What to Expect: Liver Biopsy

By the biopsy, I was terrified.  Biopsies go one of two ways: cancer or not cancer.  There really isn’t any in between.  They already knew this wasn’t some kind of cyst or vascular structure from the MRI.  Dr. K could already tell from the report this was going to be a tumor of some sort.  The only question remained was treatment: would I need chemo for cancer or would I just surgically remove some kind of non-cancerous growth?

The only other biopsy I ever had was on my left hand.  A mole I recalled having between my thumb and index finger for my entire life was oddly shaped and “worried” the dermatologist I had gone to.  She insisted that we remove it, “Just to be certain it isn’t skin cancer.”  At eighteen, I wasn’t about to argue with the doctor.  If she thought it could be cancer, I’d go with it.  I don’t recall the procedure itself hurting, I do remember hurting like hell afterwards, especially since immobilizing the spot was near impossible.  With only this example to call upon, I wasn’t sure what to expect other than post procedure pain.

I suppose, I’m glad I didn’t.  The nurse that placed my IV was nice enough, but as a clinician I know that the IV wasn’t in properly before the procedure.  It was, what we call, positional –meaning it had to be held in a certain position to run correctly.  When you’re already lying in a hospital gown, tears rolling down your cheeks in fear, the last thing you want to comment on is the IV in your arm being busted.  In fact, as I sat holding Milo’s hand, the only thing on my mind was the future.  I prayed the test results would be fine.  I hope that things could go back to normal…and I was still very tired of feeling sick all the time.  I wanted answers, but the answers looming ahead of me weren’t exactly what I had in mind.

I was, to put it mildly, terrified.  How much would it hurt?  Would the drugs work?  Exactly how large was the tumor?

They made Milo kiss me goodbye and head out to the waiting room.  The radiologist that would be performing the ultrasound guided biopsy asked the nurse to push the medication that would “consciously sedate” me.  This happened to be a hefty dose of fentanyl (for pain) and versed (to erase my memory).  It didn’t work.  I remained statue still, watching the ultrasound monitor and trying to decide which blurry gray object happened to be my liver and which one was the tumor we were biopsying.  When I asked, no one would tell me.  They numbed my stomach with lidocaine, which burned and made my eyes tear.  Then the actual biopsy began.  A long needle was inserted through my abdomen in the same location that I had been numbed.  I didn’t feel a thing until the needle went into the liver.  Then I cried out in pain –this is where that whole conscious sedation thing would have been handy.  The doctor had the nurse give me more medication, without any success.  I could still feel every time she took a piece of the tumor out.  I had tears welling in my eyes and my teeth dug into the soft flesh of the back of my lip.  When she finished, she injected a foam that would help prevent bleeding and then applied pressure to the area with her hands.  I couldn’t hold back any longer, I started sobbing.  The pain was so intense that I could have done anything to make her stop.

She didn’t stop, just had them give me some morphine until she was done holding pressure.  I was then taken to the cardiac observation unit to be monitored for four hours.  They took my vitals, which kept me from completely conking out, and was refused even ice chips for three hours.  Apparently, they monitor for bleeding for the first two hours after the procedure and not until they are certain that emergency surgery isn’t in the future will they allow even ice chips.  I would have killed for an ice chip.

They didn’t send me home with narcotics, which would have been nice since ibuprofen is off limits (it may increase the risk of bleeding) and I stopped responding to Tylenol about a year ago.  The pain wasn’t too bad at rest, but moving around I was very tender.  Coughing, laughing, and bending at the waist: all these things would cause my breath to hitch from the pain.  I have a great GI doctor, however, and he called me in a script for some Tylenol 3 (codeine is my friend!)

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