As you will likely remember but let’s have a link anyway, I don’t want to act like I assume you are hanging on my every word, I was scheduled for a biopsy today to investigate some microcalcifications. I loved the radiologist, who explained excitedly to me that the biopsy involved using TRIGONOMETRY. I have such a crush on women in STEM who love their jobs (I am similarly smitten with our oral surgeon, who wears a headlamp at all times); I hung on her every word, even though I myself would not remember how to use trigonometry even if you dangled me off the side of a cliff and threatened to let go unless I could find a cosine. (I got an A in Trigonometry in high school, but it is because I am very good at test-taking and at figuring out which problems to plug into which formulas, and not because I ever remotely understood what I was doing.)
Where was I? Oh, yes: so today was the day of the biopsy. I was a little nervous. The instructions said I could wear deodorant if I wanted to, which was nice. I was not supposed to take any blood-thinners of any kind (including ibuprofen) for 72 hours beforehand. It was suggested that I have a meal before the appointment, to avoid getting faint/shaky. I did not like the sound of “getting faint/shaky.”
As with a mammogram, I was instructed to undress down to the waist and put on the hospital smock “like a bathrobe” (opening in front). Unlike during a mammogram, I had to climb up onto a high table (as in, I had a two-step stepstool to help me, and I used both steps). The table had a hole in the middle of it. I am always anxious about positioning myself on tables for medical purposes (I feel clumsy, and when I’m nervous it’s harder to understand/follow the instructions), and I would say this particular positioning was one I was glad to have had a chance to gear up for (the radiologist gave me an overview when she was telling me I needed a biopsy). I talked myself through it by telling myself that I am HARDLY the only person who does not have experience in how to correctly lie down on a breast biopsy table, and that I am DEFINITELY NOT the only person who needs to be adjusted after the first attempt.
Anyway. The basic idea is this: one lies down on the table on one’s stomach so that The Breast in Question is down through the hole in the table, but the Breast Not in Question as well as The Ribcage Below the Breast in Question are well-supported by the surrounding table, so you don’t feel as if you will fall through. They give you a couple of thin soft pads to position under your head as you prefer; I found it most comfy to use both pads and also put my hand under the pads for a little extra lift—but this is how I sleep, with a hand under my pillow, so maybe that’s just what felt Right to me, and not what would feel Right to others. In my case, The Breast in Question was the left one, so I was supposed to turn my head to my right, and it was my right arm that was up under my head; I wanted my left arm up like that too, in a sort of Sunbather’s Pose, but they did not let me do that: my left arm had to be down by my side, palm up. It felt okay once I got used to it, but still a little awkward.
The most difficult part is RELAXING. You don’t have to hold yourself up! You are lying down, and well-supported! But it FELT like I had to hold myself up. I kept having to remind myself that I could just lie there and rest and be as comfy as possible, considering the circumstances.
Both the radiologist and the nurse were good about telling me what was going to happen next. It feels pretty weird, because you are lying there on your stomach and someone is messing with your boob FROM BELOW. It is hard to wrap one’s mind around it. And one ear is squashed, which makes it a little hard to hear, or makes it feel like it’s a little hard to hear.
There is a sort of mini mammogram machine underneath the table, so they arrange the breast into that, and then the machine squeezes—not as hard as during a mammogram, just a sort of firm grasp. The machine does imaging to make sure the breast is positioned correctly; they had to ungrasp and regrasp a few times to get things right.
I am hoping I am remembering to mention all the steps. They raised the table at some point, even higher than when I had to use a two-step stepstool to climb up onto it. It’s so the radiologist can sit UNDER the table to do the biopsy. This table-raising might have happened before the grasping/ungrasping/regrasping. (By the way: the radiologist mentioned that for people who CANNOT climb up onto the table or who would PREFER NOT TO, this procedure CAN be done with the patient seated. She said but most patients find it easier not to have to hold still in an upright position, and not to have to see the radiologist RIGHT THERE, and WITH THE NEEDLE, and so forth.)
Then the radiologist warned me she was going to clean the area, and there was a cold wet wiping sensation. Then she said she was going to do the numbing medication, and that there would be a pinch, and that I should NOT “rise up” but should instead “wiggle my feet.” Feet-wiggling was so distracting, I almost don’t remember how much the pinch hurt, but my memory is that it was less than a vaccination, but in that general range of pain: a little stab, but nothing that made me want to jump or gasp. Then she said she was going to do a second dose of numbing medication, but that I would probably feel it less than the first one, and that was correct: I still did feel something, but not much. A mosquito bite, a tiny sting.
Then the procedure itself began, and she warned me that the machine was going to make funny noises, and it did; I suggested it was the sound of trigonometry being done, because I was trying to impress her, but she said “What?” and then I had to repeat it. The noises were like…low-volume vacuuming noises, intermittent machine-running noises, cycling motor noises, that kind of thing. Nothing gross or scary, but I was glad she mentioned them. I could not FEEL much while this was happening. Sometimes I thought I felt Something, but nothing upsetting or painful—just, I could feel something happening in the breast region. At one point I felt a burning sensation inside the breast, but not painful, if that makes sense combined with the word “burning”: you know how if you take a perfectly-too-hot sip of tea/coffee/cocoa, there is a “burning” feeling in your throat but not ACTUALLY burning the way there is when you burn your tongue and you hate it? or if you get in a slightly-too-hot shower when you are chilly, it is a “burning” feeling but you are not actually yelping and turning it down? It was like that kind of burning: definitely I would use the word “burning,” but it did not hurt-hurt, it just caught my notice, like “Oh there is a burning sensation.”
Then it was done, and I don’t think this doctor and nurse had worked together much in the past, because there was a little bit of a dance about getting me out of the machine / up off the table. I am not certain, but I think the issue was that someone needed to apply pressure to the biopsy area the entire time I was (1) being extricated (i.e., as the mammogram machine was releasing its grip) and (2) extricating myself (i.e., as I was moving from lying on my stomach to sitting up), but there were not enough hands to do all the things, or rather not a coordinated/understood allocation of hands; and there was some concern that I would be pinched by part of the machine, but I was not. Anyway, it was managed: I was sitting up on the table, and the nurse was “applying compression”—that is, squeezing my breast hard between her hands, with a wad of gauze over the biopsy site. It’s not an everyday sort of thing to have happen, but she was so normal about it and that helped.
She had to keep squeezing for Quite Some Time. Five minutes? Something like that, possibly longer. Periodically she would peek under the gauze to check the bleeding. I don’t mind blood, so I looked too. There was more blood than I was expecting. When they said “needle biopsy,” I was picturing a needle like a vaccination needle, where sometimes there is a teensy little pinprick dot of blood. In this case I estimate there was half a teaspoon of blood involved total (and that’s only counting the times AFTER I was able to start looking); and the first two times she checked it, there was a sudden welling of blood about the diameter of a pea, maybe a little smaller. The diameter of a petite pea. It made me grateful I did not know beforehand (or afterhand) how big a biopsy needle is.
When the bleeding had mostly stopped, the radiologist applied two pieces of tape, and there was a word for the kind of tape but I have forgotten it. Steri-strips? Steri-tape? Something like that. [Update: I see the paperwork says “steristrips.”] She put them in an X shape over the area. The nurse then took me to have a “gentle” mammogram to make sure the little piece of titanium they put in there was in the right spot. (The radiologist called the titanium “internal breast bling,” and I could not love her more.) It was like a regular mammogram but much less squeezy, and they said the little piece of titanium was where it should be. (If it had NOT been where it should have been, there was no way to adjust it, but they would have noted the situation in my record to avoid confusion later on.)
The breast/skin area around the needle site looked a little deflated to me, but maybe I was imagining it. (I don’t think I’m imagining it. It looks a tiny bit caved in. Puckered.)
The nurse gave me a little (pink, everything breast-related is always pink) ice pack to put in my bra. It felt soothing and nice, but also it was a very hot day so I think it would have felt soothing/nice regardless. I may put ice packs in my bra every summer going forward. (The ice pack had adhesive to hold it in place, and I often get pink/itchy from adhesive, and it didn’t NEED adhesive because it could be tucked into the bra, and I DID get pink/itchy from the adhesive—so if there is a next time, next time I would ask them to skip the adhesive.
She asked me to rate the pain of the procedure on a scale of 1 to 10. I HAAAAATE those scales, and can’t believe how unscientific/subjective they are: dramatic people will say 10, it’s 10, MY SUFFERING IS ALWAYS A 10!! MAYBE A 12!! Careful anxious hand-wringing overthinkers will say “Well, 10 is supposed to be the worst pain I can possibly imagine, and I can imagine some really terrible pain like if I were shot multiple times or if I were being chewed on by an alligator or maybe I mean crocodile or maybe a shark would be worse, so I guess this excruciating, about-to-pass-out pain is probably a 4 or 5 compared to THAT.” Anyway, I told her the pain of the procedure was less than 1, about 1/2, and I feel good and non-hand-wringing about that assessment. Mayyyybe it was 1 at the worst, but I don’t think so. I think it was 1/2. Maybe less.
On the way home from the hospital, the numbing stuff started to wear off. I don’t know if everyone is like this, but when I get novocaine at the dentist office, as it wears off I get a fair amount of pain that seems to be THE PAIN OF THE NOVOCAINE DEPARTING, rather than THE PAIN THE NOVOCAINE WAS CLOAKING, if you see what I mean. That is, once the novocaine has fully worn off, I am not feeling that pain; it’s more like when a limb falls asleep and is waking up again, and you feel pain as it wakes up, but not after it is awakened. It’s one of the reasons I dread novocaine. Anyway it was like that: I felt an ache like novocaine wearing off. It was not VERY painful, but it was enough to make me want to stick my lower lip out and make a small self-pitying whining sound but not a SERIOUS one. I listened to soothing classical music, which I rarely do, but neither NPR nor my usual pop stations seemed right for the situation.
The ice-pack was small, and by the time I arrived home about 40 minutes later it was not cold. They’d mentioned it was reusable—but what to do while it is re-chilling? I am definitely saving it in case I ever have to have this done again, so that I can have one ice-pack in the bra and the other recharging. [Update: I put some frozen corn into a snack-sized ziplock baggie and tucked that into my bra, and swapped it with another snack-sized ziplock baggie of frozen corn each time it got uncold, and it was as good as or better than the ice pack they gave me, so I will just do that instead of indefinitely saving a used breast-care-center ice pack Just In Case.] I put the single ice-pack I had into the freezer, and I would say the sensation at the site of the biopsy could best be described as “stinging/aching.” Again, not terrible, not VERY painful—but stinging/aching. Putting the ice-pack back on awhile later was pleasant. The whole area feels Kind Of Sore—not agonizing, and I’m not flinching much if I accidentally touch/bump it, but I’m aware of it and it’s uncomfortable, and I am enjoying the cold of each fresh ice-pack.
There was a little bit of blood on my bra. They instructed me to wear a bra to the appointment, but I’d add that you should wear one you don’t mind getting a little bit of blood on. OLD bra. Old COMFY bra. They said I might want to wear the bra to bed tonight, to snug the owie part in and keep it from getting unexpectedly jostled. And I might. But I am someone who does not mind my bra, as opposed to someone who can’t wait to take it off each day, so your experience may vary.
I’m allowed to shower/bathe normally, but I am supposed to avoid washing the area of the biopsy, and I’m supposed to gently pat the area dry afterward. I am supposed to leave the special medical tape on until it falls off, or for four days, whichever comes first. (They said it will probably fall off after three days.) I am supposed to let them know if the area of the biopsy becomes hot/pink (infection). There is apparently a small chance of internal bleeding, which would leave a big swollen bruise but would be fine, and it would go away, it would just be icky/uncomfortable for a little while.
The radiologist will call me when she gets the results; she expects that to take two days, but says because today is Wednesday there’s a possibility the results won’t come in until after work Friday, in which case I wouldn’t hear from her until Monday.