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Needle Biopsies - the long and short of it

Posted Mar 31 2012 12:58am
Ouch - sorry for the bad joke in the title. Can't promise it will be my last. My first experience with a biopsy was right after the diagnostic mammogram. I was shivering like a leaf from the shock of realizing what was going on when the radiologist gave my breast a few numbing shots, and then stuck a really long needle with a suction tip on the end deep into my breast. He took a specimen to send to the lab to confirm whether the mass was cancerous. Even though it was so obvious from the hushed tones of the doctor and the nurse!

I had a second biopsy three days later - a needle biopsy in my lymph nodes after my first breast MRI. Your lymph nodes are these little sacs located in various parts of your body that act almost like collection sites. The nodes in your armpit are one of the first places they look to see if the cancer has spread. These little sacs may look like bright spots on an MRI if there are cancer cells in them.  Not every bright spot means cancer, but it can - so I got treated to a needle biopsy right after my MRI. Directly afterwards. Do not pass GO, do not collect $200. Do not change out of your gown.

I walked into another exam room where a different radiologist gave my armpit a shot of lidocaine, then that suction needle device got pushed in again while a nurse directed with the ultrasound.  Then the doctor said,"You're going to feel some pressure." The sensation is definitely pressure. Lots of pressure. Now I know that pressure is code for - OUCH! In your armpit where nothing like "pressure" has ever been felt before.

Then you wait for your doctor's appointment to hear the results. Results that may change your life. Results that may throw you into a tailspin so fast you lose your bearings, breath, and possibly a breast or two.

1. During the biopsy, if it really hurts - say so. Nobody wants you to be in pain and the doctor may add more lidocaine to numb you, if possible. If this is the first chance you've had to tell them what you need, think of it as good practice, because doctors can't help you if they don't know. Nobody expects you to be a martyr. You don't get any points for  it.

2. Ice when you get home. 20 minutes on, 20 - off, a few times. Personally, I recommend the gel ice packs, but if you don't have them, bags of frozen peas work almost as well. If you don't have those either, just put some ice cubes in a plastic bag and pound away with a hammer. You might enjoy letting some aggression out anyway. It just feels better if the cold molds to your body, and solid ice cubes can sit unevenly on your skin.

3. At this point, you still don't know much, so there's not much to plan for. All you can do is wait and keep asking for names of doctors. You'll need an oncologist and a breast surgeon whom you trust. I even asked the radiologist doing my MRI to recommend a surgeon.  When you start hearing the same names over and over, you know you've got your list.

4. Get organized. Buy a giant 3-ring binder and put some notebook paper in it and two folders - one that closes completely, and one pocket folder. The closed one will be for the copies of cd's of your tests; the other will be for informational flyers. You'll also need a 3-hole punch. Every time your doctor gives you a piece of paper, date it, punch it and put in the binder. You may want a separate one for bills and receipts. I  carried this around in a big bag. Every time I went to a doctor, I took the bag with me.

5. Find all your health insurance documents, look up your coverage information, and write down all relevant phone numbers, deductibles, maximums, etc. Make a copy of your insurance card to keep at home (front and back). Keep the real one in your wallet and make sure it's accessible because you'll need it a lot. Memorize the social security number of the person who carries the insurance (whether it's you or your spouse) as well as the work telephone and address of the employer. This is information you will be asked for over and over.

Keep calm. This is just the beginning. Of course, after the initial shock and worrying about whether you're going to die, the next thing you worry about is having chemo and losing your hair. That big pink elephant with the word cancer painted on it, is now a big, BALD pink elephant.

I promise I'll get to surgery, chemo, losing your hair, growing it back, radiation, and tips for dealing with all of it. Before all of that, come the tests, and nobody prepared me for those.
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