Second Lung Biopsy - Better Prepared This Time

The Girl Scout motto is: "Be Prepared."  I learned this when I belonged to the Girl Scouts in grade school.  As a kid, it seemed like all the motto meant was we were going to be doing a heck of a lot work without an option to complain about it too much since after all, we're Girl Scouts and that is what we do: prepare.  Who knew how well all that practice in preparedness was going to come in handy?

Each experience of this journey has made us a little wiser.  AND provided us with the ability to be better prepared.  When we head down to Karmanos for my second lung biopsy on Thursday, the first of September, I have taken some anti-anxiety medication.  Thankfully, the check in process this time is extremely organized and smooth.  This, combined with the Ativan, helps immensely and I head in to the procedure room with much less apprehension. 

Dr. Zhang introduces himself.  He conveys his awareness that it has only been two days since my Gamma Knife treatment and shares that he thinks I look great.  Frequently patients have two black eyes afterward which I never developed (kudos to Keith and Melissa for pulling the around the clock care again and supplying me with ice packs every two hours for my eyes and my pin holes for the last 48 hours straight).

After explaining the procedure,  I am instructed to lay on my left side and with my right arm laying on top of my left in front of me with my elbows bent, and to reach as high above my head as possible.  It feels slightly awkward but provides the best view of the mass in my right lower lung.  I am slid into the Cat Scan machine and Dr. Zhang leaves the room to look at the mass and plan his approach.

When he returns, he tells me that he is unable to find the previous views of my lung.  I inform him that I have recently switched my care to Karmanos.  All my other tests and records should have been forwarded but if they were not, my husband and daughter are in the waiting room and they might have what he is looking for as they now carry a large zippered binder of all my medical records including CDs.  Some one is sent out to ask my family for the file.

Dr. Zhang returns to the treatment room and expresses regret for the delay as it is understandable that I am probably uncomfortable from my radiation treatment.  He states that as much as he would like to minimize the time needed to complete the lung biopsy, he is not comfortable with proceeding.  Something about the appearance and shape of the mass is bothering him and he would like to take a better look.

I let him know that I am okay with waiting.  He inquires if I am allergic to iodine.  I confirm that I am not allergic as I have had more than one dye test in the last month with no reaction.  This is good as he wants to perform another one now because he thinks there is "something odd" about my lung mass and he is hesitant to touch it until he has more information.

This turns out to be significantly important.  After the dye test, Dr. Zhang looks positively triumphant.  He advises me that he has some news to share - both good and bad but indicates he will start with the good news.  He tells me how glad he is that he trusted his instinct to do some investigating before proceeding with the biopsy as the dye test revealed that there is vasculature intertwined within the mass.  If he had perforated it, I could have bled out on the table.  Excuse me?  I thank him for not killing me but if this is the good news, what the heck is the bad news?

It is this: while I would normally be given a local anesthetic and some twilight for the procedure, the situation will not allow it.  Dr. Zhang will need me to inhale deeply, hold my breath and hold still while he takes the samples.  There will be no anesthesia.  Seriously?

In the meantime, an hour has passed since Keith & Melissa were asked about my medical record file.  Since they were told the entire procedure would only take 30 to 45 minutes and it has been much longer, they approach the staff to make an inquiry.  They are assured everything is fine.  There has just been a delay.  Dr. Zhang will come and talk to them as soon as he is finished.  They have no clue that we are proceeding without the benefit of any pain medication.

After the sample is taken, Dr. Zhang suggests he can wait for me to be ready before he continues.  What the heck is he talking about?  We are not finished, he needs to do three more punches.  You can just imagine what I told him with only one guess.  Ultimately, I suck it up three additional times and Dr. Zhang gets what he needs.

Keith and Melissa are called in afterward.  Dr. Zhang is telling them how proud they should be of me because I did an excellent job.  Are you kidding me?  I don't want to call this man a liar but frankly I was screaming and crying!  He praises me none the less, saying I needed to give myself more credit as most people could not have it done - much less repeatedly.  All I know is that I am thankful I took the Ativan but I sure hope there are some options for more medication RIGHT NOW.

Immediately after my x-ray is done,  the nurse brings me not only some excellent pain med but ice packs for my gamma knife frame holes (which are now screaming bloody murder).  Bless the nurse and my family for creatively wrapping the ice packs around my head with bandages to keep all four in place so I can lay down and pass out.  Two hours later, I am awakened for my final x-ray which shows my lung is in good shape.  After another "perfectly prepared by Melissa" lunch, I am free to leave. 

As we wait for the car at the valet, I watch several other patients come and go.  I think to myself how lucky I am, as I notice that some of the other folks are unaccompanied by anyone.  Here I am, not only supported by my husband and daughter but fully confident that anytime in the future should Keith or Melissa not be available, I will not have to face coming to Karmanos alone because I have a wealth of friends and family who are only waiting for us to say they are needed.  THANK YOU TO EVERYONE FOR SUPPLYING THAT ASSURANCE.

In the end, Keith, Melissa and I marvel at how fortunate we are that I have access to such stellar medical care.  I learn that in addition to being a Diagnostic Radiologist, Dr. Zhang is a specialist in Vascular Interventional Radiology.  Thank goodness people like Dr. Zhang exist.  Not only did his expertise turn out to be portentous for me, his preparedness was prodigious.