Had the Biopsy Today

I guess for the  most part it went well.  I got about two hours of sleep last night and I was hungry and thirsty by the time I got to the hospital.  I also arrived about ten minutes late because the road was closed on the route Map Quest directed me to take.  There not even any detour signs so we had to find our way around the closed road.  The closed road, by the way, was literally within walking distance of the hospital; if there had been a place to park, we could have parked there and walked the rest of the way.  I didn't realize when we come to the place where the road was closed that it was that close, but I bet we could have walked from there to the hospital in less than ten minutes.  Instead, to get to the hospital, we had to backtrack about six miles, then drive another 12 miles to get to where we were going.

I was really, really glad my friend arrived early to pick me up.  She is a wonderful friend and has many good qualities, but she is not always very punctual.  However, she got to my place in plenty of time this morning, which I really appreciated.

The nurses at the hospital seemed a bit disorganized.  Most of them were nice enough, but they just seemed like they didn't quite have their stuff together.  For instance, I had to ask them twice to make copies of my advance directives.  Every other time I've been admitted to the hospital for any type of outpatient procedure, I've been asked if I had a living will and/or power of attorney for health care.  In this case, I had to ask them twice to make copies.

Then, apparently whomever made the copies neglected to copy the third page of my living will.  Just before I was wheeled into the OR, someone came up to me and informed me that the living will was not a valid legal document because it had not been signed or notarized.  I said it had, looked at the two pages she had in her hand, and explained that the signatures and notary's stamp were on the third page which she did not have in her hand.  I asked if they had neglected to copy the third page.  She said there wasn't a third page.  I insisted there was and said if she brought me my purse, I would get it for her.  She then went and got my purse and went through it herself, looking for the paper, which I thought was inappropriate.  Of course, she found it.

The nurse that started my IV had a hard time with it.  When I was significantly overweight, they always had trouble drawing blood and starting IV's.  They always said I had small veins, but I think the real issue was that I was too fat.  Since I've lost weight, they have no trouble.  At least, usually they have no trouble.  She seemed very nervous about doing it, though, and when she finally got the needle in, she had blood running down my arm and dripping onto the bed.  I was tempted to ask her how many times she'd started IV's before.  I checked her name badge to see if maybe she was a student, not a real RN, but it said she was an RN.  She finally did get it started, though.

The worst part was the nurse in radiology.  I had to have some mammogram films done and then the radiologist, who was very nice and compassionate and as helpful as he could possibly be, had to insert a wire into my left breast, into the area of tissue that the surgeon needed to remove.  The purpose of the wire was to guide the surgeon, to make sure he excised the correct area of tissue.  I was awake for that procedure.  It was done under local anesthesia.

Well, the RN kept saying my friend could not be with me during the procedure.  She had a long list of reasons why not.  The room was too small for an extra person (it wasn't); it would be too hard for her to keep track of another person; it was a sterile procedure so my friend could not be present because even if she wore a gown, gloves, mask, hair cover and shoe covers she might contaminate something (although neither the RN nor the mammogram tech wore any of those things and the surgeon only wore gloves while doing the procedure; apparently they were not possible sources of contamination for some reason I did not understand); my friend would be exposed to radiation when they took the x-rays, and even if she wore one of those lead aprons, that would not provide adequate protection because her eyes would still be exposed to radiation (she offered to sign a waiver saying she understood the risk of exposing her eyes to radiation and agreed not to hold the hospital liable for any damage but the nurse just moved on to other reasons my friend could not be present); they just don't allow family or friends in the room for this kind of procedure, ever, for any reason; the radiologist would not allow it (which wasn't true; when he came in and I asked him, he said, "Sure, of course," with no hesitation); sometimes when they allowed women's husbands to be in the room it caused some sort of problems, the nature of which she could not specify (she also didn't seem to understand how that made no sense; if they never allow family members in the room,  how come the husbands were there?); she didn't want to have to take care of two patients instead of one; and on and on.

My friend and I figured out that she simply did not want to accommodate my request and we also figured out that it really wasn't up to her, it was up to the radiologist.  So we said we'd just wait and ask him when he came in.  She tried to discourage us from even asking him, saying he would never allow it.  I cannot imagine why she felt so strongly that she did not want me to have a support person in the room with me, but apparently it was very, very important to her because she spent quite a bit of time trying to talk me out of it.  None of her reasons seemed particularly valid to me and I can't see how it had any kind of  negative effect on her.

In fact, I tried to explain how it was in everyone's best interests, since I have PTSD and have severe anxiety about doctors and hospitals and medical stuff.  I explained that it would be bad for everyone, myself, the radiologist and her, if I had a flashback or anxiety attack during the procedure, especially since it's very important to hold very still while the wire is inserted.  If the wire ends up in the wrong place, the affected tissue might not be excised and then the results of the biopsy would not be accurate.  Also, it might be dangerous if I started jerking or flailing around or something when sharp needles are being used; the medical staff certainly does not want to end up with a needle stick.  She seemed unconcerned about those issues, though.  She was much more concerned that the room might be crowded or she might have to "keep track of" an extra person.

The radiologist agreed right away to allow my friend to stay in the room and the nurse did not protest at all then.  I held my tongue and didn't ask him if he wanted my friend to sign a waiver since her eyes would be exposed to radiation or if he wanted her to put on gown, gloves, mask, hair cover and shoe covers.

As it turned out, I did end up having an anxiety attack anyway.  The surgeon injected the lidocaine, which barely hurt, then inserted the guide wire, which hurt a little despite the lidocaine but was not unbearable at all.  Then they took another x-ray, then the surgeon and the mammogram tech left the room, I think the develop and examine the x-ray, to make sure the needle was in the right place.  During this time, my breast was still in the mammogram machine.  To make sure they got a really good view, it was compressed really flat.  And they leave you like that while they check the film and make sure it's in the right place.  I find that a bit... I don't even know what the word is.  Barbaric comes to mind.

Well, I wasn't aware of feeling anxious about that.  But all of a sudden, I got very dizzy.  My hands got numb, I started sweating, but it was a cold, clammy sweat.  I felt nauseous.  I said, "I feel dizzy, I'm not feeling good at all."  The RN didn't even hear me.  My friend heard me and said, "Hey, she says she is dizzy and not feeling good." Guess who got to hold the emesis basin for me while the RN grabbed the phone and called for the doctor to come back in?  Yes, my friend, the one the nurse had not wanted in the room.  So in the end, even though I did have a panic attack, it seemed like it ended up working out to the nurse's advantage that my friend was there.

The radiologist did decide it was an anxiety attack, by the way.  I told him it felt sort of like when I get low blood pressure or low blood sugar, but I couldn't understand why my blood sugar would have dropped so suddenly and so severely at that moment, and I've had lidocaine or novacaine before without having a big drop in blood pressure like that.  He checked my vital signs and examined me and said he didn't think it was a reaction to the lidocaine or anything else physical; he thought it was an anxiety attack, brought on by the stress and my PTSD and everything.  I think he was probably right.

At one point my friend asked the nurse if there was something she would suggest we do differently in the future, to make sure the staff was aware of my needs and to make things go more smoothly.  The nurse said it would have helped if my surgeon had let them know I had PTSD.  I said, "He did.  Or his staff did.  I know, because a few days ago one of the nurses from the outpatient surgery unit called me to confirm the appointment and go over some instructions with me, and she also reviewed my history with me.  She said her records showed I had depression, anxiety and PTSD and asked if that was correct, and I said it was."

The nurse said, "Well, that was the nurse in the surgery department.  That was not me."

I said, "So you would have preferred my surgeon to call you directly to tell you that information?"

She said yes.  My friend, who happens to work in a large inner city hospital, had this incredulous look on her face.  Like any surgeon is going to call the hospital, try to figure out exactly which nurses will be working directly with his patient in a few days, then personally review that patient's history with each one of them.  Because, you know, that would be much more effective and efficient and cost-saving than expecting a nurse to be able to read a chart.  Right?

I do plan to write a letter to the administrator of the hospital, sharing both how wonderful the radiologist was and how unwilling the nurse was to work with me in order to meet my needs.  I am still baffled about why she felt so strongly about not wanting me to have a support person with me.  I just can't see how it created any additional work or problems whatsoever for her.  Even if it did, well, that's her job.  I just don't understand it.

Once I got done in radiology, things went really fast.  They got me into the OR quickly and the procedure went well.  Apparently the surgeon removed a hunk of tissue the size of a lemon.  I'm picturing this big gaping hole in my breast.  There is a very large dressing over it that I am not supposed to remove for two days, so I have no idea what it looks like.  But a lemon?  That's big.

When I woke up from surgery, I had no pain at all in my breast.  My right arm hurt quite a bit, though, from the IV.  That nurse needs to review her IV-insertion skills.  I just took a Percocet a few minutes ago, the first pain pill I've taken since the procedure.  I was having just minor pain but I wanted to take something before it got worse.

I've eaten, I've had an hour-long nap.  I'm feeling OK.