Wednesday, December 23, 2009

You Put The Needle In, You Take The Needle Out, You Put The Needle In, And You Twist It All About

And now, the whole shocking story...

A student of some kind came out to get me for my fine-needle thyroid biopsy. We went back into the nuclear medicine area where I had my radioactive iodine test. Wouldn't you know it? Melanie, the ultrasound gal who told me that my thyroid was a monster was the one setting up my fine-needle biopsy. She was nicer this time, by that I mean that she didn't refer to any part of my body as a monster. She was not sure if the doctor would allow Optimist H to remain in the room.

I told them I was nervous, just in case they couldn't tell, but my leg-shaking kind of gave it away. Melanie said that it took longer to set up the test than to do it. She did a bit of paperwork, noted that I have a sensitivity to lidocaine, and sent the student to see what was in the medicine cabinet. In a manner of speaking, anyway, because I'm sure they don't let students into the medicine cabinet. I told Melanie my symptoms after previous lidocaine injections, which involved a hot feeling, facial flushing, rapid heart rate, dizziness, shakiness, and nervousness. Kind of like an anxiety attack, but not really, because an anxiety attack goes away in about 5 minutes, and there's no hot feeling or dizziness or facial flushing. It has happened at the dentist, and while having a basal cell something-or-other benign thingy cut off my shoulder. Needles don't bother me, and I never felt like that even with a giant amniocentesis needle that I watched myself skewered with, so I have to blame the lidocaine. I even had it tested at St. Louis University Hospital, and the allergist said it was not an allergy per se, but a sensitivity to something in that lidocaine. So Melanie said, "Oh! Well, we don't want to use that!"

Melanie wheeled the bed to and fro to set it up right for the Needleator. It seems that each doctor likes a different set-up. When he came in, Needleator needled Melanie by explaining like she was simple that he preferred my head at the other end of the bed. Melanie performed her wheelie-bed ballet again, and things were just right. The Needleator grasped my hand in a handshake, and very calmly told me that he could understand why I was nervous, but that he couldn't have my leg shaking while he was needling me. He told me exactly what he was going to do, as in put a drape over half of my face, numb me up with number, make a small incision that would look like a shaving accident, stick the needle-puncher into my nodule, gouge out a hunk of tissue while making a loud clicking sound (times 3), apply pressure to my wound, and we would be all done. Melanie had told me that it would take about 15 minutes of actual numbing and gouging.

The Needleator taped down the drape, asked if I could still breathe, and swabbed the side of my neck with alcohol. It was cold, and a little stingy. He told Melanie that Rudolph would have to go. Rudolph was a beanie baby that sat at the corner of the ultrasound screen. Melanie asked me if I would like to squeeze Rudolph, but I had tucked my hands under the sides of my butt to stop the urge to grab at the needle, so I declined.

The Needleator turned my head to the right, touched exactly where that nodule was (which I can't even see or feel), and told Melanie to put some gel on her wand thingy. He said I would feel some sharp sticks and burning as he injected the anesthetic. It did hurt. A burny feeling after a pinch. I think he poked me 2 or 3 times, and twisted that needle to spread the squirt of burny fluid. I knew it wouldn't take long, so it was bearable.

Then the Needleator asked if I was doing all right. I said 'yes', though I had a bit of tingling all down my legs (must have been what Chris Mathews felt like when he heard his favorite candidate give a speech), and a bit of heart thumping. It only lasted a couple of minutes, and then I was fine. The Needleator said he was going to take his samples. He told Melanie to use her wand, and he proceeded to poke a puncher needle thingy into my neck. We had seen them laying on the tray when they were preparing, several needle thingies about 12 inches long, wrapped up in translucent paper or plastic. I couldn't see, because of the drape, but I would not have watched anyway. Optimist H said Neeldeator was using the ultrasound as a guide, and stuck that puncher into different parts of the nodule, which Optimist H saw on the screen. He said the puncher needle was like his lancet dealy that he uses for testing his blood, all spring-loaded, but with a vacuum thingy that sucked tissue in after the punch. The Needleator then shot the sample it into a specimen jar, held by the reluctant student. Melanie cautioned her not to hold it with her hand on the bottom, because that puncher could go right through plastic and stick her.

The Needleator mentioned how my neck was seeping, which was to be expected, because the thyroid is a vascular organ. Optimist H said I might have lost a tablespoon of blood. I saw the wand as Melanie put it up at the end, and its gel was covered in blood. But that didn't bother me. The clicks of the puncher were loud, right in my left ear, but I knew that there would only be 3 of them, so it was OK. When he was all done, The Needleator put pressure on my wound for about 5 minutes. It kept seeping. He told Melanie to put pressure on it, said we would need a clean-up, and stepped aside to do something that I couldn't see, because I was still turned sideways. Melanie nearly choked me with her heavy hand. I think she shoved my goiter out of place, because it felt like she was pushing on my trachea.

The Needleator told me that I shouldn't worry, that I had done all that I could do, and that I should enjoy my holidays and not stress over things that were out of my control. When he first came in, he had commented that I had this goiter for quite some time, and I agreed, but said that it seemed to be getting bigger. He said he wasn't sure that it was all that much bigger. I said that if I had this for 4 years, it must be a somewhat good sign, and he agreed. The Needleator said we needed to make sure that there wasn't something slowly growing that would harm me. He said that even if there was something, that the cure rate is very good for the most common type.

After he left, Melanie patched me up with a band-aid and asked if I wanted to see what The Needleator took out. Of course I did! At first I just saw clear fluid that came with the specimen jar, but when I held it to the light, there were some whitish-pinkish little floaty stringy things. I don't know what that was supposed to look like, so I guess it could be good or bad, depending on what the pathologist finds.

Melanie gave me a little gel ice pack that could be stuck on like a big blue cardboard band-aid, but I elected to just hold it in place. She said not to lift anything heavy for 24 hours, since that could dislodge the little blood clot, and start the bleeding again. Optimist H and I hit the road to the Mansion, from which he went to work, and I drove back to my mom's house with The Pony as she took #1 to basketball practice.

I laid on the long couch with the soft blanket, The Pony covered my feet with the horse blanket, and I put a baggie of ice on my holey neck for 20 minutes. From there I took a 40-minute nap. Upon awaking, I had the most pain of the entire episode, what with the local anesthetic having worn off. It hurt inside my neck, and on both sides of the outside neck area, especially when I swallowed. More ice eased the pain. No aspirin or ibuprofen was allowed, and since acetaminophen does not help me at all, I did not even bother.

Back at the Mansion later, from 3:00 to 7:00, I was busy with other things, and had no time for the ice. I did manage three more frigid sessions after #1 fixed the ice-maker in Frig. I fell asleep in the recliner from 11:00 to 2:00, woke up freezing, and went to bed.

This morning I had very little pain except when coughing, and a little knot right over the nodule, and three tiny holes in the side of my neck. Unless I turn my head quickly, or lean it back, or laugh too hard, I forget that my neck was pierced by a hole-puncher yesterday.

The anticipation was definitely worse than the actual event.


Kathy's Klothesline said... making me crazy. Carley Simon? She was right about anticipation. I am glad that you have this out of the way and you can now enjoy your family and all things Christmas. Bless you!

Hillbilly Mom said...

That's it! My life is like a bottle of Heinz Ketchup.

Merry Christmas to you and your family. You are much more ambitious in your decorating and holiday goody making. The annual Christmas Chex Mix is about as far as I go.

Integrator said...

Let me spoil your blog with one more comment.
Sometimes the doppler color flow ultrasound mode is used to in order to avoid hitting the larger blood vessel which can lead to bleeding and dilution of the sample making it less informative.
Thanks for very realistic and informative description of the procedure!
BTW, one time the dentist gave me the "elephant dose" of ledocaine, which froze my eye, ear, and lips (for superficial filling of tooth on the lower jaw)
As a result of this "fun", I had my cleaning and curretage procedure done WIThOUT analgetics and it was not as bad as most people thought!

Hillbilly Mom said...

You are not spoiling my blog. Your input is appreciated. A dentist one time cut through a nerve when doing a root canal on my lower right jaw. I had numbness 24 hours later, and called his office. He admitted the slicing and dicing, and said that a normal nerve will regenerate, in 6 weeks to TWO YEARS. Good to know. Lucky for me, right at the 6 week mark, the lip and jaw became tingly, and within a week it was back to normal.

It was no fun for those 6 weeks, having my lip and chin numb, not knowing if I was drooling or had food on my chin.

I let my Doc punch out a skin sample from a suspicious forearm mole without any lidocaine, and was none the worse for it. No dizziness or any other symptoms. People think I'm nuts about the lidocaine issue, but something really goes haywire when I'm injected.