Biopsy Day

I began to prepare for my CT Needle Biopsy. This is a procedure performed by a radiologist to obtain a small tissue sample through a needle. This tissue is then analyzed by a pathologist to determine the type of tissue in the lesion. The CT scanner is used to guide the needle into the lesion in the safest possible manner. This is a minimally invasive procedure and is an alternative to an open surgical biopsy. CT guidance generally results in fewer complications, a faster recovery time, and avoidance of general anesthesia. My tumor sits very close to the front of my chest, so my medical team determined that this will be a better procedure than accessing the tumor through my windpipe and lungs.

As I prepared for this procedure, I started to notice some anxiety about it. This may sound strange, but in these first weeks after the initial x-ray, as I did begin to contemplate my mortality and the possibility of a difficult prognosis and early death, I actually felt more at ease with this process than my fears about possible surgery, hospital visits, etc. Those that know me well, know I have a bit of a needle anxiety and have never been a fan of getting poked or tested. I don’t even like getting my blood pressure measured.

During these weeks, I was also spending a lot of time considering surgery – this was linked to the fact that my first referral was to a thoracic surgeon, and also, a common wish amongst people when finding out they have a tumor is “Take it out of me!”.  I was speaking to my astrologically-talented friends to consider the best dates for a surgery over the next month. The general theory is that one should perform removal surgeries in the waning moon and should avoid the dates where the moon is in the sign that governs that part of the body. For example, Gemini governs the lungs, Cancer governs the breasts, Leo the heart, so I would seek a date in the waning moon phase not governed by Gemini, Cancer or Leo. If you want to know more, read here, or here.

In retrospect (knowing now that I will not have surgery), this process of picking a day was a means for me to exert some control over something I had a tremendous amount of fear around. Given the size of my tumor, the surgery would have involved a full sternotomy, a procedure used in open heart surgery where vertical inline incision is made along the sternum, after which the sternum itself is divided, or "cracked" to give the surgeon full access to the chest organs. A portion of my lung would be removed as well as other tissues and blood vessels in the area. Just writing this I feel my blood pressure dropping…

Tuesday arrives and I am at the hospital at 8am – the nurses get me all hooked up to an IV (it took her two tries which really, is the worst thing in the world for me!) and the radiologist comes down and explains the procedure – I sign a form acknowledging that there is a 30% chance I will have pneumothorax (lung collapse) and that there are a few side effects possible, including death. He assures me this has never happened to him- phew! A little while later I was wheeled out of the recovery room towards the radiology department. I was wheeled right into the the big waiting room on the gurney and noticed the awkwardness with the 50 or so people in that space mostly pretending I wasn’t there as we waited many minutes for an elevator. It was eerie.

Eventually I find myself in the CT Scanner, injected with some fentanyl and preparing for the radiologist to stick a needle 5.25cm inches into my chest. I can turn my head to the side and see the screen the doctor is looking at to direct his needle(photo below). After applying some local anesthetic to my chest, he tells me the needle is already in! Then he says he will prepare to take a series of samples (7-8 in total) to make sure they get enough samples to ensure a successful biopsy. He slides the first extraction tool into the needle, telling me I will hear a sound, but won’t feel anything. Snap! And OOOOOOOOOOOUCH! I think I almost jumped off the table. I felt pain all over my shoulder and chest, like lightening bolts. A nurse asks me to try and stay still – ha! The doc orders some more pain killers and luckily the rest of the samples go pain free, and within an hour or so I was on my way back home. Results will be ready in about two days.

The date is January 21, 2020.

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