never done one.  They brought in some other nurses and another doc.  I had an audience.  She showed them what to do.  Nurses do often say they do the doctor's work.  The doc followed her directions and I got the anal pap.  He told me to spread the word that he will be doing them now.  He also said when he gets paid (guess he's kinda poor now just starting there after being a doc in the military), that he is going to attend this conference on things like anal paps.  It is in San Francisco.  He was excited about the conference and the conference being there, because he said they will definitely have more education on sexual health (HPV) and colorectal issues in the poz community.  He said he will remember me as patient number one.

So, after 5 years of being told no by 3 different colorectal docs, I finally got it done.  They had the equipment.  It seems docs just were too lazy to bother with them.  I was stunned, when he said many of them don't want to deal with anything regarding the anus.  I applaud the assistant for not taking no for an answer and calling a nurse, who knew exactly how to do them.  I will tell the HIV clinic they can now send patients to them, although they said they would contact them as well.  He said he was glad I was persistent and that he is glad he can add this to what he does.  He was embarrassed that he had to be shown how to do it (he knew the basics, but not what to do with the sample), but said this isn't something they teach in school and practices are not having docs add this to what they do. 

Offline mitch777

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Re: Breaking Anal News
« Reply #1 on: October 25, 2013, 06:21:33 PM »
That's quite the report Ted. :)
Nice title too. tee hee.
31 years hiv+ (oct. 2013) with a curtsy.

Offline WillyWump

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Re: Breaking Anal News
« Reply #2 on: October 25, 2013, 06:39:07 PM »
Glad you finally got your Pap.

It's very easy to get them at my doc, no asking required. They just surprise you with it...it would be nice to have a little notice so I could at least get the hole bleached and all pretty for them
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Online Jeff G

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Re: Breaking Anal News
« Reply #3 on: October 25, 2013, 06:43:07 PM »
Pics or it didn't happen .

Offline mitch777

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Re: Breaking Anal News
« Reply #4 on: October 25, 2013, 06:49:20 PM »
Pics or it didn't happen .

Sounds like it would be a grope group shot. :)
31 years hiv+ (oct. 2013) with a curtsy.

Online Jeff G

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Re: Breaking Anal News
« Reply #5 on: October 25, 2013, 06:50:36 PM »
Sounds like it would be a grope group shot. :)

Ted on a stick . 

Offline Habersham

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Re: Breaking Anal News
« Reply #6 on: October 25, 2013, 06:52:49 PM »
Glad you finally got your Pap.

It's very easy to get them at my doc, no asking required. They just surprise you with it...it would be nice to have a little notice so I could at least get the hole bleached and all pretty for them

It would be nice if you cleaned any mucousy white stains off it before hand too. You're a spunky guy.
Because I Can

Offline mitch777

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Re: Breaking Anal News
« Reply #7 on: October 25, 2013, 06:55:55 PM »
31 years hiv+ (oct. 2013) with a curtsy.

Offline Joe K

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Re: Breaking Anal News
« Reply #8 on: October 25, 2013, 06:57:40 PM »
Ted on a stick .

... backs out of thread very slowly...

Joe

Offline mitch777

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Re: Breaking Anal News
« Reply #9 on: October 25, 2013, 07:00:05 PM »
... backs out of thread very slowly...

Joe
I hope Ted backed out slowly. :)
31 years hiv+ (oct. 2013) with a curtsy.

Offline buginme2

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Re: Breaking Anal News
« Reply #10 on: October 25, 2013, 07:58:51 PM »
Ted, you really should be commended.  You didn't take no for an answer and not only may you have improved your own health but very possibly a lot of other hiv positive people as well.  That's very awesome.

Offline buginme2

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Re: Breaking Anal News
« Reply #11 on: October 25, 2013, 08:05:22 PM »
curious did you discuss with them what they will do if the results are abnormal?


Offline RobbyR

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Re: Breaking Anal News
« Reply #12 on: October 25, 2013, 08:15:49 PM »
Good for you for being so proactive. The clinic I go to, my doctor did a routine study screening all her consenting male patients for HPV, the anal pap. I'm glad she did, mine came back showing low grade lesion, which at first scared me but basically means I just need to stay on top of it & have routine paps & a High-resolution anoscopy if any of the future paps show a higher grade. Even if they did though, it's very treatable. The name of the game is being proactive! Have paps every 6 months or so, if there's a positive result, even for low-grade, even if a higher grade result shows up, often it never amounts to anything. Again being proactive is the name of the game.

I think routine paps are a MUST for anyone who has anal sex, just like they do for women in the cervix, HPV knows no boundaries.
Started Atripla August, 2010.

Offline tednlou2

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Re: Breaking Anal News
« Reply #13 on: October 25, 2013, 10:51:36 PM »
With all the people in the room, it felt like we were doing some huge ground breaking medical experiment.  I was waiting for the cameras to show up, which would have been fine.  The first few times I had my butt looked at, I was very self-conscious.  This time, I dropped my pants and assumed the position.  The docs finger hurt as he was turning it around.  The tiny scrub brush for the pap was only very mildly uncomfortable.  No big deal at all.  I know many here, Miss P especially, said it was ridiculous they wouldn't do them, saying a GP could do it. 

About the results-- They said I should know by Wednesday.  Hopefully, all is good.  The doc wasn't sure whether the lube used for checking out the lump (since it was done first) would interfere with the results.  The nurse said no, but she blotted up as much as she could.  It is good this doc was already planning to attend that conference, so he can become more knowledgable.  He was very giddy about learning something new and expanding his knowledge on this.  He's young.  The other 3 docs I've seen were probably all around 60.  I'm not bashing 60 year-old docs, but I think they were just set in their ways and not interested in this at all.  This doc was genuinely excited about being able to do his next one.

Offline LiveWithIt

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Re: Breaking Anal News
« Reply #14 on: October 26, 2013, 01:13:44 AM »
I just went to a talk at our local Pride Center Wednesday,  It was a colorectal surgeon, the last topic was HPV and anal cancers and how the anal pap can detect them early.  I had a dr's appointment the next day so I asked him to do one for me.   I had one done about a year ago and everything was fine, I don't have any issues so I hope to be okay.
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Offline Miss Philicia

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Re: Breaking Anal News
« Reply #15 on: October 26, 2013, 12:33:34 PM »
I know many here, Miss P especially, said it was ridiculous they wouldn't do them, saying a GP could do it. 

Over the course of 20 years in treatment for HIV I have had four HIV specialists that were also my GP. All of them were capable and/or comfortable sticking what really only amounts to a large Q-tip up my Holland Tunnel and sending it off to a lab for analysis. I just always find it quite odd that so many of you are encountering difficulties with this.

Also, as my first smear came back showing irregular cell structures they've never seen any reason to do repeated smears, well except one but that had more to do with my moving from one city to another. But at any rate once irregularities show up (or certain ones) from the smear you'd be seeing a colorectal specialist anyway, to have a better look with an anocope (also called an anal speculum).

I will also add that in the absence of a high-resolution anoscope the colorectal specialist can do a regular anoscope procedure meaning that's better than nothing for those of you in areas that do not have the HRA resource.

And if you read this comparison of Pap smears vs. HRA in terms of diagnosing anal dysplasia in HIV-infected patients it's clear that the use of Pap smears is less valuable, as they are simply not sensitive enough. Basically the colorectal specialist needs to get up in your poop chute and take a couple of biopsies/nal cytology. Also, read this. But in the end if all a patient has I suppose a Pap smear is better than not having one done.

This link to the American Society of Colon & Rectal Surgeons has a locator function and perhaps it would be helpful for those of you experiencing issues in locating a specialist. Of course, you will need to make some calls to see if they utilize HRA. And remember, as you reach the age of 50 you should be having colonoscopies as well, and in fact if you have a family history of polyps being found it's useful to begin colonoscopies before that age, perhaps 45. I had my first one at 47 because of that reason, performed by the same specialist that does my anoscopies.

I know my colorectal specialist, as well as the one I had in NYC (they know each other) regularly attend seminars around the US teaching others how to treat anal dysplasia, etc. And I know of at least three off the top of my head in Philadelphia that are fully versed in all of this.

If anyone here is in the Philadelphia metro area and needs a reference simply PM me. As well I will try and remember during my next visit (next Spring) with my specialist to inquire how one can more easily locate specialists treating HIV patients with high resolution anoscopies.
« Last Edit: October 26, 2013, 12:43:32 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline alberche

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Re: Breaking Anal News
« Reply #16 on: October 30, 2013, 11:24:34 PM »
Hi Ted,

What a story!!!

I was diagnosed with HPV in 2007, they did an anuscopy and a biopsy and found a low level squamous cell displasia. Since then, I've been passing controls every 6 to 10 months. Last month they detected my displasia have become a higher level one, a precancerous lesson. They have phoned me yesterday to give me the results. I will pass a little surgery with infrareds to burn it out, they have told me not to be worried, since I am being checked and followed up periodically and this permits to detect and tackle these lessons before they become serious or a cancer.

So, this is why it is very important to get routine PAPs and anuscopies.  It is also important to make a RNA test to determine which variants of HPV you have: 16, and 18, also 32, seem to be the most risky. Also it is a good idea they check whether you may have Herpes virus in your anus. It is usually asympthomatic, but it may interact with HPV to speed the growth of these epithelial displasias.

I just hope the infrared thing does not hurt too much!!!. Sometimes I get fed of so many bugs inside me!!!

By the way, the group thing: in one occasion, for a routine check, my doc had company, a whole class of medicine students, they were about 12 people, watching me and my screened anus. It's embarrassing, but if this helped them to learn something and to prepare to be future specialists, let's see it as a contribution to the progress of medical science ;-)

Take care, hugs!
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Offline buginme2

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Re: Breaking Anal News
« Reply #17 on: October 30, 2013, 11:28:22 PM »
Hey Ted you should have gotten your results by now, any news?


Online Jeff G

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Re: Breaking Anal News
« Reply #18 on: October 31, 2013, 07:37:35 AM »
Here is a video of Teddy's test being performed .

http://www.youtube.com/watch?v=AdYaTa_lOf4

My apology for the hijack but simply could not resist .   
« Last Edit: October 31, 2013, 08:56:47 AM by Jeff G »

Offline mitch777

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Re: Breaking Anal News
« Reply #19 on: October 31, 2013, 10:59:31 AM »
Here is a video of Teddy's test being performed .

http://www.youtube.com/watch?v=AdYaTa_lOf4

My apology for the hijack but simply could not resist .

Too Funny! LOL. Oh Teddy!
31 years hiv+ (oct. 2013) with a curtsy.

Offline tednlou2

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Re: Breaking Anal News
« Reply #20 on: October 31, 2013, 11:18:06 PM »
Here is a video of Teddy's test being performed .

http://www.youtube.com/watch?v=AdYaTa_lOf4

My apology for the hijack but simply could not resist .

Ok, that will keep me awake tonight.  I thought it would be watching Michael Myers, but it will be Teddy. 

Hey Ted you should have gotten your results by now, any news?


They said Wednesday and I still haven't heard anything, so I will call them tomorrow.  I must admit that I've been wondering whether this is something I want to know-- whether it will just cause me more anxiety, when a negative result may never progress to disease.  But, can't hide my head in the sand.  Better to know, so things can be monitored.  And, of course, I may get a good result. 

I actually ended up seeing another colorectal doc yesterday, who I've seen before.  When I made the appt with the doc I did see last week, their computers were down and they said they would have to call me when they were back up.  When I didn't hear back, I called this other doc I've seen before and made an appt.  A few days later, the first doc called and gave me an earlier appt.  I forgot to cancel the other.  When they called to remind me of yesterday's appt, they were already closed when I got the message.  I didn't want to cancel an hour before the appt, so I decided to just go.  I figured I could get a second opinion on the lump.  He said the same thing-- it was an enlarged blood vessel that will go down.  And, I got to tell him he can send patients to the other practice for anal paps.  Since many docs are like many businesses, I'm not confident he will send patients to a "competitor."  I hope he doesn't see medicine as competition and would refer them there, if he's not going to do them. 

I bring that up, because that doc had this X-ray (see below) hanging on the light board.  I wondered whether that belonged to the guy I saw leaving.  I had to ask about it.  He said it is a real X-ray and that he puts it up as a way to put patients at ease.  They did mark out the patient's name.  He is a big joker. 



Offline pittman

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Re: Breaking Anal News
« Reply #21 on: November 01, 2013, 12:17:55 AM »

I just hope the infrared thing does not hurt too much!!!. Sometimes I get fed of so many bugs inside me!!!

Take care, hugs!

When I was first diagnosed, the clinic scheduled an appointment for with the anal dysplasia doctor on staff. He used an anal scope, and then a swab soaked in vinegar, followed by a q-tip swab with iodine. That helped him identify areas of concern that did not soak up the iodine, which he then biopsied.

I then came back due to some high grade spots, and had the infrared treatment. It was rather uncomfortable, and afterwards left me feeling like I needed to go to have a bowel movement for a little while. It was not however, particularly painful.  He suggested I take a normal acetephetomine or advil dose if I had pain, but that was it. I would not look forward to doing it again, but then it was also not so bad that I would avoid it either.  The initial biopsy was more uncomfortable all in all than the actual infrared treatment.

Offline edfu

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Re: Breaking Anal News
« Reply #22 on: November 01, 2013, 01:40:33 AM »
www.youtube.com/watch?v=ytOTNi8yVOc

Herewith video instructions for all those dumb-ass, homophobic, anal-phobic doctors who claim they don't know how to perform an anal Pap smear. 
« Last Edit: November 01, 2013, 01:55:26 AM by edfu »
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Offline Ann

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Re: Breaking Anal News
« Reply #23 on: November 01, 2013, 08:33:53 AM »
www.youtube.com/watch?v=ytOTNi8yVOc

Herewith video instructions for all those dumb-ass, homophobic, anal-phobic doctors who claim they don't know how to perform an anal Pap smear. 

After wasting 27 seconds devoted to hand washing at the beginning of the video, they show him agitating the swab for four seconds, while the text explicitly says: "agitate swab for 1 minute". ::)

Otherwise, good video. Should be required viewing for most doctors.
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Offline Miss Philicia

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Re: Breaking Anal News
« Reply #24 on: November 01, 2013, 02:43:55 PM »
I actually just found a new colorectal specialist I may switch to. I love my current one, especially because his name is Dr. Butcher, but I have to travel on public transport all the way out to Havertown on the Main Line and that involves two subways and a bus.

This other guy I've found is just a couple buildings down from my podiatrist, which is a mere four subway stops away. Plus he's right across from Hahnemann University Hospital (part of Drexel and where I've had my hooves repaired) so I'd have my colonoscopies there too. And yes, he does HRAs, etc. So I'm thinking when my next inspection is due in the spring I will make the switch. Plus he's Chief of Drexel's Division of Colorectal Surgery and named "Top Doctor" 2013 by Philadelphia magazine.
"Iíve slept with enough men to know that Iím not gay"

Offline mitch777

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Re: Breaking Anal News
« Reply #25 on: November 01, 2013, 02:58:39 PM »
I love my current one, especially because his name is Dr. Butcher,
Funny. My PC doc is Dr. Graves.
31 years hiv+ (oct. 2013) with a curtsy.

Offline RobbyR

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Re: Breaking Anal News
« Reply #26 on: November 01, 2013, 05:01:15 PM »
I've had a ton of butt issues this year. Early this year I had some kind of polyp in my lower rectum, biposies came back benign for it, but it was bleeding a lot & so I had general surgery to have it removed. They think it was just an infected gland inside my anus. That was that for awhile.

Fast forward 4 months, I had a brief bout of constipation, & this seemed to cause a minor small roid to flare up & ooze just a bit. I went to see my colorectal doc in July, & he said everything looked okay, & that I just had rectal skin tags.

I had a pap done in December 2012, came back showing low grade lesion, but doctors told me to just follow up in a year or 6 months with another pap & have anoscopy if I wanted.

About two weeks ago, I was constipated & passed a hard stool & since then I've had a stinging feeling when I go number 2 on the right side, like it's coming from outside the rectal area. I don't know if it's the skin tag acting up or a tiny fissure that formed or what.

I'm going to see my colorectal doc again next week, hopefully it's something minor I can treat at home with high fiber diet which I've been doing, & warm baths, etc.

I also plan on having another pap done & a high-res anoscopy if he agrees to it. I've altered my diet to add tons of fiber & water, but still had a tiny bit of spotting on tissue today, first time in about 12 days. Hoping this is just a small fissure that can heal on it's own.

Anyone know whether warm baths/dabbing the area with ice cubes can help foster healing aside from eating all the fiber? The colonoscopy back in March was clear other than the small polyp which they removed & which was benign. I'm hoping this is not a fissure or roid but if it is, maybe it can heal itself.

Good luck on your results tednlou. You're staying on top of things & that's so important. That's the key.
Started Atripla August, 2010.

Offline alberche

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Re: Breaking Anal News
« Reply #27 on: November 03, 2013, 08:10:15 AM »
Dear Robby R,

Anal fissures could occur after constipation episodes, and also after diarrhea episodes. Warm baths are useful since they provide some pain relief and also help tissues to recover.

But these symptoms could be also due to an anal herpes.

I tell you this because that is my case. I have an anal herpes, and it comes and goes every few months. The appearance and the feelings of it is just as if it's an anal fissure.

I have had these symptoms since i was diagnosed, in 2006. As I had many diarrhea episodes at the beginning due to meds, I thought this could be related with that.

In fact, my former doc just diagnosed it as an anal fissure, and recommended me warm baths and to apply a cream containing "centella asiatica" extract (a plant that helps to repair tissues).

Nevertheless, it did not disappear, neither get better. This problem just came and go every few months, including an intense red bleeding when going to the WC. I also noticed that, a few days before a new episode will occur, my inguinal lymphatic nodes were swelling and aching a bit. Then I felt as if I am going to pass a flu, you know, fatigue, some pain in muscles and bones, etc.

I commented this to my new doc (I moved to another town) and he was curious about it, so he  made some labs and a frotis from this "fissure", and the result was herpes virus. It is just similar to labial herpes and hurts as much or even more.

My doc says that stress, not sleeping enough hours, concomitant conditions (flu, allergic reactions), and tissue damages that always occur during anal intercourse, may also contribute to reactivate an anal or genital herpes as well.

He prescribed symptomatic treatment with acyclovir (in pills) and also recommended trying to sleep as well as possible, of course eating more fiber to ease stools, and being careful when having anal sex.

In fact, anal sex should be totally avoided when the herpes is active (in fisure-like mode, with pain and inflammation), not only because it is painful, but also because it is highly contagious in those phases, so your partner could catch it and condoms protect only partially from this.

My doc also told me that there is no cure, but just simply taking the treatment each time I notice the first symptoms. And, if it occurs more than 2 or 3 times a year, then a permanent treatment will be needed with acyclovir or other similar antivirals.

Hugs!  8)

love is blindness...  a wonderful song!

 


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