Saturday, June 11, 2011

Liver Biopsy

It was a lovely spring day after a cold, wet, and very long winter. On this day, June 9, 2011, I was scheduled for a liver biopsy. This did not make me nervous as I:

a) have never had an uncomfortable medical test and,
b) asked others who'd had the test, and all responses were "it's nothing to worry about."

I knew the hardest part would be not being able to eat or drink for 8 hours before my 1:00 procedure. I have been very thirsty for a long time and can rarely go ten minutes without drinking water (a tamoxifen side effect). I'd originally planned to work a half day, but knowing donuts and water bottles would be there to tempt me, I decided to take the day off instead.

I slept until about 9:30, and woke up thirsty and longing for coffee. I determined that a nice, long bath would be an acceptable substitute, being both hot and wet. I decided not to let my dog in with me lest his bathwater lapping technique tempt me to do the same.

The biopsy was scheduled at the same location where my previous biopsies had been. It's in a lovely building downtown (with parking) and my husband, who was my designated driver, and I, scored prime spots far away from the TV.

They have a little patio outside the waiting area with some tropical plants and a large fountain, and the longer I sat and waited, the more inviting that patio looked. I finally told my husband, "I'm going to sit outside in the sun, let me know if they call me." I went out, laid flat on my back on the bench and soaked up the long-awaited sun. You all know me by now, so you can guess what I did - I took a little doze as I listened to the tinkle of the fountain.

It was a light sleep, and the rippling water of the fountain captured my hazy, dreamy attention. The more I listened, sun on my face, the louder it got, until it roared like Niagara Falls. This was not acceptable to a person as parched as I was, so before I stuck my head in the splashing, shimmering pool I went back inside.

My name was called and my husband and I were taken to what looked like the pre-op area of a hospital. They had those snazzy curtains on wheels with a design nobody would choose in their own house; the pattern that just screams, "You are about to have a medical test created in 1982!"

The very sweet and pregnant nurse came by and did my intake. She asked me my name, my date of birth, the name of the street I grew up on, the name of my first pet, and asked me to say the letters in this word:

After she determined I hadn't snuck in off the street for a free liver biopsy, I was given a gown and told to undress from the waist up. I could keep my shoes and jeans on.

After I was properly attired, she came back in and started an IV, and told me that the doctor would be there shortly. I would be given drugs right before the test that would consciously sedate me. I needed to be conscious to comply with instructions. I asked her what the drugs were, and she told me that I would be getting Versed and Fentanyl.

I don't know about you, but the idea of being sedated and unaware but awake freaks me out. What if the doctor is cute and I make a pass at him? What if I spill my family secrets, like the time my son and I broke the pickle jar at the grocery store and walked away like it wasn't us? What if I turn into a Weiner and start sexting teenagers?

Who is awake and unaware, I ask you? Zombies, that's who. What if I rip somebody's throat out?

Who knows what those drugs make you do that you won't remember, but can still be prosecuted for.

And, just my luck, a very cute and young doctor did walk in. It's getting quite disturbing how many doctors I am encountering that could be my children little brothers. I know I'm not getting older so they must be skipping some lessons in medical school these days, is all I'm saying.

I was supposed to have a CT-guided biopsy, but the doctor explained that they would try to find the spot with the sonogram first. Sometimes, he said, these lesions just "jump out" at him and the CT scan isn't necessary. I explained about my shoulder and he said he would work with me to find a comfortable position, and he had me lie on my left side, a pillow propping me up, and my right arm straight down by the pillow.

They greased me up and he started the sonogram. I twisted my head to the right so I could see what was on the screen - if there were going to be jumping lesions I didn't want to miss them. He did, indeed, see what he was looking for so we didn't have to move into the CT area. All I saw on the screen was a white streak, so clearly, I need to brush up on my sonogram reading skills.

Lesion found, it was time for the actual biopsy. I was calm and relaxed as they prepped and draped me. I was in the position they wanted, they found the ribs they wanted to get between and the go was given to drug me.

I don't react to drugs like other human beings - I don't know why. They asked me if I could feel the medicine and I said no. So, they gave me some more. Then, they decided that was enough so it was time to do the biopsy.

He said it would sting a little as they put in the numbing medicine but the deep liver has no nerve endings so all I would feel is pressure. That jibed with what I'd read online so I was good.

Suddenly, I felt a stabbing, searing pain, starting from the skin but plunging deep inside, into my stomach, my liver, my entire mid-section. I was shocked, it hurt so badly. I didn't move but I did tell them it OMG IT HURT! and they gave me some more medicine. They went for another go around and the same thing happened - deep, piercing pain, exactly like being attacked by a serial killer. (Which I know about because I have read approximately 500 books about serial killers.) I became nauseous, it felt like my insides were tearing and my intestines were jumping back to get out of the way of the weapon. Was the doctor using a butcher knife instead of a needle? They gave me more sedating medicine and IV Zofran for the nausea, and went at it one more time. And, it hurt as much the third time. Fortunately, the third time was the last. I was left quivering and sick, knowing exactly what it felt like to be stabbed.

Suddenly, big welts appeared on my arm. I remembered that when I came out of surgery after my mastectomy they had found welts on me too. Both times, I was given IV Benedryl to counteract the reaction. The doctor told me that it appears that I am allergic to Zofran and not to have it anymore.

The bendryl took care of the welts, and the pain from the stabbing biopsy subsided, I guess because the drugs finally began to work, and I went to sleep. I had to stay there for 2 hours, and they wanted me to sleep on my right side, which I can't do because of my shoulder. So, she said sleep on my back, which I can't do because I don't like to. I decided to sleep on my left side and screw them.

I woke up several times, grouchy as hell. The drugs didn't make me forget, and they didn't turn me into a zombie.

They turned me into a bitch.

At one point, I woke up hungry and they brought me peanuts. My husband ripped the bag open too hard and they spilled everywhere, and I got mad and yelled at him. Those peanuts were all that was standing between me and starvation and I let him know that. Then I went back to sleep. I woke up again and wanted to go home, but they said I had 35 more minutes. I went back to sleep and I heard them talking about how I could go now but was asleep and not to wake me. That got my attention and I woke up fully and said, "Nope, I want to go."

As she removed my IV, the nurse asked me if I remembered the procedure, and I said yes. She said "even the pain?" Um, especially the pain - why would that be the forgettable part?

She then said some fateful and disturbing words. She said that she didn't want to give me false hope but cancerous tumors are usually "yucky" and don't have feeling, but when they biopsy liver abscesses, it usually does hurt.

That actually made me angry. It was hard enough to come to terms with what is probably very bad news, but now I have to rethink it all, research it again. Most people, I know, would be happy to hear an alternative theory, but not me, not at this point. I was prepared and now I'm slightly uncertain.

So, now, I wonder: can a person have two abscesses on opposite parts of their liver? Can they grow in five months? Why would a person who hasn't travelled get an abscess anyway? What are the symptoms of an abscess - bloating, pain, exhaustion? Does an abscess masquarade as cancer? Are people with cancer more prone to them?

I wonder about the nurse: Did the doctor tell her something? Was she going on experience? To be honest, I haven't found that nurses have very much medical knowledge. They know how to do things but they don't understand the biology about why they are doing things, or the processes that lead to them doing things, at least in my experience. They know what they know within very narrow confines.

She said that biopsies are painful in people with abscesses but not in people with cancer - but how often does she even know the results of the tests? How big is her sampling? Does she follow up with everybody? Is this a hobby of hers?

Because of that remark, I've done deeper googling and have found that many people, indeed, had painful liver biopsies that did show cancer. I can't find one instance of a more painful biopsy because of an abscess. But, now I'm sitting here hoping it's an abscess, while knowing it probably is not, but maybe it is. I am now beating hope back with a stick, so it doesn't overwhelm me and then bring me down on Wednesday.

It's a lot easier to hear good news when you are expecting bad news, than it is to hear bad news when you are expecting good.

Anyway, back to biopsy day. The very nice staff let me go home, and I slept for the rest of the day and all night. The next day I felt like I'd been kicked in the ribs by a horse and was more than an hour late to work, but I did go to our high school graduation and help hand out diplomas and take photos for the school webpage. The ceremony was lovely and I got to say good-bye to some wonderful kids. I'm so glad I didn't miss it.

Today, I feel like I've been kicked in the ribs by a goat. Tomorrow, I imagine I'll feel like I've been kicked in the ribs by a dog, and Sunday, by a cat. Monday, perhaps by a mouse, and Tuesday, by a flea.

Wednesday, I see my doctor. We'll see what kind of kick I get then.

I guess my luck with painless medical tests has run out. I can tell you one thing for sure though - I just had my very last liver biopsy.


  1. Wow. You took the time to write a riveting play-by-play. You rock!

    I know what you mean about being sedated, yet awake. I had an endoscopy a few years back(chemo about chewed up my esophogas and stomach) and I was talking to the doctor like I met him at a bar! What’s your first name? (his name is Mohammed but he goes by Mo) What kind of car do you drive? (A Mercedes) (to which I replied “Ooooh!!)and so on. embarassing!

    I did laugh out loud when I got to the part about the intake nurse and the word verification. Your humor is endearing!!

    It’s funny (not funny ha ha) I remember one of your beloved readers commented that she’d had a liver biopsy and that it wasn’t pleasant. I’m so sorry you were tortured that way!

    I nodded my head in agreement as I read your reflections on the nurse’s expert opinion. REALLY? Come on…She should know better!

    Glad you didn’t miss graduation. I was present at my school for graduation Friday. (6th grade, not such a big deal) but was too busy to say goodbye to the kiddos. Good for you!!

    Continue to feel better every day, okay? Come Wednesday you’ll be ready to kick ass no matter which way your appointment takes you.


  2. Thank you Gayle. I am going to have to go back and read the comments. Knowing me, I blocked out the person who had the bad experience, not wanting to hear it.

    The graduation was held downtown and I was nervous about attending - I thought it might be too much for me and I couldn't get home. But, it was great. These kids are off to college and new lives and some of them I got to know well. It is always bittersweet to say good-bye to them, as you know.

    They all looked so happy! My own son will be graduating in that very location in only three years and I intend to be there too.

  3. Free Liver Biopsy: worst state fair booth ever.


  4. I know it sucks, but please hang in there. Google is not a medical diagnosis. You may have another liver biopsy if it means you get to live.

  5. I laughed out loud when I got to the peanuts, though I'm sorry for your pain. Sincerely hoping for the best, whatever that may be.

  6. Ann, you have quite the sense of humor, and that has got to get you somewhere! I'm sorry it was so painful for you, and I hope at least you get good news out of all the pain. I'll be checking back in with you in a couple of days to see how you are. Stay strong!

  7. Lost for words... how can someone write so witty, sharp, humorous and beautifully after such an ordeal...

  8. Ann. Soft hugs to you! I've come to learn that the words, "you'll just feel a slight pinch" generally means that someone will need to be on hand to peel me off the ceiling. Always ask for the triple dose before anyone gets withinn6ft of you. Thinking of you as you wait this crap out.

  9. I guess I've been lucky, because up until now, a small pinch has been just that - a small pinch. I didn't realize a stabbing was in my future. My mantra has been if you are relaxed during these tests, they don't hurt. Well, I made myself a liar. :)

    I have to say I am getting very anxious about Wednesday. It seems a long, long way off. I don't even know why I'm anxious, I'm pretty sure I know what I am going to hear.

  10. Ann,

    I'm sorry you had to endure such hell, and I know how hard waiting is. I'm hoping that today you feel like you've been kicked in the ribs by a mouse.

    Your humor and wit are endearing, and I will be sending hugs and good thoughts your way. I'd recommend staying off the Internet. It often leads one astray.

  11. Ann, I agree with Beth...stay off the Internet and avoid Dr. Google while you are waiting. I'm hoping the kick is only a flea tomorrow. After how you described your liver biopsy, I don't think I would ever opt for one. Sending hope and love your way.

  12. Waiting is so hard... excruciating sometimes, isn't it??

    You could try a call to your doctor tomorrow morning and plead hysteria? ask if you can see him sooner?

    Otherwise, you'll have to whine here. we'll listen. and understand....


  13. Excruciating is a pretty good word. As is agonizing, tormenting, distressing, unbearable. But, I don't think there is any way to push this appointment up. My doc won't get the results until Monday (supposedly) and he's not in the office on Tuesday. So, Wednesday it is.

    At least I get to work tomorrow - that will put my mind back in order.

    I'm not googling - there isn't anything to google.

    I'm not even sure why I'm on edge. I have little doubt what I'll be told on Wednesday so why my nerves are wracked is a mystery.

  14. Ann, your sense of humor never ceases to completely amaze me. I am laughing out loud over here; my cats think I'm a looney tune. I'm also properly horrified that you were put through such an ordeal without adequate pain medication and I wish nurses wouldn't say anything about our cases to us unless they were sure - I get that sometimes they feel really sorry for us and cross the line from empathy to sympathy and try to smooth it over for us - but as you have remarked, it's so often based on no conclusive evidence and garners false hope. Still and all - I am keeping my fingers crossed that this is fully treatable and you will be making all of us spit coffee onto our keyboards laughing for many years to come.

  15. Tom Petty knew what he was singing about, didn't he? The waiting is the hardest part. I really get irritated with nurses who try to behave as doctors. There is one at the cancer center who minimizes nearly everything that you have to say. She asks you the 20 questions that they always ask you, the screening stuff that they do every single visit, and every time that I'm concerned about something, she says, airily and dismissively, "It's probably menopause," or something else that makes you feel vaguely foolish, as if you're making a mountain out of a molehill. At one point, I just said quickly, "You know, when you've dealt with cancer, probably is not a lot of comfort." Boy. She got pissed and I mean, right now! Good luck, Anne. I am praying for you.

  16. Ann, I am a new reader in Britain. Can't even remember how I came across your blog but you are so hilariously funny, I can't stop reading it. I am sorry for what you are going through. My aunt lived for 16 years with a secondary breast cancer in her liver. I don't know the specifics of her cancer ie estrogen, her2 etc etc and I'm sure you hear a lot of meaningless trivia like that and it doesn't mean much in the greater scheme of things.

    Just wanted to let you know that your attitude and humour is appreciated over the pond. I even read bits of your blog to my husband last night as I couldn't stop laughing. Humour is a wonderful coping mechanism and you have it in spades!


  17. Hey Cathy, hi and welcome. :) It does help to hear positive stories like that! I'll take 16 years.

    Melissa, I'm not sure I was given inadequate pain meds - I don't react like most people to them. I'm very tiny and I think they have to dose me like a 300 pound man. Nobody who doesn't know me is going to do that. It was over pretty quickly though.

    The nurse was trying to help and I know that. I'm sure she assumes that all cancer patients are grasping at any good news we can get. She doesn't know how much mental energy it takes to face the possibility of stage IV and I hope she never does. She was super cute. :)

  18. Ann,
    What an amazing account of an awful ordeal! So sorry you had to go through such agony for a biopsy. Thank goodness it was over fast at least. Waiting for news is so hard isn't it? It's like mental pain. Thinking of you as you wait. Good luck.

  19. That is an interesting theory about cancer not being painful. My husband said his liver biopsy was easy and pain free and he has 10-15 cancerous lesions (but we already knew that going in to the biopsy) so I hope that nurse's theory is correct! My husband did have Y90 embolization and everyone said it would be painless and he spent the night in the hospital due to pain. So, we tend to not believe "people" when they say "no pain or pain" Good luck. I am hoping you get very good news on Wednesday. and yes, waiting IS the hardest part. We don't go see the dr. until Thursday to find out the results of the radiation treatment (ie working or not working). Trying Not to think about it....impossible.
    --Melissa R.

  20. I'm sorry to hear your procedure was so painful. Wishing you peace during the waiting!

  21. Ann, you crack me up... thanks for sharing your story with us!!!
    I don't know how you couldn't be anxious for Weds... I'm anxious and I don't even know you!!! Thanks for helping to break the tension with your humor!

  22. It's wednesday, and I'm just back to let you know I am thinking of you ...

  23. The worst pain happened to me when I came out of the anesthesia after my hysterectomy/oophorectomy January last year. There were more than 6, 7 other patients in the recovery room, and I was the only one that was crying out loud for help.

    When I asked the person who'd been sitting by my bed adjusting the dosage in the IV pump, he only commented that everyone has a different tolerance to pain. I thought that was odd - since I'd had four major surgeries prior to the 'elctive' one. Then it dawned on me! I must have built up some kind of tolerance to the pain medicine because of the previous surgeries...

    Just wanted to let you know that I understand, I feel your pain... Hanging there. Jackie07

  24. Hi Ann!

    So sorry you had to go thru such pain! But your account had me laughing out loud in my office!

    Can I just say, "I feel your pain!" After my second c-section they did not give me enough pain meds and I was sobbing as they moved me to my bed...felt like I was ripping in half! UGH! I can still remember that pain like it was yesterday and the baby is now 17 years old!

    You amaze me everytime I read one of your posts! I will keep you in my prayers and will be thinking of you tomorrow.

    Peace...Suzanne aka...mommafluff61

    here is a great funny man, Brian Regan, talking about emergency rooms and pain scales...enjoy...

  25. Lol! Ann That was very funny... Which i find funny as i went through the very same thing... only minus the sleepy stuff... They just gave me a local and a nurse held my hand VERY TIGHTLY, which was reassuring but in hind sight was probably to stop me jumping... Funny enough after all that is said and done, i found my breast biopsy to be more painful that my liver one... so go figure! Any hoo Good Luck!

    (Ps)...i ended up with inoperable central liver cancer metastasized from the left breast- which first i had a lumpectomy & lymph removed & then a mastectomy... and THAT (the mastectomy) didn't hurt a bit and i was PETRIFIED as at the last minute the docs decided to offer me a kind of anesthetic that you described for your biopsy only it was delivered in to my back... AND i laughed so much with your post as i was so relieved to read someone else thinking the very same 'crazy woman' thoughts that i had Lol! So i am not so strange afteral??? (((Hugs))) for that xox

    (Pps) i recently had very successful chemo (although had heaps of side-effects) that reduced the liver nodules from 5 to 2 and i am now on hormone treatment (Femara)that is supposed to keep working like chemo but i am impatient and am currently investigating some new techniques aimed at this kind of cancer that are relatively un-invasive... So my interesting journey continues X;-)

  26. Ann,
    You had me laughing out loud. I really can't believe that nurse said such a thing. She must be one of those overly optimistic types that says if you just stay positive everything will be fine. I prefer to prepare for the worst and then I can be pleasantly surprised.

    I also found Jeanne online a couple of years ago and have become "virtual friends". She even featured me in one of her posts since I have a rare disease that doesn't necessarily get much attention. I can't think of a better person for you to reach out to right now.

    Here's hoping that your results are better than your worst case scenario.


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