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Author Topic: Anal Cytology...  (Read 10332 times)

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Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Anal Cytology...
« on: December 13, 2021, 07:21:50 pm »
Hello All....

Hope everyone is doing well, and getting ready for the holidays !  :)

I had my 6 month visit with my ID, this past Friday. We discussed quite a few things. While my HIV is under control, she is concerned with my age, ( 70), and length of time that I have been positive, about things that I need to take care of.

One of these is my cholesterol. We got to get that number down further. I believe my last cholesterol was 177.

Another thing discussed was that she is wanting all her HIV positive people, to have an Anal Pap smear. So on Friday, and with my approval, she sent an email out to a new person in the VA healthcare system, that is working between two VA facilites, one in Tampa, and the other ST. Petersburg.

By Friday afternoon the appointment was made, so today,... I had my Anal Pap Smear completed.

I believe it consisted of 3 separate swabs,  long story short, took maybe 20 minutes in the office of my ID doctor.  She ( My ID Doctor) wanted to watch the procedure being done, so she was explaining a lot of the procedure to her.

She was telling me, That everything looked good, will just wait now for the lab results.

In all my years, I have only had this done once before. Shortly before I had some condeloma, and anal warts removed, in I believe 2004.

That was one of 3 appointments I had today. I also had an EKG, and a visit with my cardiologist, shortly after that procedure was completed.

So far, he doesn't believe it is time yet, for my Mitral valve to be replace or repaired yet, but he firmly reminded, that the time will come to seriously consider and get it done. I told him I understood that, but was not looking forward to that.  :o

My next appointment with the Cardiologist is in 6 months, and an ECHO will be done then, and if he feels it is needed, Possibly another TEE ( trans esophogeal echocardiogram. ( I have had 1 TEE done in the past)

Meanwhile, I am doing OK. I do not get out of breath, or get dizzy or get light headed. I have no problem exercising, or power walking.

Problems to deal with are weight and cholesterol, and getting my blood pressure down a little. All my weight is in my stomach. My current weight at 5 feet 7 inches is about 185 pounds.


As soon as I get the results from the Pap Smear, I will post it here. If it is anything urgent, the doctor will call me, and it will be treated,.. otherwise I will receive a letter in the mail, or I can read the results online, through the VA portal, when it becomes available.

I am hoping for the best results !

Looks like New Years resolution, will be healthier eating, and weight loss !  ::)


Ray  8)

Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline Grasshopper

  • Member
  • Posts: 738
Re: Anal Cytology...
« Reply #1 on: December 14, 2021, 08:37:24 am »
Hi Ray,
is that Anal Pap smear different from the AIN screening ?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479653/

Logged

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #2 on: December 14, 2021, 09:38:37 am »
Hi,
Really not sure, but I will certainly ask her about when I speak with her later this week.
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline Grasshopper

  • Member
  • Posts: 738
Re: Anal Cytology...
« Reply #3 on: December 15, 2021, 03:22:28 am »
Hi Ray,
I've had the AIN screening done a couple of time.
They insert a clear plastic canule, then they apply an accid and with a camera they'll look for discolorations...as these are signs of dysplasia. They will then remove them or take biopsy for further analysis.
Logged

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #4 on: December 15, 2021, 07:49:54 pm »
Ok,...

I am getting some preliminary reports, but no lab report yet, It is still early.  Received this on my VA portal site, a little while ago:


Veteran with history of treated HIV desires anal dysplasia screening. +
History of anal warts treated years ago. Wants anal dysplasia treated if
discovered to reduce SCC risk.

Vitals reviewed in CPRS. Stage 1 hypertension, going to cardiology today.
Well appearing, no distress
normal gait
abdomen non distended
examined with NP ..............


Perianal skin with 4mm ? skin tag vs condyloma in L anterior quadrant
buttock skin just outside perianal area with three flat, pink-brown lesions each
about 4mm

hemorrhoids noted but not inflamed, no fissure.

Tolerated anal cytology and gc/c swab without difficulty
DRE no mass, normal tone, prostate non suspicous
colonoscopy last month without concerning anal mass


- Anal cyotlogy and gc/c sent
- Veteran already sees dermatology but never got perineal exam with them. HIV
provider ++++++  will ask dermatology to look at the perineal/perianal skin
lesions in this veteran with personal history of NMSC.


Ray
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #5 on: December 18, 2021, 12:04:58 pm »
GREAT NEWS !!

The Doctor called me yesterday, and gave me the "All Clear". No indication of HPV, squamous cell, or pre cancers. She said there were some non determined, non specific cells, but it was nothing to be concerned about.

I still cant get the results on line yet.  I may have to go to the VA, and go to Release of Information to get that data, Because I really like to look at the pathology reports, I am kind of serious about that.

She does want to see me in six months ( Completely voluntary on my part) to do one more check.

So all in all, it was a good day yesterday with the news. !

Ray

Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #6 on: December 19, 2021, 05:22:13 pm »






Discussed above results - ASCUS with good specimen - with veteran.
Generally would recommend anoscopy to determine if he should have HRA or serial
cytology/DRE. However, he did already have a colonoscopy last month in which the
anal tissues were directly examined, so he and I both feel comfortable with
deferring colonosocpy.


Special Note:

What does ASCUS mean on Pap smear?


According to the Mayo Clinic, when it comes to atypical squamous cells of undetermined significance (ASCUS), a Pap test may reveal “slightly abnormal” squamous cells, but such changes do not necessarily mean that precancerous cells are present.





Ray
« Last Edit: December 19, 2021, 05:48:20 pm by J.R.E. »
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #7 on: December 19, 2021, 05:57:12 pm »
 8)

By the way,... I am posting this, so that it may help others, who may at some time, have to go through this same procedure.

Life is a constant learning experience !  :)

Ray
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #8 on: December 19, 2021, 06:00:24 pm »

Wait till I get my mitral valve replaced or repaired... That thread will be a doozy !!  ::)

Ray  :)
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #9 on: December 19, 2021, 06:12:45 pm »
Duh,...

Somehow I deleted the main content of post 6. This is what happens when one gets older.  Anyway, I received more notes today:   ::)  :P

LOCAL TITLE: Infectious Disease Follow-up Brief Note (tp)
STANDARD TITLE: INFECTIOUS DISEASE NOTE
DATE OF NOTE: DEC 17, 2021@14:17 ENTRY DATE: DEC 17, 2021@14:17:53
AUTHOR: ***************  EXP COSIGNER:
URGENCY: STATUS: COMPLETED

ID TELEPHONE NOTE
CYTOPATHOLOGY DIAGNOSIS
SPECIMEN SOURCE:
Anal canal.
SPECIMEN ADEQUACY:
Satisfactory for evaluation; transformation zone component(s) present.

INTERPRETATION:
Few atypical squamous cells of undetermined significance (ASC-US).

This report is prepared in compliance with the revised Bethesda 2014
system of terminology. This test result should be correlated with
other clinical, pathologic, and laboratory findings.

Ref: The Bethesda System for Reporting Cervical Cytology. Ed. Ritu Nayar
and David C. Wilbur. Springer International Publishing Switzerland 2015.
IHK/ihk


************, RAYMOND JOHN
CONFIDENTIAL
Page 25 of 122
Discussed above results - ASCUS with good specimen - with veteran.
Generally would recommend anoscopy to determine if he should have HRA or serial
cytology/DRE.

 However, he did already have a colonoscopy last month in which the
anal tissues were directly examined, so he and I both feel comfortable with
deferring colonosocpy.

Agrees to ~6 month repeat cytology.
Will schedule with me in June for now.
Alternatively, could be completed by NP ********* at his May appointment.
RTC placed
/es/ ****************, MD
CHIEF, INFECTIOUS DISEASE
Signed: 12/17/2021 14:20
Receipt Acknowledged By:
12/17/2021 14:50 /es/ **************, AMSA
ADVANCED MEDICAL SUPPORT ASSISTANT
12/17/2021 14:29 /es/ ****************** ARNP
INFECTIOUS DISEASE
Date/Time: 13 Dec 2021 @

Ray
« Last Edit: December 19, 2021, 06:19:08 pm by J.R.E. »
Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG

Offline MitchMiller

  • Member
  • Posts: 672
Re: Anal Cytology...
« Reply #10 on: December 22, 2021, 11:02:02 pm »
I had an anal swab done a year ago, all clear. 

However this year I got this result:
ATYPICAL SQUAMOUS CELLS OF UNDETERMINED SIGNIFICANCE (ASC-US)

My APRN referred me to a cancer treatment center.   I've read there are a lot of false positives when this test is performed to detect cervical cancer in women.
Logged

Offline J.R.E.

  • Member
  • Posts: 8,207
  • Positive since 1985, joined forums 12/03
Re: Anal Cytology...
« Reply #11 on: January 30, 2022, 04:47:04 pm »


Just to add to this thread.  I noticed a couple more results today, that I did not see before,  when this procedure was completed on December 13th.. I still have a future rectal exam scheduled for June 22nd,22. ( Not sure what this entails yet)


The below test, were done on December 13th, the results don't surprise me, But I am glad they were done anyways.

**   Structure of rectal ampulla (body structure):

C.TRACHOMATIS TMA,RECTAL   NOT DETECTED 

DETAILS: C.TRACHOMATIS TMA,RECTAL
Result:    NOT DETECTED
Units:    
Reference Range:    
Lab Test:    Chlamydia/GC Panel~QUEST DIAG



N.GONORRHOEAE TMA,RECTAL   NOT DETECTED   

N.GONORRHOEAE TMA,RECTAL
Result:    NOT DETECTED
Units:    
Reference Range:    
Lab Test:    Chlamydia/GC Panel~QUEST DIAG




Ray


Logged
Current Meds ; Viramune / Epzicom Eliquis, Diltiazem. Pravastatin 80mg, Ezetimibe. UPDATED 2/18/24
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of Oct 2nd, 2023, Viral load Undetectable.
CD 4 @676 /  CD4 % @ 18 %
Lymphocytes,absolute-3815 (within range)


72 YEARS YOUNG
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