Biopsy at sunrise

I was the only person in the waiting room. My appointment was early in the morning, and I had arrived 20 minutes early. I had to drive downtown for my biopsy appointment. I had never been to that branch of the hospital and had no idea what traffic would be like, so I gave myself plenty of extra time. The drive was actually very easy. The difficult part was finding the correct building. I only got lost once. Despite trying my best to sound courageous, my voice broke when I asked the desk clerk if I was in the right place. I walked away casually, because I didn't want a complete stranger that I will never see again knowing how nervous I was.

I watched the sunrise over the city while I waited for my name to be called. It would have been serene if it weren't for my situation. My thoughts were racing, so reading a magazine or using any of my phone apps was out of the question. Not long after I sat down, loud banging started sounding through the ceiling, coming from the floor above me. I hoped it was construction and not some mad scientist fighting a lab-created monster. Whatever it was, the noise didn't help my nerves.

A view of the city from the parking garage before dawn, and
sunrise as seen from the waiting room. 

Eventually, I was led to a curtained area to replace my shirt with a robe. I almost joked about my disappointment that this robe wasn't incubated. Then, I was led to a room and met two nurses and a doctor. It was a relief that the doctor and one of the nurses were the same people from my ultrasound. A familiar face meant a lot that day. They all seemed to be in a pretty good mood, until the banging started again. The doctor left to have the construction stop- you don't want a sudden bang on the ceiling to ruin your concentration when you have a large needle in a patient. 

As always,  I had to repeat my name and birth date. The doctor got excited that we share the same birthday. She put her hand up to high five, which the nurse quickly told me not to do since the doctor had already finished her sterile scrub. We did an air five. I said 'sterile five' with a smile on my face, but I don't think they understood the Scrubs reference.

Soon, I was laying back on a table. One nurse scrubbed my skin with a couple of different solutions, this minimizes the risk of infection. The doctor injected something to numb the area, like Novocaine at a dentist's office. The other nurse located the lump with an ultrasound and kept the ultrasound probe in place so the doctor could be sure she was getting samples from the lump.

The doctor started by making a very tiny incision in my skin, then inserted a long tube with a sharp end through my skin and tissues to the area of the lump. Her numbing skills were fantastic, I felt no pain, just the occasional change in pressure. There was another smaller needle that would trigger into the lump and collect a sample. She warned me when she was going to take a sample because it made a plastic-sounding click, like a cheap toy gun. Only I am sure you can buy hundreds of cheap toy guns for the cost of one biopsy tool. Each sample was a tiny cylinder of reddish-pink tissue that she dropped into a jar of liquid that would get sent to a pathologist for diagnosis. When I looked at the tiny cylinders, I imagined my doctor was playing the role of climate change scientist and my boob was the glacier from which she was collecting ice samples. My entire body was Antarctica... it was a pretty powerful feeling for a second. The doctor collected four or five samples from the area, all through the same incision and large tube, so it went quickly. When it was all done, she injected a tiny marker into the area that would show up on future mammograms. This is important, because if the results came back normal, you don't want to get biopsies of the same area after every mammogram shows the same suspicious tissue. The marker isn't metal, so it is safe for MRI and wouldn't set off any security machines.

Afterwards, a nurse held pressure on the incision for 10 minutes, which of course was a very awkward 10 minutes of small talk. The doctor didn't place a staple or a stitch over the incision, just two small bandages call steri-strips that would need to stay in place for 3 to 5 days. Next, the nurse took me to a room for a quick mammogram to make sure the marker was in place. It was. I thought to myself, Three mammograms in two weeks, I feel like I should have gotten a sticker or a lollipop or something. All I got was a bag of ice and some extra steri-strips to have on hand.

The steri-strips (two small bandages over the biopsy site). The blue lines on my skin were drawn by the
doctor to mark the area. It only took a couple of showers for the marker to be washed off.

I was instructed that I could use an ice pack for 15-20 minutes every 1-2 hours, so I got used to having ice packs in my bra that day . The nurse recommended I take an acetaminophen product such as Tylenol if I needed it, but I didn't. She also recommended that I not shower for 24 hours, and avoid any strenuous activity for 24 hours. I was to call if I had any excessive bleeding, pain, or fever. The small skin bandages stayed on well for the full 5 days, even with daily showering after the first day. They were easy to remove as well. There was a yellow bruise on the skin for 1-2 weeks, but most of the discomfort was gone by the next day. I had a very small scar at the site that lasted until my surgery. I'm not sure if it ever would have gone away.

The biopsy samples were sent to a pathologist, whose job is to look at the tissue on a microscopic level. A pathologist can tell the different between normal cells and cancer cells. Tissue samples often need special staining and cutting techniques, so it can take time to get a diagnosis- no one is going to have a diagnosis that day. I made an appointment with my doctor for a few days after the biopsy. She would discuss the results with me and the plans for the next steps, good or bad. I left the biopsy appointment determined to keep my mind distracted, and I hoped the pathologist would work quickly.