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Tag: stereotactic biopsy

Post-biopsy Recovery

Smaller breasts have more densely packed nerve endings and hence are more sensitive. I never knew that.

I learned this as the radiology tech pulled and stretched my breast – and eventually my shoulder, too – through the hole in the lead-lined table and into a position where she could clamp it tightly between paddles. Focused radiation beams transmitted digital images onto the computer screen a few feet away.

The invasive radiologist came in and opened a window in one of the paddles — everything happened though that window, I’m told. I was frozen in place for the duration and could only see the computer screen. The last image showed several dark holes around a u-shaped titanium chip.

“I got them all,” the doc told me with a warm smile and a squeeze on the arm, reminding me how glad I was that I didn’t get this done by the cold, clinical male doctor who was all business, the one who had read my original films and recommended this procedure. After talking with him I sat in my car in the parking lot and cried.

The breast surgeon had told me that her patients said good things about Dr. Kelly McAleese, and they were right. Dr. McAleese kept up a steady stream of conversation to distract me from the things that were happening. I felt like she was a caring person, and I like that in someone who has the power to save or damage my breast. She had good energy.

The best thing I did was take the valium to calm my anxiety. Instead of the uncontrollable steady stream of tears punctuated by sobs which have been the hallmark of so many other scary and uncomfortable medical procedures in my life, I was able to face the whole thing calmly. Because my body wasn’t tensed up and then depleted from the internal anxieties, the healing already seems easier. There were still moments of pain, but the anxiety was muted and the rest of my body wasn’t clenched the whole time.

Afterward, meeting me in the waiting room, my mother commented on how brave I was being – she’s been to many of these procedures with me over a lifetime – but it wasn’t me, it was my friend valium (or rather the generic equivalent, diazapan). 8 mg didn’t make me loopy, it just took the edge off. And it didn’t make me work to get the peace of mind, like I would’ve had to if I had chosen to use self-hypnosis techniques instead. As I joked with the doctor, it’s times like these that call for valium. Ok, maybe I was a bit loopy. But she agreed.

Because of my allergy to adhesive, the surgical tech used gauze and direct pressure to stop the bleeding, and then mummified my chest in an ace bandage and sent me home with my mom. I took some homeopathic hypericum in the car, then some bellis parennis and arnica remedies once we got home. (More about these homeopathic remedies here.)

Just because we may choose to adopt many natural paths to health doesn’t mean we have to omit other treatments. We can safely use homeopathic remedies, for example, at the same time we’re using antibiotics or sedetives or blood pressure medications, etc. One does not preclude the other. Most natural remedies can work safely alongside western medications, and often are used to help wean off of medications.

My kids were farmed out for the night, hubby away on a business trip, and I got to do nothing but sit in bed and gab on the phone to girlfriends all evening. What a treat!

This morning I unwrapped and removed the gauze, put a dab of Neosporin on the hole and covered it with a little spot band aid. I’ll have to change the bandage frequently to avoid hives, but so far so good. Rewrapped tightly with the ace bandage and supported further with a sports bra, it’s a little achey. I don’t want to move that shoulder much, especially since I don’t want to expand the hole that is only held together by a blood clot.

For “mild discomfort,” the post procedure instructions say, “take Tylenol.” But I haven’t needed to crack open the sample packet they handed me at the end. I rarely take painkillers anyway.

It has been incredible to receive such an outpouring of positive energy as I’ve been going through this anxious time. Thank you all for your kind thoughts and wishes. I will likely hear the results by Wednesday next week – I’ll keep you posted.

I wish you all a wonderful holiday weekend!

To Biopsy or Not To Biopsy?

Although I am choosing to get a stereotactic biopsy today on (from?) my left breast due to a constellation of stars on my first mammogram, it was by no means a foregone conclusion. There were things to consider first.

“So, what is this procedure?” I asked the receptionist at the imaging center when I booked the first appointment.

“Oh, it’s nothing!” she assured me. ” I had one during my lunch hour and came back to work in the afternoon!”

I eyed her. She had perhaps 6 inches, 50+ lbs., and two or three or four cup sizes on me. She looked pretty robust. However you measure, it was quite a bit more breast to work with than I have.

“So it’s a needle?” I have a pretty severe needle phobia. I was trying not to let it show by acting all casual and nonchalant and psyching myself up inside to face a needle. “And they, what, suck out a sample?” Needle biopsies, my husband would point out to me later, have become controversial as they may actually cause an encapsulated cancer to spread.

“Oh no,” she assures me. Oh good: no needle. “They’re going to make an incision, insert a vacuum tube and suck the grains out.”

An incision? A tube?

“Um,” My questions were starting already. “How are they going to close the incision afterward and keep out infection? Stitches?”

Nope. Steri Strip Skin Closures. Hypo-allergenic strips of surgical-grade tape that you leave on to keep a wound closed until they roll up and fall off, maybe ten days. Houston, we have a problem: Adhesive bandages, including hypo-allergenic ones. Leave ’em on me for more than a day and I start to hive. So much for the “hypo-allergenic” claim. Two days will be intolerable, not to mention that the inflammation of the hives will create an environment not conducive to healing the wound.

They call in a surgical tech who tells me that perhaps we can do Steri Strips for the first day and then return the next day to have the strips exchanged for paper tape. Well, yeah, I tolerate paper tape slightly better, but not for longer than a day. They won’t discuss stitches. Now I’m looking at follow-up care.

It’s really nothing, they both assure me. Unless, they accidentally nick a vein and cause a hematoma — a massive bruise, in other words. But that’s very rare, they say earnestly. We’ll give you a compression bandage to wrap around your breasts if this happens. It hardly ever happens.

A possible hematoma? You mean, a “side effect?” Yeah, I’m familiar with “unlikely side effects” from medical procedures. Two weeks flat on my back after a withdrawal of spinal fluid that most people “go right back to work after.” Six weeks of agonizing dry sockets after removal of my wisdom teeth. And more, of course. With side effects like these, you develop a healthy fear of being poked and prodded.

Oh, and one more whammy: “You shouldn’t lift anything for about two weeks.”

I tried to digest this. It became quite clear that this procedure best not be scheduled two days before a cross-country flight to an active family vacation at the shore with seven children under seven years old

The breast surgeon filled in the rest of the details. I’ll be lying on a table with my breast hanging through a cutout, smashed with mammogram paddles. They’ll use radiation to make a couple of images in order to locate the spots on several planes. More radiation from medical tests that I’d rather not be exposed to, all things considered.

Will I be sedated, I asked? I have MS and I’m dangerously sensitive to anesthesia and ibuprofen. No general, she said, just a local anesthetic like lidocaine injected directly into the site. A big, long needle, in other words.

And, they’re going to deposit a titanium chip as a marker so that the follow-up surgeon will know where to go, if necessary. I can choose not to get this piece of metal, but then if the biopsy came back malignant the surgeon would end up taking more tissue during a subsequent lumpectomy than she would have had to if the marker were there.

I called on my resources and I’m going into this well prepared, I think. I’ve got my homeopathic arsenal ready: hypericum to help heal the puncture wound quickly, if I’m in a lot of pain an hour later bellis parennis will help heal the tissue trauma, and arnica in case there’s bleeding or bruising.

Oh yes, and a prescription of valium for my nerves. That one’s not homeopathic, of course, but I will be grateful for it nonetheless!

So many of you have written and left comments that I feel surrounded by good energies. I’m honored and so touched to connect with you through my writing and cooking. Thank you for sharing your strength with me today. I’ll let you know how it goes.

Breast Health: Knowledge is Power

In my last post I talked about the spots on my films from my first-ever mammogram. They seriously look like specks of dust on the “contact print” image of the first set of shots. Smaller than grains of sand, even. They look like… like… nothing.

I hadn’t missed them during a manual breast exam because they were far too small to be palpated. There’s not a lump to feel. Before advanced body imaging technologies, we would never have known they were there at all.

A stereotactic biopsy was recommended. I wasn’t sure I wanted to do that. Are biopsies always safe? This was not a poke with a needle they were talking about. What were the options?

I called a pathologist in the family to see what he thought. He sees these kinds of things come through the lab all the time.

“They look like a constellation of stars,” I tried to explain. “Like pinpricks, only they’re clustered. Not clustered like grapes, but clustered like stars.”

I knew I could count on him to give it to me straight. He went right to the point.

About 80% of things that present like this are found to be calcifications. (This is what I’m counting on!)

Of the rest, most are ductal carcinoma in situ, or cancer in a mammary duct. As cancers go, this one is 100% curable when caught early, which this most undoubtably would be.

A very small percentage of the cases that present like this at my age turn out to be invasive ductal carcinoma. This would be, shall we say, um, not so good, as cancers go.

We won’t know without a biopsy, he noted. He also recommended a second opion before getting a biopsy (the first came from the radiologist who read the mammogram films). Wise words which I took to heart and went to see a breast surgeon.

She looked at my films, noted the jagged edges on the magnified shots, and concurred that I absolutely must have a biopsy. She told me about a recent study done in the Netherlands that showed that 18% of cases like mine turned into cancer within 5 years. That means that 82% are not cancerous, of course! Ten years ago they would have told me to watch and wait, but now they biopsy earlier.

So much for the haze of denial I’d been living in for a few weeks, thinking she would say they were likely calcifications and we could wait and watch. Punctured like a helium balloon in a rose bush.

Now that I know it’s there, I feel I need to know for sure what it is before I can work on healing it.

I go in for the biopsy on Thursday.