Runs for Cookies: Thyroid Biopsy
My needle biopsy for my thyroid was on Friday. I wasn’t dreading it–I used to be truly trying ahead to it, so I can get all of this over with as rapidly as doable. And since I’m the kind of particular person that desires to know every little thing I can count on going into one thing, I learn as a lot as I might about it forward of time.
Primarily, the physician inserts a number of small needles (one after the other) into the mass, which acquire samples to ship to the lab. Sounds easy sufficient. Not nice, but it surely’s not like having surgical procedure.
Jerry wished to go along with me, so we went to the hospital’s radiology division. It is executed in radiology as a result of a tech makes use of an ultrasound for the physician to have the ability to see the place to information the needle in the course of the process.
First, the tech did the same old ultrasound to get photos of the mass (once more). It took a short time for the physician to come back in–the tech known as somebody a few occasions on the cellphone, asking if so-and-so was accessible for a biopsy. I ought to have seen that as a purple flag (and my instinct was undoubtedly telling me so, but it surely being my first time for one thing like this, I simply assumed every little thing was regular).
Lastly, a doctor assistant (PA) got here in and began prepping my neck. I needed to lie on my again with my head tilted again, a pillow underneath my neck. After every little thing was prepped, she injected lidocaine to numb the spot that she can be inserting the needles. The lidocaine was undoubtedly essentially the most painful half. I am by no means afraid of needles, however I wasn’t anticipating the lidocaine to burn a lot. After that, although, I did not really feel a lot in any respect.
The PA took the primary needle and inserted it into the mass. Then she moved all of it over–if you have ever seen how liposuction is completed, it is like that–about 20 occasions. Pulled it out, bought a brand new needle, and repeated that 5 occasions. After the final one, she put a gauze pad on my neck and left the room for the tech to bandage me up.
The tech was about to exchange the gauze with a bandaid and when she lifted the gauze, she instantly pressed it again down and mentioned one thing like, “Oh! You may have a fairly large hematoma.” She informed me to carry stress with the gauze, as a lot stress as I might with out choking myself. I did that for about 5 minutes, and requested her some questions within the meantime.
[Side note: A hematoma is where blood pools in a space outside of a blood vessel, but since there is no opening for it to come out, it just sort of collects in the location, forming a lump.]She had appeared a bit of alarmed by the scale of it, which made me nervous. I requested her if that occurs typically and she or he mentioned one thing like, “Not too typically, but it surely occurs and will probably be nice.” I simply wanted to carry stress and ice it for 20 minutes each hour. She changed the gauze with a bandaid after which gave me an ice pack for the trip residence.
Over all, it wasn’t a foul expertise. It wasn’t enjoyable, but it surely wasn’t painful (apart from the lidocaine shot). Once I bought residence, I used to be STUNNED after I regarded within the mirror. The lump on my neck was big. This made me actually nervous, so I googled it. And naturally, that gave me much more nervousness about it. It mentioned that having a hematoma in that location is critical as a result of it could press in opposition to your esophagus and trachea (the tubes for consuming and respiratory, respectively).
| Hematoma after thyroid biopsy |
I would already had problem swallowing (that was the primary symptom of the massive mass within the first place), however I observed that it had undoubtedly gotten worse for the reason that biopsy. I had a tough time deciphering whether or not it was additionally affecting my respiratory as effectively, however one of the simplest ways I can describe the sensation is like sporting a really tight turtleneck. I stored reaching as much as pull my shirt away from my neck, solely to comprehend my shirt wasn’t there–it simply felt prefer it.
For the reason that tech mentioned it was nice, I simply trusted that she knew what she was doing. I despatched an image of it to my sister, principally to indicate her the scale of this hematoma. I assumed she would have the identical kind of “holy cow!” response, however not due to it being dangerous–just spectacular. She informed me she would not suppose that is regular and that I ought to return to the hospital.
I figured she was overreacting, so I despatched the image to Becky as effectively (she’s an RN). Becky is all the time calm and one way or the other has this magical method of constructing me much less anxious about issues. I used to be anticipating her to inform me it is okay and perhaps give me some recommendation for lowering the scale or no matter. As an alternative, she (gently) informed me that I really want to go to the emergency room. She mentioned that if it is nonetheless bleeding (the bleeding is inside–you do not actually know if it is nonetheless bleeding or not and not using a CT scan) it could get larger and push in opposition to my airway quite rapidly.
The roads had gotten horrible as a result of it was snowing actually exhausting. The expressway was even closed at one part due to accidents. (Keep in mind the final time I drove to the ER throughout a snow storm?) I actually did not need to go. I actually felt prefer it was an overreaction to go to the ER over it and I assumed for certain they’d ship me proper again residence, however I figured it might be higher to be protected and simply go get it checked out. I would had the biopsy at 1:30 pm and Jerry and I arrived on the ER at round 5:00.
[Also, this just reminded me of the time I went to the ER for a suspected hematoma after my skin removal surgery… the bump on my hip seemed foreign and when the doctor examined me, I learned that it was my hip bone. BAHAHA, I’d never felt it before!]As an alternative of sending me residence, they took me again to triage instantly, bypassing the crowded ready room, as a result of it might apparently be fairly critical. Because the numbing wore off, it was getting extra painful. However the stress on my neck was actually beginning to scare me.
From triage, they put me in a room to attend for a physician. A nurse arrange an IV and took some blood samples. At this level, time appeared to not exist anymore as a result of it is so mind-numbing to take a seat in a small room with nothing to do. Jerry was with me, fortunately, so we talked whereas we waited.
The physician and her med scholar got here in and WOW–this was actually the nicest, most caring physician I’ve ever met. She was by no means rushed, she defined every little thing rather well, she informed me I did the proper factor by getting in (I do know folks are inclined to abuse the ER, and I had felt like perhaps I used to be doing that). She even despatched her med scholar out of the room for a second so she might ask me privately how I used to be feeling mentally/emotionally about all of it. She might see how nervous I used to be as a result of I are inclined to wring my fingers and fidget lots.
I defined to her the occasions from earlier and she or he stopped me after I talked about the await the PA to come back in and do the biopsy. She mentioned, “Wait a minute–they had a PA do the biopsy, not the ENT physician? Are you certain?” She exchanged a glance along with her med scholar, and I might inform that one thing wasn’t proper. She wished to know the small print about who did the biopsy and what directions I used to be given. She mentioned that it’s NOT frequent to get a hematoma from a thyroid biopsy, particularly one as massive as mine. And it actually IS an enormous deal. The PA by no means ought to have left with out checking it and the tech by no means ought to have let me go away with out calling the PA again in to look. (At this level, I do not know whether or not it is routine for a PA to do the biopsy, however from the ER physician’s response, I am guessing not.)
The ER physician mentioned she wished to get a CT scan to see if it is nonetheless bleeding and that she wished to maintain me in a single day for remark, simply to be protected.
When she left and I had time to course of all of it, I felt so let down and indignant about all of it. I ought to have listened to my instinct when the ultrasound tech was in search of somebody who was accessible to do the biopsy. I ought to have seen the purple flag after I observed that the tech appeared type of shocked and alarmed by the hematoma, whereas making an attempt to appear prefer it was fairly routine. I felt a bit of uncomfortable with the truth that a PA can be doing the biopsy quite than a physician, however I do know that PA’s are very certified of their jobs, so I assumed it was regular.
At round 9:00 pm, I used to be taken for a CT scan. I would had one earlier than after I broke my jaw, however I did not bear in mind something about it. I do know they did not use distinction (the place they inject one thing in your IV in the course of the scan and it helps them get an image of blood vessels). I wasn’t fearful in regards to the CT in any respect till I used to be informed in regards to the distinction.
I do not know why it freaked me out a lot, however the CT tech defined that after they injected the distinction, I’d really feel a sensation of getting actually heat/sizzling from head to toe, feeling type of like a sizzling flash. And that it might most likely really feel like I peed myself, but it surely was simply the distinction doing its factor. It was at this level that I began to have a panic assault. Not from the biopsy, not from the hematoma, not from going to the ER, not from the CT scan, or any of that… it was merely being informed in regards to the distinction.
I actually did not suppose I would be capable of undergo with the CT. She known as my nurse, who was in a position to give me some ativan and hopefully get me to settle down. The scan solely took about 5 minutes and the worst half was the anticipation of what the distinction would really feel like. It felt similar to the tech had described, but it surely was over with in a short time and ended up being no huge deal in any respect. (If I ever want one other, I am not going to fret about it.)
I used to be taken again to my room within the ER to attend for the outcomes. It wasn’t very lengthy (perhaps half-hour) earlier than we bought the results–the bleeding appeared to have stopped, however they nonetheless wished to maintain me in a single day for remark. They mentioned they only needed to await a mattress to open up but it surely must be lengthy. Then we waited. We waited and we waited and we waited. At this level, I used to be drained. I hadn’t eaten since Thursday, and I hadn’t had any water and even peed since simply earlier than I would left residence (I wasn’t anticipating all of this or I’d have deliberate higher).
I often go to mattress at 9:00 and it wasn’t till 1:00 am that I lastly bought a room. I used to be type of delirious with exhaustion and I do not bear in mind if the one that transported me defined something earlier than they left. However as soon as they have been gone, I spotted I did not know the place the toilet was or if I might get some water and even the place the sunshine swap was so I might flip off the sunshine. I could not discover a name button. And I used to be too exhausted to do something however attempt to sleep. I had requested for a xanax to assist me sleep, in order that, together with the ativan from earlier, made me actually sleepy.
I did not know flip off the lights (there are quite a lot of switches and I did not need to begin messing round) so I simply pulled a blanket over my head and managed to go to sleep. Sooner or later, I bear in mind somebody asking me if I wished them to show off the lights and I mentioned “sure! please!” and I fell again asleep. At round 5:45 am, I awakened. Once more, could not discover the sunshine swap, so I opened the curtains within the room to get sufficient gentle to go searching.
I lastly noticed a small signal on one other door within the room that mentioned “sufferers solely” and I used to be so pleased to see that it was a toilet. I picked up my purse from the bedside desk and found that there was a styrofoam cup of water there–it had been behind my purse, which is why I did not discover it earlier than. I used to be so able to get out of there. I used to be ravenous! Since I could not discover a name button, I walked to the nurse’s station to say that my husband was going to come back decide me up.
They informed me that the ENT physician needed to log out on my discharge papers however he would not be there till 10:00 am and that my nurse can be in shortly to speak to me. I waited within the room for a short time and even took out my IV.
My nurse lastly got here in, and was extraordinarily type and caring. She’d had the “home physician” come along with her to elucidate why I ought to keep. They weren’t planning another checks or therapies, however they felt it might be finest to let the ENT physician ensure I used to be good to go. I confirmed them how the swelling in my neck had gone down fairly a bit (I had photos for comparability) and the tightness was again to “baseline” (nonetheless hassle swallowing, but it surely was again to what it was earlier than the biopsy). The nurse apologetically informed me that I’d possible be there many of the day as a result of the physician had over 60 sufferers to see.
I knew I’d be leaving in opposition to medical recommendation (AMA) however by that time, I would stopped being so blindly trusting. I had had a foul biopsy, I hadn’t eaten in like 36 hours, I used to be utterly sleep disadvantaged, sore, anxious, and simply emotionally drained. How can anybody make good selections in that state? If my neck had nonetheless been as huge because it was the night time earlier than, I’d have stayed. But it surely regarded fairly a bit higher (even the nurse and home physician mentioned so). I ended up signing the AMA papers and heading residence at round 9:00.
As anticipated from the biopsy, my neck is bruised and ugly and the hematoma remains to be there (it ought to go away by itself however it could take days and even weeks). There’s NO method that I’d really feel comfy getting the thyroid surgical procedure at that hospital and even within the Henry Ford system. After Noah’s foot incident, Jerry’s horrid lumbar puncture, and now this biopsy complication, I’ve misplaced all belief. I haven’t got the outcomes of the biopsy but, however I do know I will not be going again.
My cousin, who I used to be very shut with once we have been youngsters, is definitely a nurse practitioner within the ENT division on the College of Michigan hospital. Looking back, I ought to have simply gone there from the start. But it surely’s not the identical healthcare system (Henry Ford vs. U of M) and I figured it might be best/finest to remain inside the identical system whereas seeing completely different specialists. Particularly contemplating the biopsy was “no huge deal”.
I requested my cousin if there’s a explicit ENT physician that she actually trusts and she or he mentioned those she works with are fantastic–she gave me some names and mentioned that if she or her household wanted an ENT, that is who she would go to. I actually belief her and and determined to make an appointment with one in every of them for a seek the advice of and plan transferring ahead. I actually do want the surgical procedure to alleviate the signs, whether or not it is most cancers or not.
I’ve all the time taught my youngsters how necessary it’s to hearken to your “intestine feeling” (instinct), even when it makes you appear to be you are overreacting. If you happen to really feel like one thing is not proper, there’s a motive for that. I had that feeling tug at me all through the biopsy however I satisfied myself that I used to be simply anxious in regards to the process.
I am not saying it was anybody’s fault. It is doable I’d have gotten the hematoma regardless of who did the biopsy. However I by no means ought to have been despatched residence with a big hematoma on my throat, particularly and not using a physician trying it over first.
I understand this publish is tremendous lengthy, however only one other thing… after I was being wheeled to get my CT scan, I assumed I heard Jerry speaking to somebody outdoors of my ER room. I did not suppose something of it, however after I bought again he informed me that he’d run into Kelly, one in every of my roommates from school that I hadn’t seen since 2001! My freshman yr was a lot enjoyable and I’ve nice reminiscences along with her.
I used to be bummed that I missed seeing her, however she ended up coming into my room a short time later as a result of she is a nurse there. Years after I would final seen her, when folks have been beginning to get on Fb, I discovered her and realized that she had a son on July 13, 2004–which occurs to be Noah’s birthday as effectively. Is not that wild?
Anyway, my neck is feeling and looking higher immediately. You’ll be able to nonetheless see the hematoma bump and bruise, however hopefully that can go away quickly. Subsequent, I ought to get my biopsy outcomes. Tomorrow, I’ll name U of M and make an appointment with one of many docs my cousin really helpful. And simply pray that every little thing goes effectively from right here on out!
