Friday, April 1, 2011

The importance of hyphens

Was March a crazy month or what?  I just looked at my post titles for the past month, reminding me that the platelet transfusion, spine biopsy, and mastectomy were all in the first week.  After that it was mastectomy recovery, herceptin therapy, drainage tube removal, physical therapy, and radiology consult.  Geez.  When did this become my life?

Speaking of my life, yesterday turned out to be far more stressful than anticipated.  Our journey to Iowa City began with car trouble, but we made it just fine (shout out to my grandparents for swapping vehicles with us at a moment's notice).  We had a nice lunch with my undergrad research advisor and his wife before heading to the appointment.  And it is at the appointment where the nerves were hit, both literally and figuratively.  Literally:  Dr. Surgeon totally just whipped her hands all around my incision business.  It was fairly uncomfortable and surprisingly uncompassionate, diminishing the positive impact of her verdict that I am healing nicely.  Figuratively:  Dr. Surgeon clarified that Monday's procedure is not a needle biopsy but a needle LOCALIZED biopsy.  Yes, I had heard members of her team insert that pesky word "localized" previously, but I didn't understand that it is a grossly different procedure than a needle biopsy.  Why would I?  I have previously experienced a needle biopsy where a LOCAL anesthetic was used to ease the pain of a NEEDLE going in and extracting a relatively tiny piece of tissue.  I therefore just thought that this sort of thing is what was meant by "needle localized biopsy".  NO.  I was not hearing the hyphen.  Monday's procedure will be a needle HYPHEN localized biopsy.  Why am I so bummed?  Because a needle-localized biopsy means I will go through the following steps in the following order:  1) mammogram 2) local anesthetic 3) insert wire into the breast while the breast is in the mammogram 4) leave the wire in the breast 5) roll Heather on a cart to the operating room 6) general anesthesia 7) removal of walnut-sized piece of breast tissue 8) breast walnut gets carried back to mammography and visualized 9) stitch Heather up 10) wake her up.

I hereby decree that this should be renamed "directed biopsy".  Leave out the two words that imply other things, or improve the audibility of the hyphen!  And tell patients what the heck it means regardless!!

Does this not sound horrible?  I have many problems with this plan.  1) mammograms of the right breast now hurt like a son of a gun because it pulls like the dickens on my port, which I remind you is stitched to my muscle.  2) A wire being inserted while the breast is squished in the mammogram sounds pretty much like the most awful thing ever.  My bet is that thanks to the port issue it will be more painful than having a hole drilled into my spine.  I'll let you know.  3)  The piece being removed is the size of a walnut.  My right breast is merely the size of two walnuts.  So the reason we're bothering with a biopsy and not doing a mastectomy is because... .  The nurse finished this sentence for me by pointing out that if the biopsy comes back negative, a future mastectomy will be a simple mastectomy.  However, if the biopsy is positive for some sort of cancer, a future mastectomy will include some sort of lymph node dissection.  This is a fine, logical point, and worth it to avoid the lymph node dissection that has life-long side effects.

I am delighted that I finally have some thorough doctors, I really am.  I feel bad for complaining, I really do.  But so far no amount of logic is helping me think that Monday's procedure is going to suck any less.  Arg.

Despite my concerns about the procedure itself, I am not worried about the results of this biopsy.  Again, there was no increased metabolic activity by PET or MRI.  I'm off to have a lovely weekend with the ladies, watching our crocuses bloom!      


  1. The good news is, you brought the Thanksgiving Turkey. The bad news is, its your date!

    Relevant? No. Will it make you smile? I hope so. I love you and miss you.

  2. you are allowed to complain. You are allowed to look forward to Monday with dread. You are allowed to scold the medical profession that fails to explain things in more detail ahead of time and just assume we understand the procedures that they perform daily.

    Wishing you the best on Monday. Just one more step. (Keep on swimming, keep on swimming).

    Saw our crocuses up today. Not sure what happened to the 100 daffodils I planted last fall. I see only about 7 bunches, and I am wondering if those were ones that were already planted?!?!

  3. "walnut-sized!" ouch. Sounds like its time for more pain fighting super powers. Hope you at least get to enjoy the lovely weekend! Will be thinking of you Monday.

  4. Sorry for your shitty upcoming day. If they are going to put you out, why not do it before the wire is placed? I know there is probably a good reason; I mean this more as a rhetorical question (i.e. God damnit Dr. Surgeon!). I love you so much. I am in awe of your bravery and tired of you having to be so brave.

  5. I'm thinking of you today, Heather! I hope you're doing ok and that it all turned out to be less awful than you feared (although it sounds pretty scary). Big hug!


  6. Instead of talking about said walnut sized dreadedness, I'm going to talk about the pink peonies I planted yesterday.

    I've never planted peonies. Ever. In fact, the last time I "gardened" was at The Farm with dad. Remember that? Do you remember Missouri, and we had rows, and rows, and ROWS of cherry tomatoes? It's no wonder that it's taken me so long to recover and finally want to plant my own garden! :)

    OH! And remember that Fourth of July when we were ALL in our swimming pool and we were trying to make a whirlpool?

    In all seriousness - I hope today went well. Having recently been subjected to the torture chamber (mammography room) for the first time, you're moooost decidedly in my thoughts today.

    Sucky indeed.


    PS - What are crocuses? I feel like I'm missing out!