Ultrasounds, Arthrograms, Mammograms, and Biopsies

In the past eight months, I've had three ultrasounds on my leg, two arthrograms of my hips, a mammogram + ultrasound, and now an ultrasound-guided biopsy + mammogram, all at the same imaging place. Fortunately the quality of care is amazing at this place; everyone from the people who do the registration to the techs to the radiologists are top-notch. I have no complaints, other than the fact that I have been to this place way too freaking many times over the past year.

I was supposed to see Dr. Not Friendly, the doctor who does PAO surgery, on Monday. However, he canceled last minute due to an emergency, and his scheduler offered me an appointment today. This was not doable because I had scheduled a biopsy for today, so I ended up scheduling an appointment in, like, three weeks. Whatever. My hips are pretty low priority right now. The only reason I was unhappy about my appointment being rescheduled is that it would have been a good distraction.

Anyway, I've decided to write about the biopsy here, just because. So many different things are going on my life that are impossible to separate.

I've mentioned that I have a stressful work situation right now, and I had a lot of really bad work stress today. After I got done teaching, my stress level was at an all-time high, and I wasn't getting any work done, so I decided to leave around 1:00. My biopsy was at 2:00 and supposedly I was supposed to arrive at 1:45 to do paperwork, even though I don't have to do paperwork anymore because they know me by now, and I have not moved or changed insurance since the last time I was in a week ago. LOL. Nonetheless, I vaguely remembered a tech telling me not to come in for the biopsy on an empty stomach, so I decided to treat myself to lunch before my appointment.

After two arthrograms and several cortisone injections, I wasn't expecting the biopsy to be horrible in terms of physical pain. However, I was in a terrible mental state when I arrived for my appointment. Some of the stress was due to extreme work anxiety and some was due to the unknowns. And then there is obvious anxiety centered around the results, which one cannot help but think about during the biopsy, even though those come much later. Also, my husband really wanted to go to the biopsy with me. I am a very private person when it comes to certain things, and I often do better if I'm alone, especially when the stress is something medical. I know this is an issue I need to deal with because a common theme amongst people with medical issues is that they need friends and family to help them get through, and I just don't do this well. I shut people out. My husband being at the biopsy stressed me out more than if he had not been there, but I know that him being there was his way of dealing with his own stress about this whole thing, so I had to accept it.

All in all, I was not in a good place by the time the radiologist arrived.

Both the tech and radiologist explained the procedure in detail, though I wasn't exactly listening. The radiologist said it was okay if my husband stayed in the room during the biopsy, but that he had to sit down 'so you don't pass out.' Awesome. He then observed that I looked really nervous, and tried to reassure me by saying that he had been doing biopsies since 1992, and that most women didn't find it too bad. He did add, however, that he understood that the most the stressful part was the anticipation of the results. I didn't have the time or energy to go into why I was such a wreck, so I just nodded.

The doctor started off by applying an anesthetic, lidocaine - first topically, then injecting it. This was uncomfortable, but not unbearable. I definitely cringed a bit, to the extent that the tech asked me if I was okay and gave me a washcloth. (Apparently crying is common during this procedure.) With the arthrograms, I always wondered if the anesthetic was worth it, because that was always the worst part - which, duh, makes sense, because obviously that dulls the pain, but I always wondered what the pain would be like without the anesthetic. Unfortunately, I learned the answer to my question the hard way. Once my breast was numb, the doctor informed me he would be inserting an 'automated' needle into the lump, so I would hear a loud sound and feel pressure. At that point I was thinking, okay, that sounds doable. I heard the sound - it was sort of like a staple gun only not quite as loud - then felt the pressure, then felt this intense pain radiate through my breast. At that point, I completely lost it and started crying underneath the washcloth the tech had given. That was definitely not what I would describe as 'just feeling pressure.' WTF?

I was so embarrassed that I was crying, especially after the radiologist had just told me most women didn't find this too bad. Am I really that wimpy compared to 'most women'?! And I honestly wasn't even sure exactly WHY I was crying, so I just buried my face in the washcloth without making a sound. I mean, it HURT, but I've felt worse pain before. However, after a while - probably a few seconds - the radiologist asked me, 'Are you crying because that hurt?' So... he noticed I was crying. I nodded. Work stress and general anxiety issues aside, I was crying because it hurt a lot more than I was expecting; it really took me off guard. Then the tech asked me if it hurt on the surface or deeper, and I somehow managed to eke out 'deeper.' Then the radiologist said a few things I didn't fully pay attention to, but the upshot was that due to the location of the lump, he hadn't been sure that he could get the anesthetic 'onto the other side,' but that he would try. A few more moments of discomfort followed as he attempted to get the lidocaine into a new area, and all the while I was crying into my washcloth.

Finally he delivered the second 'shot,' and that one definitely didn't hurt. That one was just as he had told me the first one would be - a loud noise followed by pressure. Both he and the tech seemed relieved when they asked me about the second one and I said it was fine. And I was also relieved to know that I wasn't some super wimpy woman who was unable to withstand a procedure that 'most women don't find too bad.' After shooting me three more times, the doctor then informed me that he was done. After the fifth, he asked the tech, 'Was that four or five?' She informed him that it was five, which thankfully meant I didn't have to. I was definitely counting.

At that point, I was crying... a lot. Once I started, I just couldn't stop. And then, after all that, I had to have another freaking mammogram, for whatever reason. (I'll have to read up on breasts as I have read up on hips.) The mammogram by itself was not a big deal, but when you're already crying and in a lot of pain, it's not exactly something that will snap you out of that. So I continued crying throughout the mammogram and in the waiting room while waiting for them to tell me if I could leave or not. Fortunately, my husband left after the biopsy, which made it a little easier. I had told him the best thing he could do to alleviate my stress was to take care of the kids, so he left around 2:45, saying he needed to get our son to gymnastics, even though I told him he probably didn't need to leave until around 3:15. (Later he told me he felt sick during the procedure, lol.)

Eventually I got the okay to leave, and since my husband was taking care of the kids, I went home and fell into a deep sleep with the ice pack the tech had given me in my bra. I slept for about an hour in a deep sleep until a text message from a friend snapped me out of it. At that point I realized I couldn't just lie in bed all afternoon with my Woe Is Me attitude; I remembered I had a night class to get to. This started a whole new round of tears, but eventually I pulled myself together and managed to get to class. I was a little worried because my class is very hands on and I was instructed to 'take it easy' with 'no heavy lifting' for 24 hours, otherwise I would have bad bruising and the recovery would be worse. I wasn't sure if I had it in me to try to explain to a bunch of strangers that I could not do certain things because I just had a breast biopsy.

Fortunately, I'm glad I ended up dragging myself to class. For a few hours after the biopsy, I definitely felt like I had been punched in the ribs, but this feeling went away fairly quickly. After I woke up from my nap, I felt pretty good, and in the end, going to class lifted my mood in a major way. If there's one thing I've learned from all of this, it's that no matter what challenge you have, you have to keep moving forward. Even if you are limping, you have to keep moving, somehow.

And so... I keep trying to move forward.