Breaking a taboo

It’s taken me quite some time to dare to write this post; it feels like such an unmentionable topic. But, I’m coming out… I have genital warts. There, I’ve said it! Phew! But, don’t fear, I will NOT be posting any photos this time! 😉

I’ve felt very reluctant to go public about this particular issue, for reasons which you will understand. Many readers may even think that this is just way too private and perhaps I should keep it to myself. But it’s part of my myeloma journey, and I want to be open about the whole experience. I’m also aware that other myeloma patients read this blog and it feels important to share so others can benefit, if only to know that they’re not alone and it’s ok to speak about.

It’s quite simple… my immune system has been suppressed due to the disease itself and even more so following two stem cell transplants. It is now and will continue to be compromised, so I am particularly prone to fungal, bacterial and viral infections. I now fall into the group of people who are entitled to an annual flu jab (which I’ve already had this year). I also have to take prophylactic antibiotics (Penicillin and Pentamidine) and antivirals (Aciclovir). While the antiviral medication will gradually decrease over time, I will be taking antibiotics for the rest of my life. These support mechanisms don’t eliminate my chances of catching an infection; they simply support my immune system and thereby lower the risk.

I became aware of the warts in April and mentioned them to my consultant. She was very keen that I have them treated and ‘get on top of them’ prior to the transplant, as they could readily proliferate and be harder to treat following the transplant, due to the lowered immunity. She referred me to the genitourinary medicine (GUM) clinic, otherwise known as the sexual health clinic. The doctor I saw is married to one of the haematology doctors, so she understands well the process I have gone through and the connection between my disease/treatment and my sexual health.

Initially, the doctor suggested using Warticon, which is a cream I could apply myself. They even provide a wee hand mirror so you can see what you’re doing. I didn’t see much of a response to the cream, so the doctor prescribed Aldara cream, which is used to stimulate the immune cells to manage the virus that causes the warts. That didn’t work either.

I had a gap in treatment while I went through the transplant and in the first few months of recovery from it. But since the end of September, I have been going for weekly treatments of freezing (cryosurgery) by a nurse. They spray liquid nitrogen directly onto the offending areas, using a ‘gun’. It don’t half sting!!! At last, it does seem to be working; they are vanishing. In fact, it’s working so well, that they gave me a week off! 🙂

Because freezing kills off all cells it touches, the healthy skin around the warts is also affected, and the nurse was concerned in case the skin broke or became painful, so she gave me some aqueous cream to use as a wash. It’s very greasy. In fact, when she advised me to ensure I washed it off after use, she explained that if I didn’t, I’d feel ready to swim the Channel… like being covered in goose fat!

I’ve asked questions and done a bit of online research too. Here are some of the answers that I wanted:

Many adults are likely to have encountered a range of viruses, but only a small percentage actually develop symptoms. This is the case with Human Papillomavirus (HPV) that causes genital warts. Most people are exposed to the virus during their life, but it has the ability to remain latent within the body over long periods – even years or decades before developing into warts, so it is usually not possible to determine exactly when, or from whom, an individual contracted the virus.

For most individuals the immune response appears to dominate and lesions (warts) never develop, or they develop but are suppressed by an immune response before the person ever realises their presence.

Other viruses that can lay dormant without causing any ill effects are Herpes Simplex (HSV) and Cytomegalovirus (CMV). I mentioned in my post “A walk in the park…” that both my donor and I were screened for CMV prior to transplant, as this can be life-threatening for the immunocompromised, whereas it typically goes unnoticed in healthy people.

I also read that persistent infections of HPV may lead to cervical cancer as a result of cellular transformation. The last thing I need is another cancer, FFS! So, it’s critical that to knock this thing on the head. I’m off for another bout of freezing on Thursday. Ouch!