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.