Month: July 2019

Stereotactic Biopsy

I decided to split up the biopsies into two posts in case you fainted from reading about the needles in the first post. They only get bigger in the second part!

I was moved to a different room and sat on a table. They lifted me up very, very high, and prepped the under part of the table. I couldn’t see much of that apparatus from my ivory tower on top, but it is basically a mammogram machine thing but under a table. When they were ready, I lay down and my left breast hung through a hole in the table. So comfortable. At least my right one was still numb from the previous procedure because I got to lie on it for a while.

They bring the two parts of the under table mammogram machine thingy – technical term – together and use that as guidance for where to do the biopsy. They took some pictures, the doctor looked at them and the area to be… accessed… was cleaned to prepare for the procedure.

Another shot of lidocaine! I didn’t see the needle for that this time. I had in the previous procedure, but it was tiny. Then the procedure was started. The ‘large-bore needle’ used for this procedure is a 9 gauge.That means it’s bigger than the previous needle. They apparently shove more lidocaine in that hole two and I felt very little. I shouldn’t say nothing, but no pain.

The samples were taken and at one point it sounded like a drill from the dentist’s office was being used. I commented on it. There were at least three people in the room for each procedure, and they all assisted, but also to make sure I wasn’t freaking out, I think. 

The giant needle was removed and the area compressed to stop any bleeding. I then went on my side and they lowered the table and they put on the Steri-Strips and gauze. 

Next, I got to get up and move to the mammogram room and have two mammogram pictures taken on each side. Always a fun time. They didn’t squish them as hard I was told, but I couldn’t really feel anything. 

These biopsies are performed by a radiologist who has special training. Things I’m learning that I could have blissfully lived my life unaware of and been content. C’est la vie.

I behaved through all procedures. The last thing I want is to have to repeat anything or start anything over. I am nice to all the staff as they are doing their jobs and I trust that they are good at them.

The last part was with the nurse to discharge me. I was given numbers to call if I was freaked out and advised that the operator answering would not know who I was. Apparently people have gotten upset with the operator not knowing them immediately and having to look their information up and get the on-call doctor for that area to call them back. Really, people? Let’s all take a step back and just be nicer and more understanding. Okay?

No showers or swimming for 24 hours. No lifting anything over 10 pounds (lbs) for 24 hours – sorry, Arthur, you’ll have to jump up into my lap yourself – he’s 12.6 lbs. Take it easy. Ice every two hours. Sleep in your supportive bra. I didn’t ice overnight. I slept in the bra, though. Remove the gauze after 24 hours and then you can shower. Don’t remove the Steri-Strips. They will fall off on their own. Any concerns? Call. And here’s an ACE bandage in case you need to compress the area due to swelling. And some ice packs. They’re round. I was given one – asked for a second because, hey! I got two owies. 

Finally, released. The entire appointment was four hours. About half was the procedure, the rest was waiting. I did pretty well with the waiting. I’m trying to be more patient because I know there will be lots of waiting. 

The drive home took almost an hour. The drive in had taken about 45 minutes. Please pay more attention when driving, people, so that you don’t block every route out of downtown with accidents. Thanks!

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And in the afternoon…

Biopsies. Two. Right and left. Why? My MRI showed additional areas of concern. 

On the right, a smaller mass similar to the initial mass. It was not seen on a mammogram or the initial ultrasound. Although, to be fair, they were looking at the 2 centimeter (cm) mass. My MRI said it’s 2.1. Hence the Stage 2 now. Just .1 cm makes it sound scarier.

On the left, an irregular calcification that is kind of linear and in an area 1.6 x .7 cm. This was noted on the mammogram but only after being viewed on the MRI. The chances of it being caught with just the mammogram were maybe not great. Plus, they were concerned about the right mass and focused there.

I know you want to know what this was like. It was so fun! Kidding. The PET scan was a cakewalk. Biopsies? Less so.

They were running late. We showed up at the appointed time, and I had to wait. I was pulled into a room to do a mammogram on my left side in preparation for my stereotactic biopsy. I behaved and held my breath when requested and the pictures were fine. Then I kept waiting. I think it was around an hour and a half to two hours of waiting until we got down to business. They were running behind. I hope it wasn’t because they’d had complications with someone and needed lots of extra time.

Right biopsy. Ultrasound-guided. I was face-up on a table and a bolster placed behind my right side to elevate the area. My offenders have all decided to be on the under part of my breasts, so that’s where they needed access to. After thoroughly cleaning the area, I was numbed with lidocaine that the doctor inserted into the affected area after spending time making sure it was the correct spot. That hurt a little, but it’s just a pinch. And much better than feeling, oh, anything. 

I haven’t read the notes on this biopsy yet, but I did a little research on the size of the needles. A core biopsy needle will be 14,16, or 18 gauge. The higher the number, the smaller the needle. There is a ‘click’ as they take the samples, but she let me know so I would hopefully not jump. I didn’t jump. Trying to behave in the parts I can control and make their job easier any way I can. 

Samples were taken. Three or four, I don’t remember. I just stared at the ceiling mostly. Then, the biopsy needle was removed and pressure applied to the wound. Steri-Strips were placed over the area and then gauze was taped on. I can remove the gauze tonight before I shower – no shower for 24 hours after these procedures – but I am to leave the Steri-Strips until they fall off.

When they do a breast biopsy, they put in a little marker that is called a clip. It is titanium-based and is to mark where the site of the biopsy occurred to help mark where surgery might be needed. I have three clips, two in the right, one in the left. I am fine with this number of clips. I was fine with one. Obviously I would have preferred zero. I don’t want to collect the whole set since apparently they put different clip shapes in every site to note on my charts. Three is good, and I think all doctors currently involved would agree.

Next: Stereotactic biopsy!

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One Test in the Clear!

My positron emission tomography scan, or PET scan, showed no additional areas of concern beyond the areas we know about already. I am relieved. Husband is relieved. Friends and family are relieved. Dogs are napping.

The person who brought me in and prepped me for the scan did a great job describing it. You are not to eat for 7-8 hours before you get scanned. Before that time, you should avoid sweets and carbs. I ate some chicken and a salad I made with lettuce from our garden. I didn’t eat any tomatoes out of abundance of caution. I put homemade Italian dressing on and some feta cheese. And then I had a snack later in the evening of smoked pork. Then I went to bed.

On the way in to the office I saw an employee walking down the hallway carrying cupcakes. I briefly toyed with the idea of tackling him, but decided that would be frowned upon.

The prep once you are there. They check your blood sugar to ensure you are not out of whack because the delivery system for the radioactive drug, or tracer, uses glucose to move throughout the body. In my quick research, it appears that the tracer can be swallowed, injected, or inhaled. Depends on what they’re testing for. In my case, it was an injection. 

When the radioactive glucose (not what they call it, that’s what I call it – not a medically correct term!) is initially injected into your body, it goes through your bloodstream and if they were to scan you right then, your scan would be gray. This is because you have been fasting and everywhere wants some of that yummy glucose. 

Your brain and heart, of course, do not rest. I was told they would appear yellow on the imaging. Areas of concern would also show up in a similar way because the cancer cells are greedy and keep a hold of the radioactive glucose long after the rest of the body has had its fill. Therefore, they show up on the scan.

They’ve conducted all the studies, of course, and determined that 45-60 minutes after the radioactive glucose is introduced is the best time to run the scan. In that 45-60 minutes, you rest. I saw in a recliner in a room with subdued lighting and a warm blanket over me and dozed off. It was 7:15am when I went there. We’d had to get up at 5am to make this appointment. I was tired.

After this time, they come and get you and then you have to take a wee. I’d read that online before I went, so I was prepared when they wouldn’t let me go any further without a pit stop. Done. Then on to the room. This particular room was very relaxing. Subdued lighting during the actual test, and a color-changing ceiling with little points of light to resemble stars.

That helps you keep calm and to not think too much about your arms behind your head and hands maybe trying to fall asleep. I was face-up on a table with my head between two squishy things and then slid into a tube. It’s open on both ends, so unless you are super claustrophobic it’s not too bad.

First they did a computerized tomography (CT) scan. It’s a fancy X-ray that provides much more information than a normal X-ray. I was told they would overlay the PET scan on the CT scan, so try not to move. No problem. That was the short part.

Then the PET scan. The actual imaging surface is not very wide, so I was slowly moved into the machine as they started around mid-thigh with my imaging. I moved bit by bit and was as still as I could be during the whole process because I wanted good pictures on the first try.

They wanted to be sure there was no cancer anywhere else. This is the best scan they have for that. They didn’t see anything beyond what we know already. I am pleased. Still mad at cancer, of course, but glad that we caught it so early due to screening.

Apparently after I was escorted out of the waiting room they started handing out shakes! No fair… (they were meds for screening, so I was only jealous because I was hungry)

Filed under: Medical Definitions

Well, Shit.

I’m meeting two oncologists. One was today. He ordered a PET scan – that will be Wednesday – and we have no treatment plan because of my other areas I need biopsies on now. Also Wednesday. But he did tell me that because of my tumor size, I would be considered Stage 2. And that’s if it hasn’t spread anywhere else. That’s what the PET scan will show or hopefully not show.

Tomorrow I will meet the second one who will probably tell me the same stuff, but she’s five minutes from my house. I think he realized by the end of today I would probably end up with her. She’s close. I’m not a good candidate for a clinical trial because my main concern is neuropathy. I don’t care if my hair falls out. I don’t care if my breasts have to be removed. I don’t care about anything except being alive after all this is done, being a happy little family, and being able to keep doing what I love.

I love my work. I am a stenographer. I help people in intimate settings and at large events. I have helped amazing intelligent people in college work towards and achieve their degrees. Having a disability should never hold someone back from their dreams, no matter how large or how small. I honestly believe that many of the people I have worked with will change the world for the better, and I am humbled to have played my small part.

Neuropathy is numbness. I talked to a neighbor who survived Stage 3 esophageal cancer – treated by the oncologist I’m going to see tomorrow – and he has some numbness in his fingers and feet. He has to be careful how he walks. I know being alive is the ultimate goal, but I don’t want to have to figure out something new to love because I can’t feel my fingers and control where they go.

At the end of the day, I still don’t have a treatment plan because I need additional testing and scans. Hopefully my PET scan will just show that I have naughty, naughty breasts and that’s it. Hopefully my biopsies will show no new cancers because if I have another one, and it’s hormone positive? That would change my treatment plan a lot.

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