The Biopsy
The following morning after we sat down with the doctor to discuss the results of Sheila's mammogram and ultrasound imaging, we were headed back to the hospital for a biopsy.
Sheila has been down this road before. Her first biopsy was 11 years ago, then surgery, radiation, chemo and the years of follow-up testing, imaging and exams. But, this morning, we were back at square one again. I have to say that it was not a pleasant feeling to be back at square one again.
We both were so anxious that we thought we couldn't eat. We sat down to eat but we both commented that we had no desire for food whatsoever. The funny thing is... once we started eating, we pretty much finished our meals. I think the food absorbed some of the stomach acid being pumped into our empty stomachs due to our nerves. We felt a bit better after eating.
On the drive to the hospital this morning our conversation changed from a pep talk type of thing giving positive reinforcement to someone who has already effectively experienced these same exact trials and tribulations to one of the harsh realities of this type of event.
We discussed how to manage work, annual leave, sick leave, family leave and which doctors need to get involved in this paperwork. We discussed types of chemo-therapies. We discussed insurance. We discussed out-of-pocket expenses and how we would manage financially. We discussed how and when to introduce the grandkids to this frightening world of the unknown and visible physical changes in their Gee. But, we held it together and discussed it as we would expect any mature, grown adults to do. After all, all of this stuff has been in the forefront of our lives since before Sheila and I even met. We came together as two chronically ill people. We were definitely familiar with this life. We have an advantage in that both of us are intimately experienced in life-threatening chronic illness.
The discussions would happen in spurts. Whenever one of us would get choked up, we'd slow down and breath while the other picked up where the discussion left off. Then the choked up one would slowly ease back into the discussion.
Thinking about the biopsy was tough enough but being slapped in the face by these often forgotten harsh realities of cancer that people rarely talk about or even know about added a significant emotional burden. We talked about it to ease our concerns as much as would be possible at this stage of the game.
We learned a very long time ago that keeping concerns bottled up with no discussions only brings on a trainwreck later. Burying a head in the sand does not work and only brings on needless worry which interferes in the whole healing process. This was more an exercise in alleviating concerns by sharing them and breaking some of the concerns down into a couple of specific and concise options. Unfortunately, at this point, there still are a number of unknown specifics especially when it comes to treatment, costs and insurance coverage.
When we arrived at the Breast Care Center at the hospital, we were barely seated before they ushered us into a room where the biopsy would be performed.
"Performed" may seem like a silly choice of words but, as a spectator on this day (rather than the patient of which I have been more than once), I can honestly tell you that it is indeed a performance.
There is a delicate ballet being performed between the doctor and the nurses to avoid contamination of anything that will come near Sheila. The nurse quietly explained what would happen... then the doctor would explain what would happen, how it should feel and how it will sound so that the sudden metallic gun-like sounds would not startle Sheila.
One nurse would hold up a package containing a sterilized instrument... the other nurse would peel it open so the doctor would have easy access to it. Even the ultrasound wand was sterilized and carefully covered in a sterile 'glove'... placed on the end of the wand, inside-out, then peeled over the entire wand and cord. It was a well choreographed dance and commentary of explanations. This biopsy was being "performed".
Sheila's breast was sterilized... she was completely covered except for her face and breast. She had her arm up away from her right breast, draped over her head with her hand dangling behind her. I was behind her holding this hand with one hand and my camera in the other. She was injected about four times with a local anesthetic all around her breast as the doctor and nurses continued their smooth and delicate ballet.
I had a clear view of the ultrasound screen. The ultrasound allowed the doctor to see a direct route to the tumor. The unfortunate thing for Sheila was that this thick biopsy needle was inserted on the opposite side of the breast as the location of the tumor. The doctor would ease the needle in... slowly pushing across her breast closer to the tumor while we watched the screen... then, as she reached the tumor, she would trigger the large needle... it would make a metallic popping sound like a pellet gun as the needle would plunge through the tumor... then she would ease back out. One down, only three more to go...
At this point, I couldn't help but compare my own bone marrow biopsies to this biopsy. I knew Sheila was going to be sore after this abuse! This biopsy was much more involved and invasive than I had previously thought.
Near one of the last sample collections, Sheila's face was spattered with blood. The doctor and nurses apologized profusely as they cleaned her up. Hey... at that point we needed and welcomed a little comic relief by something unexpectedly silly as though we were in a television sitcom.
After four biopsy samples, they again inserted another large tool to place a tiny marker chip next to her tumor.
They applied pressure to Sheila's breast at the site of the incision for the needle. They held pressure for seven minutes then the nurses cleaned up Sheila.
When all the cleanup was finished and Sheila was sitting upright again, she was brought down the hall for another but more delicate mammogram to ensure the marker chip was in properly in place.
While Sheila was in the other room for the mammogram, I chatted with one of the nurses about my observations of this breast biopsy compared to my own bone marrow biopsies. I even told her about the one time when the needle bent and got stuck in my bone... then they inserted a heavier gauge needle... it too bent and got stuck... yanking on the needle to dislodge it... then the largest gauge needle did the trick. I told the nurse that I honestly didn't expect Sheila's biopsy to be as invasive as I had just witnessed so it was good that I saw it. I expected the needle to go in... then come out with a sample... clean her up... good to go. It wasn't like that at all. There was no doubt in my mind that Sheila would be hurting when the local anesthetic wore off.
After Sheila dressed in her own clothes again, we were given a parking pass and respectfully and empathetically escorted to the exit of the Breast Care Center.
Things are happening quickly in this initial whirlwind and I have to say that this is good. It is the idle time when you are waiting for things to happen and waiting for results that get to you.
Today, Sheila is resting on the couch... Tylenol... ice... a little snooze... a very quick, restful day. One of our friends, Judy, stopped by to give Sheila a hug and wish her luck. Christine, our mail carrier, also stopped in to give Sheila a hug. Thus far, it has been a much needed nice day!
We invited Sheila's parents and a couple of friends over for dinner tonight. I'll be making a roast beef, some mashed potatoes, carrots and I might even make some Yorkshire Pudding. I think it is safe to say we are both looking forward to a little bit of socializing in the comfort of our home.
Sheila has been down this road before. Her first biopsy was 11 years ago, then surgery, radiation, chemo and the years of follow-up testing, imaging and exams. But, this morning, we were back at square one again. I have to say that it was not a pleasant feeling to be back at square one again.
We both were so anxious that we thought we couldn't eat. We sat down to eat but we both commented that we had no desire for food whatsoever. The funny thing is... once we started eating, we pretty much finished our meals. I think the food absorbed some of the stomach acid being pumped into our empty stomachs due to our nerves. We felt a bit better after eating.
On the drive to the hospital this morning our conversation changed from a pep talk type of thing giving positive reinforcement to someone who has already effectively experienced these same exact trials and tribulations to one of the harsh realities of this type of event.
We discussed how to manage work, annual leave, sick leave, family leave and which doctors need to get involved in this paperwork. We discussed types of chemo-therapies. We discussed insurance. We discussed out-of-pocket expenses and how we would manage financially. We discussed how and when to introduce the grandkids to this frightening world of the unknown and visible physical changes in their Gee. But, we held it together and discussed it as we would expect any mature, grown adults to do. After all, all of this stuff has been in the forefront of our lives since before Sheila and I even met. We came together as two chronically ill people. We were definitely familiar with this life. We have an advantage in that both of us are intimately experienced in life-threatening chronic illness.
The discussions would happen in spurts. Whenever one of us would get choked up, we'd slow down and breath while the other picked up where the discussion left off. Then the choked up one would slowly ease back into the discussion.
Thinking about the biopsy was tough enough but being slapped in the face by these often forgotten harsh realities of cancer that people rarely talk about or even know about added a significant emotional burden. We talked about it to ease our concerns as much as would be possible at this stage of the game.
We learned a very long time ago that keeping concerns bottled up with no discussions only brings on a trainwreck later. Burying a head in the sand does not work and only brings on needless worry which interferes in the whole healing process. This was more an exercise in alleviating concerns by sharing them and breaking some of the concerns down into a couple of specific and concise options. Unfortunately, at this point, there still are a number of unknown specifics especially when it comes to treatment, costs and insurance coverage.
"Performed" may seem like a silly choice of words but, as a spectator on this day (rather than the patient of which I have been more than once), I can honestly tell you that it is indeed a performance.
There is a delicate ballet being performed between the doctor and the nurses to avoid contamination of anything that will come near Sheila. The nurse quietly explained what would happen... then the doctor would explain what would happen, how it should feel and how it will sound so that the sudden metallic gun-like sounds would not startle Sheila.
One nurse would hold up a package containing a sterilized instrument... the other nurse would peel it open so the doctor would have easy access to it. Even the ultrasound wand was sterilized and carefully covered in a sterile 'glove'... placed on the end of the wand, inside-out, then peeled over the entire wand and cord. It was a well choreographed dance and commentary of explanations. This biopsy was being "performed".
I had a clear view of the ultrasound screen. The ultrasound allowed the doctor to see a direct route to the tumor. The unfortunate thing for Sheila was that this thick biopsy needle was inserted on the opposite side of the breast as the location of the tumor. The doctor would ease the needle in... slowly pushing across her breast closer to the tumor while we watched the screen... then, as she reached the tumor, she would trigger the large needle... it would make a metallic popping sound like a pellet gun as the needle would plunge through the tumor... then she would ease back out. One down, only three more to go...
At this point, I couldn't help but compare my own bone marrow biopsies to this biopsy. I knew Sheila was going to be sore after this abuse! This biopsy was much more involved and invasive than I had previously thought.
After four biopsy samples, they again inserted another large tool to place a tiny marker chip next to her tumor.
They applied pressure to Sheila's breast at the site of the incision for the needle. They held pressure for seven minutes then the nurses cleaned up Sheila.
When all the cleanup was finished and Sheila was sitting upright again, she was brought down the hall for another but more delicate mammogram to ensure the marker chip was in properly in place.
While Sheila was in the other room for the mammogram, I chatted with one of the nurses about my observations of this breast biopsy compared to my own bone marrow biopsies. I even told her about the one time when the needle bent and got stuck in my bone... then they inserted a heavier gauge needle... it too bent and got stuck... yanking on the needle to dislodge it... then the largest gauge needle did the trick. I told the nurse that I honestly didn't expect Sheila's biopsy to be as invasive as I had just witnessed so it was good that I saw it. I expected the needle to go in... then come out with a sample... clean her up... good to go. It wasn't like that at all. There was no doubt in my mind that Sheila would be hurting when the local anesthetic wore off.
Things are happening quickly in this initial whirlwind and I have to say that this is good. It is the idle time when you are waiting for things to happen and waiting for results that get to you.
Today, Sheila is resting on the couch... Tylenol... ice... a little snooze... a very quick, restful day. One of our friends, Judy, stopped by to give Sheila a hug and wish her luck. Christine, our mail carrier, also stopped in to give Sheila a hug. Thus far, it has been a much needed nice day!
We invited Sheila's parents and a couple of friends over for dinner tonight. I'll be making a roast beef, some mashed potatoes, carrots and I might even make some Yorkshire Pudding. I think it is safe to say we are both looking forward to a little bit of socializing in the comfort of our home.
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