POZ Community Forums
Main Forums => Living With HIV => Topic started by: buginme2 on September 02, 2012, 12:38:37 pm
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Was Diagnosed with high grade anal dysplasia (AIN 3), had 2 lesions. Initially treated with tricloracetic acid and Aldara cream (Imiquimod). Did that for 16 weeks, had another pap and HRA. One lesion resolved, the other hadn't. Treated with tricloracetic acid again and this time started on Efudex cream. That last about 2 weeks before it felt like my intestines were attempting to turn themselves inside out. Had to stop.
Now have Infrared Coagulation scheduled for Friday. I took Monday off work. Has anyone had this treatment? How is the recovery? Would three days off work be enough or should I schedule more time off?
Anyone who has experience with this would be interested in what your experience was. Thanks
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Following a routine HRA, i was surprised to learn that I was diagnosed with internal warts (luckily no cancer) and started with tricloracetic acid in the specialist office and than home to apply Aldara cream internally for 4 weeks which was fine.
5 months later had another HRA and the warts were found to be still there but had reduced in number. Had the IRC (infra-red coagulation) treatment in the specialist office after they applied some numbing gel to the treatment area. The whole procedure was about 20 mins.
Took the day off but really no need. For me there was no pain during the treatment and for the days following......completely surprised by this! First bowel movement a tad uncomfortable but no real pain to speak of. Back in action 10 days following treatment :-)
Having another HRA for a check up soon, being 6 months after the initial IRC treatment. Read that one may need a number of IRC treatments to resolve one's issues. Hope not but will know soon enough.
The IRC is supposed to be the gold standard for anal dysplasia and warts.
Best of luck with the treatment.
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bugsy, I think it's absurd that they didn't use this treatment straight away -- it's what I had in the same situation 8 years ago, and nothing has ever come back. I would be livid to have gone through all of that bullshit for nothing. You don't use aldara cream for high grade anal dysplasia.
That said, there's a wide variety from what I've read on this board in terms of reaction to the treatment, as in discomfort. 1) take a xanax an hour before the procedure -- I'm not making it up, my physician prescribed it for me. Simply calms you down for the procedure, which actually in the end wasn't horrific. You're basically being zapped with infrared light. Sorry, as it was 8 years ago I'm fuzzy on some details but I assume they shot up the area in my asshole to numb me up, like at the dentist. Same type of small needle. 2) It's always best to do this on a Friday, and probably good to take off Monday. Also, buy some feminine sanitary napkins to wear in your pants so you don't have any blood stains -- it's not like anything gushes out but you can have some seeping issues. 3) Also, don't sleep on your best bed linens for the same issue, and cover bedsheets with towels just to make clean up easier if there is any blood -- but I don't want to worry you, as in the end I didn't have any issues like this when sleeping, and only had some blood in my pants on the way home from the doctor's office. The rest of the weekend I rested, but also was up to getting work done sitting on a chair with my laptop. 4) Now for the worst part will be your 1st bowel movement, and there's not much to say but it hurts and you'll just have to deal with it. Some people here have said it hurt for days and days, but for me it was only bad the first time, and much less so the 2nd time, and after that I was fine. In fact, I was back at work on Monday.
So yes, for me my experience was more in line of friskyguy, but I will reiterate that I've read other stories here that are much worse. So much so I've always been surprised and assumed that I got off easy.
But still, cheer up -- like I said I've now gone 8 years with just regular check ups, some biopsies done, but never any additional infrared coagulation treatments/high grade issues (and that's even after being neglectful when I moved from NYC to Philly and didn't get a check up for four years :)
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Thanks that's a lot of good info.
I'm not sure why they didn't do the IRC straight away and started with the Aldara and then Efudex. I'll ask on Friday if I have a chance. I really hope this gets resolved, it's been a pain, literally.
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Update: had the IRC.
Zero pain, zero blood, zero side effects. Was so much easier and more tolerable than both the Aldera and the Efudex treatments (especially the Efudex).
I did ask my doctor why not just treat with IRC immediately, why go through the dealing with Aldera and Efudex. I am paraphrasing here but they start with the Aldera because the goal of treatment is to clear the HPV infection, not just clear the lesion. Aldera and Efudex stimulate an immune system response that combats the HPV. The IRC removes the lesion but does nothing about the underlying HPV.
They also mentioned that there is a limit to the numbre of IRC treatments you can have. I got the impression that this was more important that the reason mentioned above. You can only have IRC done a few times (about 4 times) before it is no longer an option.
This has been an ordeal. Have another HRA and PAP in 3 months to check on how this treatment worked.
One thing I would recommend to others. Get checked, get a PAP and HRA done. I had zero impression that there was a problem. I have never had warts or any other problem and expected to be free and clear. I was kind of shocked when they said I had high grade AIN. I would have never known.
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I get a PAP once a year , just had one done a few weeks ago . I use UAB hospital , which is a pretty good health care system but they don't do HRA , seems odd to me .
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HRA isn't widely available. Even where I live, a metro area of 6 million, there is only one doctor that does it. Even Ivy League U-Penn's medical department doesn't have it. Nor Thomas Jefferson Univ. hospital or Hahnemann Univ/Drexel hospital or Temple Univ. These are all huge, for profit teaching/research medical institutions that one would expect to offer this.
That said, in the absence of this option you can still have a regular anoscopy done. If I didn't travel way out to see my current doctor I would have the option of a downtown LGBT-specific health clinic that performs regular, non-HRA anoscopies. But then if there is a high-grade issue you get referred out of there to a colorectal surgeon. Whereas if I have any issue my doctor (the lone one that does HRA here) also performs any surgery.
So Jeff, if/when a PAP comes back showing an irregular cell structure reading what is the next course of action down there?
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So Jeff, if/when a PAP comes back showing an irregular cell structure reading what is the next course of action down there?
It has already come back showing irregular cells , so they did an anascopy last year and didn't see anything . They are recommending regular PAPS and an anascopy every 5 years .
It would all be so much easier if we had baboon butts so we could just look in the mirror .
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It would all be so much easier if we had baboon butts so we could just look in the mirror .
It's going to take some effort to get that image out of my head. Thanks Jeff, you just gave me something to do with my Sunday morning. ;D
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Glad it went well for you. I've never had any problems with IRC, the scope is the most painful part but then, I have an extremely tight sphincter (at least according to "reviews" ;).) I've never heard that there is a limited amount of times you can have IRC done though.