Apr 22 2010
Our appointment is with the Woman’s Imaging Center. It’s easy here to have stereotypical thoughts about how we are receiving better and more compassionate service on the giant boob issue from a center oriented specifically to women’s needs. They try to stop Nathan from coming back with me, saying that he isn’t allowed in the procedure room, but I speak up and say that we have some medical advocacy concerns and he’s here to help me get some questions answered before the procedure. The nurse is receptive to this change, saying that he can come back as long as I’m in the prep room but he still has to wait up front while I’m getting the actual procedure done. We agree, pending our concerns being adequately addressed.
This is the first time in the cancer experience, but not the last, where I observe the reaction I will get from each subsequent female in the medical field with whom I interact up through the surgery: a particular facial expression of sympathetic horror, sort of a combination of “you poor thing” and “thank the gods that’s not me!”, that flashes across each female face I will meet for the next few weeks. I amuse myself imagining that they’re having a similar stab of empathetic breast pain when looking at my gigantic zomboob, as men do when they flinch at seeing one of those “funniest home videos” where some poor gent gets smacked in the testicles by a vigorous pet, projectile, or person.
The nurse does a very good job reassuring us that they will NOT be smashing the boob in a mammogram machine, that they understand I’m about to explode internally with fluid and they will drain as much as they can during the biopsy, that the pain is extreme and they will be using as much local as they need to so I don’t feel the biopsy or draining. She tells us she’s conveyed to the radiologist that my tumor is the size of her head (she has a smallish head, so this is pretty much true) and so he’s aware of the (heh) magnitude of the situation. She also mentions that she’s setting up the room with extra supplies of drains, lidocaine, syringes, and everything else because she thinks it’s too large for just one set to deal with. They spend a few minutes finding drain tubes and needles long enough to deal with the size of the mass.
The previous ultrasound indicated, and this one confirms, that the size of whatever is going on inside is around 13 cm across. For perspective, a breast mass counts as “large” when it’s over 2.5 cm or so. Your cervix is considered dilated enough to pass a baby when you’re at 10 cm. It won’t be the last time the words “holy shit!” are uttered. Not even today, as you’ll soon learn…
I get Nathan to take a couple of pictures of me pre-drained, and we wait nervously until they are finally set up and ready. He heads back to the waiting room and I go into the procedure room. The nice nurse starts getting the tray ready, making small talk about my recent experiences while we wait for the radiologist. He comes in a minute later, and nearly the first thing he says is “The nurse said it was as big as her head, I didn’t realize she wasn’t exaggerating!” We chuckle, the nurse says some version of “I told you so”, and the radiologist adds, “she said it was big, she should have said it was a Texas-sized tumor!”
More chuckling, the radiologist conveys genuine concern along with professional efficiency as he starts telling the nurse which prep to start. It becomes evident quickly that more hands are needed, so we disrupt the rest of the center’s afternoon schedule by tying up two nurses and a radiologist for over two hours as they call in an extra nurse to help. We end up going through three times the normal amount of supplies for such a procedure. At the beginning I ask if they will be measuring the fluid as they take it off. The radiologist starts off replying “There’s no real need to…”, whereas both nurses reply “Oh yes, we’re really interested to know how much!” I really like these nurses.
They drain off 550mL of fluid from the area before proceeding with the core biopsy. Combined with the fluid that was removed the previous Friday for testing, I’ve now had 2/3 of a liter of fluid removed from my left breast over five days’ time.
“Holy shit!” will be a very useful, simple phrase we use frequently over the next several weeks. Feel free to employ it here. (For those of you with distaste for cursing, consider “you poor thing”, a Southernism I’ve heard many times recently — starting with these nurses.)
And now, a Public Service Announcement: biopsies are NOISY. This was a vital piece of information everyone managed to leave out of the pre-biopsy informational process, and it was startling enough at the time that I feel it’s worth informing others about. I was a little surprised I didn’t jerk away and screw up the sample when he first used it, it sounds like a small and fairly-loud-for-its-size pneumatic drill (which, essentially, it is, go figure). They make several drilling sounds before they’re done. The radiologist explains afterward that he’s inserting a small titanium place marker under the skin to indicate on future scans and xrays where he took the sample from. We joke about my first step towards my bionic woman status as he carefully places it so it will actually be lodged at the edge of the area rather than falling into the open fluid region and floating somewhere else. (Um, ew.) He says it’ll be there for the rest of my life; neither of us know then that only 8 days later he’ll be a liar on that.
There’s no perceptual tactile difference while I’m laying on the table, but when I sit up after they are finished I can feel some temporary pain and pressure relief from the removal of so much fluid. I no longer feel so immediately like I am about to explode. They have yet another person (empathetically horrified look + “you poor thing!”) come in to assist the first two nurses with the clean-up. I find out from Nathan that the rescheduling delays caused by my involved procedure pissed off only a family of very upper-class conservative-looking folk who were obviously very unused to being told “no” or forced to wait on anything. (They also assumed during small talk that Nathan was there with his mother, and shut up fast when he corrected them.) Haha, my lower-class Texas-sized tumor has just as much right to treatment as your fancy preserved boobs, here in the Woman’s Imaging Center.
We go home to await the results, supposedly available within 48 hours, and I enter what I will later call Vigil Week.
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