Thursday, May 28, 2015

The Story of a Needle Biopsy: Part 2

Part 1 is here

I lay on the "bed" of a CT scanner with my arms over my head, and in excruciating pain for reasons I didn't understand.  The interventionist radiologist had just majestically declared to me and to the handful of assistants in the room that the needle biopsy of my left lung had concluded.  My thoughts were, "I hurt.  This hurts.  What just happened?"  But, no words came out.  The doc vanished.  Other people were talking about their plans for the weekend.  They had no reason to think that anything was amiss; I had been fine until a minute or two ago.  My scrambled brain didn't know what to make of any of it.  I was unable to eke out a sound.  It hurt too much.

Every breath felt like daggers were slicing into my lungs.  I moved from the scanner to a gurney, trying not to breathe.  They wheeled me to a busy area just outside the scanning room.  The nurse came by and asked if I was in any pain.  I nodded through tears.  I tried to indicate that my shoulder hurt.  She gave me a long, searching glance and then said, "I've never heard anyone say that before.  Maybe it's because of the way we had you positioned, maybe your port has something to do with it."
  They left me sitting upright on the gurney, my husband close by in a chair.  Eventually, the stabbing happened only sometimes, which was a big improvement.

When the doctor stopped by some time afterward he mentioned that at least one of the "cores" appeared to him "by gross examination" to contain abnormal lung tissue.  Really, really not a great time for this conversation.  I never saw him again after that.

X-rays were taken to check for pneumothorax, and I stayed for observation as per the protocol.  I was sent home nearly five hours after arriving that morning.  Stabbing pain upon inspiration continued the rest of the day.  I noticed something else, too.  When I bent to pick something up from the floor there was a "sloshing" sensation.  Mostly, I rested and tried to take shallow breaths.

It wasn't long before the pathology report was ready.  I braced myself for the "Attention!  Attention!  Attention!" banner at the top of the page, but there was none.  It read, in part, this:

Preoperative diagnosis: Presumed metastatic colon CA
Postoperative diagnosis: Same
The sections show cores of pulmonary parenchyma with emphysematous changes. In addition, there are cores of essentially unremarkable splenic parenchyma.  Within these there are some focal collections of foamy macrophages. These are usually associated with tissue destruction at some other location within the body.

I was more confused than ever.  I wondered about the word "emphysematous" could the spots be emphysema? (That would've been pretty great news, considering.)  I emailed a friend-doctor and asked him to go over the pathology report.  He called me later that night after contacting both the pathologist and the interventionist radiologist listed on the report.  He then revealed the jaw-dropping news that the doctor had inadvertently took a biopsy of my spleen!  Gahhhh!

The instant the word "spleen" sunk in, I was acutely aware of exactly where my spleen is located.  This was remarkable only because I had largely ignored the fact that I even had a spleen before that very second.  Had I known prior to this happy conversation where in fact my spleen was, I probably could've figured out that day in the CT room that the radiologist was taking a sample of my spleen, but no, I had no idea.  I tried to wrap my head around the fact that the I.R. had punctured my spleen...while I was awake...and...without the benefit of...spleen-numbing (which I'm pretty sure isn't even a thing).  ack!  ack!  ack! 

To laugh?  To cry?  A little rage, maybe?

I did a some of each.  "Abnormal lung tissue," indeed.  Splenic tissue would qualify as that.  At least we knew that my spleen was cancer-free.  ha!  The worst part was that we still didn't know what was growing in my lungs.

I met with my oncologist, and she decided that it was time for another PET scan.

No comments:

Post a Comment