Western education 2013

Wednesday, June 12, 2013

..... biopsy Wednesday.....

..... I got up this morning and decided since the instruction sheet called for a fast prior to the biopsy that I would just stay in bed and begin writing my paper for Spec Ed.  Max is busy working on a project and has gone downstairs.  We both just need the time to be alone and to do our own thing.  I have been in great spirits all week working with Sara at Fanshawe and gettting the student projects ready to go for the September intake.  I have been keeping busy to take my mind off the last biopsy I had, which wasn't too bad but now we are dealling with a lump and its involved nodes that are nestled in amongst a very densely rich venous area and major nerve system. 

At 11 am, we decide to head out to the hospital to make it to admitting for 11:30 following the instructions to report in 2 hours prior to the procedure.  When we arived in the new patient admitting area, we were told that we did not have to report to them 2 hours prior to the procedure and that we were to go directly to Ultrasound on the 1st floor in D building.  I began to wonder, what in fact was accurate on this list of instructions as my hungry tummy snarled at me as we stepped off the elevator in D building.  I would soon learn that essentially the only accurate instructions on the appointment sheet were the ones on how to get to the hospital and park.  Since we were already there, we might as well sit it out...... that was noon....

The ultrasound waiting room consists on a small enclave hosting an adult waiting room and a child's waiting room just beyond the main reception desk.  It serves both ultrasound and Xray patients and  judging by the ebb and flow of incoming.... most of them have been recently served in the emergency room.  There are a number of very small children and one little tot whose hands appeared to be awkwardly facing back up along the arm.  He was simpering and trying to suck on the fingers of his right hand through the bandages that encased them.  This hand too was cantered at an odd angle to his arm.  His round eyes rolled in his cute cherubic face and he would begin to simper as he arranged his bandaged fingers to poke away at his eyes.  A mother with 3 young boys in tow and a baby in a stroller has manoevered her way through and into the childrens waiting room.  Its hosts a beautiful tank in the center of the waiting room with tropical fish. One of them looked remarkably like Dori from Finding Nemo..... I prayed she would forget the trauma executed through the hands of the trio of boys slamming the glass repeatedly.   An attractive young woman and her equally attractive mother arrive at the kiosk.  She wants to know how long it will be before she can be seen and touches  the round of her belly.  I see her concerned look and she winces as she takes a seat.  Her hand is tapping on her knee likely trying to distract her from her discomfort.  Her mother has moved to sit in a chair and promptly removes a book and begins reading.  I can hear a small child crying from somewhere withing the back hallways of the xray department.  Max has settled in and is working on a project of his own.  He is tapping out notes on his iPad, much like I am doing now.  There are so many patients moving through this waiting room where I would sit for the better part of 2.5 hours before my number is called.... I wasn't even considering calling bingo..... my humour was waning while my anxiety was increasing.

Tracy will be my ultrasound technologist for this procedure.  She is lovely, with a sense of humour and a gentle voice.  She asks me if I understand what a biopsy is and I nod my head.  I let her know that I have had both needle and core biopsies.  She procedes to ultrasound the left clavicle and searches around until she locates all of the involved lymph nodes.  She focuses on the largest lump which is just above the clavical and begins to document the size of the lesion (medical term for cancerous growth) and then turns on the feature that shows venous involvement.  A cancerous growth needs to feed itself and in so doing, will often draw a blood supply to it.  This test will often help to guide the physician to take samples closest to this supply.  A lump is not full of cancerous cells, it is a body's way of attempting to protect itself and often the cancerous cells are microscopic and often difficult to locate unless the entire lump is removed.  In that case, the lump would be sliced thinly enough to be seen through a microscope. 

The doctor comes in a few minutes after Tracy consults with him about her ultrasound findings.  He decides to go with a core biopsy.  This is done after the area under test is frozen with a local.  The core biopsy is done with an 18 gauge needle and since it is unable to perforate the outer skin layer, a sharp scalpel is used to nick an opening to allow this large gauge needle to enter the tissue to be sampled.  The core biopsy needle requires assistance to remove the tissue and so a retractable plunger is used to draw the sample into the needle.  With a quick push of a button and an audible click, the plunger retracts quickly with its sample safely pocketed in the shaft of this 6 inch needle.  This is then ejected into a sample vial for pathology.  The physician wants to be thorough and he does this procedure 5 times using the ultrasound to guide him to his mark each time.  The procedure is painless for the most part but becomes uncomfortable after the freezing comes out.

It has been a long day and I am beyond tired.... emotionally, I will have a little cry outside of the MacDonald's as my husband runs inside to get me something to eat.  Well, that part is done and now the wait begins again for pathology that will report back in about 10 days.  I am heading off to bed now that I have eaten.  Lydia has arrived from school and bounds up the stairs to say hello.  She got her iPad for a birthday gift and needs me to help her download some games.  She is growing up so fast.  

I want to dedicate this blog to my soul mate who does his best no matter what.  I am proud of how wonderful a husband and father you are.  I love you with all my heart. 

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