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!