Thursday morning I woke for my test feeling a little weird about the dream I had. In it, a little girl was sitting on someone’s lap but her ice blue eyes were locked on me as she talked a mile a minute to someone else. Her hair was pure white and short, her cheeks chubby; she reminded me of an angel. By time I had arrived at the hospital for lab work and my biopsy, I was calmer about it all. I felt at peace; apparently, I am getting quite used to being a lab rat. I wasn’t even the slightest bit nervous about the biopsy (well, not at the beginning). The only thing I felt, besides cold, was a longing for my husband. He was working, but I wanted him to be there with me like he was the very first day.
The same nurse from the last biopsy was there and she was willing to access my port-a-cath instead of start an IV. She definitely looked a little nervous, which didn’t inspire much confidence, and admitted that it wasn’t often she accessed a port anymore. Once it was done, however, we had a working line to pass meds through and the pain wasn’t so bad. I was glad there wouldn’t be any possibility of IV issues to keep me from my medications like the first biopsy.
The nerves kicked in when I met the doctor, Dr. B (since I can’t recall his exact name). He seemed nice enough, until he began the spiel he gives patients about side effects. Most of them I already knew: bleeding, infection, puncture of surrounding organs. However, he just went on and on about how it was possible, but unlikely, that they would occur. In case I didn’t understand, he repeated himself at least six times and seemed shocked when I asked about the foam to prevent bleeding. This started a fresh round of reminding me how likely bleeding is and how he prefers entering the liver through good, living cells because they are quicker to heal. As no one had said any part of my liver was dead, this surprised me slightly. I know tumors can kill off living tissue, but since my liver function tests all came back fine I just assumed my liver was…well, functioning. Now, this Dr. B had me questioning that assumption.
He also warned that sometimes he had to “gently twist” people’s arms to get them to continue with the biopsy as they would change their mind when he was ready to begin. It wasn’t until later that I understand why people would have concerns and not want him to continue.
After he left, I was alone for a while before the nurse took me to the CT room where the ultrasound and CT were ready to lead the biopsy. The ultrasound tech this time was so much nicer than last time. When she found the tumor, she showed me how it was the darker spot in my liver and she pointed out other organs as she moved. I felt really confident about having her at my bedside and since I knew the nurse I thought this was going to go well. A woman named Sharon joined us and introduced herself as Dr. B’s assistant. This was a bit of a twist; the last interventional radiologist last time worked alone. I was missing her a lot by this point.
Dr. B eventually joined us and took control of the ultrasound machine to see if he could find the tumor. I joked with him that it would be rather hard to miss; after all, it is the size of an orange. This man had no sense of humor as he grumped and said, “Well, it has gotten so big it is hard to distinguish good liver from cancer tissue!” I teared up at that; last I knew the tumor was the same exact size it had been during the first MRI. If it was growing, why are we bothering with chemo and being sick three weeks a month? What was I putting myself through all of this for?
He didn’t get any more impressive when he started complaining that he was not getting the right angle and found the tumor “far too close” to my gallbladder to go in around the area they used last time. He insisted he would nick my gallbladder that way and I would end up in surgery. This really didn’t assure me that I could trust the man about to shove a sharp needle through my liver to pull out fragments of a tumor. Dr. B asked the tech to show him where she was able to find the tumor, and she did quite quickly only to be rebuked because that would limit the angle he would be able to go in. “I want to go in straight!” he insisted and decided that the ultrasound was out and we’d have to do the biopsy via CT machine. Because that’s what a cancer patient needs, a doctor that freaks her out and more radiation. This is where I understand people not wanting this dude touching them.
Determined as I was to get the sample, I reluctantly climbed onto the CT table to have them rescan my abdomen. If the nurse and Sharon hadn’t stayed with me and talked so calmly, I am not sure I would have been as comfortable. The nurse finally pushed some drugs to help me relax during the CT and the scan began. Once again, this CT machine talked and would tell me when and how to breathe. The medication must have started to kick in because at one point I told the CT machine it was being awfully bossy and then began to giggle. I must be amusing when truly stoned.
After they had the landmarks they needed, I was given a bit more drugs (a total of 75mcg of fentanyl and 2 of Versed), but was still conscious enough to remember everything. I didn’t, however, hurt near as badly as last time. I believe he numbed part of my liver, which burned, but I was able to tolerate the test without tears. Mostly, I just laid back and let him work.
Before long, they were taking me down the hall to recovery. On the way, I mentioned to the nurse what he had said about the tumor being larger. I asked, if she had time, could she go back and look at my scans and let me know if that were true. She didn’t hesitate to say yes and promised she’d look into it. I was really terrified that the abdominal pains I have been suffering from were the tumors growing and spreading while we were completely unaware.
I didn’t sleep at all in recovery and was able to have a clear liquid lunch (yum, broth and juice!) Sharon came in to see me long before Dr. B did. She had a wounded puppy look on her face and said, “I was told that you had concerns your tumor had grown and I didn’t want you leaving here defeated. I have the pictures from your last MRI and today’s CT with the measurements on them. Remember, an MRI is more detailed so we’ll see boundaries more clearly, but from what I saw your tumor is unchanged.” She showed me the photos and the tumor shows no growth. I nearly cried from relief and I was so thankful she was willing to go above and beyond to ease my concerns.
The next little drama occurred when my bladder told me it was clearly time to use the bathroom. My recovery nurse took this time to inform me that I was on bed rest until two. I really didn’t want to use a bedpan. I hate bedpans just from the fact that you have to sit on some little plastic bowl and then wait for someone else to help you. I just want to pee in peace dang it! No luck, however, as my nurse wouldn’t budge and gave me the options of holding it or using the bed pan. Holding it required my bladder to be fine for two more hours; so not an option. And thus, I had my first experience peeing on a bedpan. This feat is nearly impossible. It took me five minutes to find a position I could urinate in and another few to convince myself that the sharp plastic digging into my legs and butt was fine. Even after, I felt like I hadn’t completely relieved my bladder –because really, the second the urine hits your flesh since you are sitting in your waste, you don’t really want to keep going. To my patients, I am so, so very sorry you ever have to experience this. I promise I will redesign the damn bedpan for comfort sake!
By time Dr. B did finally get around to checking on me, I was just ready to get out of there. It was a good thing, too, since it was almost two and I could finally get up, stretch my legs and use the real bathroom. I was ready to go home and get some actual solid food into my stomach and was really glad that pain was minimal. The biggest nuisance happened to be the itching around my port-a-cath; I might be allergic to the glue on the tape.
The rest of the day was uneventful and Friday was a standard chemo day. Dr. Brooks met with us this week, which was a pleasant surprise. Milo, Malika and I entertained his medical assistant and him with our energy and constant jabbering. Dr. Brooks told us it would be about two weeks before we knew anything from my biopsy, but that we would certainly continue with chemo until then so we wouldn’t lose ground against the tumor (who might need some dark, evil name.) Once the results are back, he is going to forward the information to some other physicians and get their feedback on trials and medications we might want to use. I’m determined that something good will come from this second biopsy, especially after the fiasco it was. I recounted this story to Dr. Brooks, who is going to write to someone at the hospital about how poor the other doctor’s bedside manner was, and I told him that Dr. B had me exceedingly concerned for my safety as well as my overall condition. In fact, he was “chock-full of awesome!” (Said quite sarcastically, of course). Dr. Brooks seemed to really appreciate my humor, energy and outlook. He said it must be incredibly difficult for people to believe I am sick, which I get a lot.
I don’t know what’s keeping me going, maybe it is the kind words of support in cards and emails, the calls and the love I get from everyone. Maybe it’s just me being me. Either way, I appreciate the team of people around me who care so much and are behind me. I do read the cards, even if I don’t get time to reply to them all so please don’t stop sending notes and emails. I love getting them and they cheer me up when I am down. The comments on the blog are also appreciated, as are the ones on my Facebook wall. I’m going to keep pushing through and will inform you as we progress. Let me know if there are any questions I’m not answering; I’ll be happy to respond. I’m seriously honest, as if you couldn’t tell…or as Dr. Brooks put it “a loud backseat driver who has no fear of saying what’s on her mind.”