The dream and reality of a breast lump core biopsy

I woke up this morning in a state of great apprehension following a bad dream about the biopsy.

I remember fragments of the dream. In the consulting room, a nurse made me drink 4 kidney bowls of custard which contained the anaesthetic. I also had to eat as much as I could from many other bowls of different foods including spiced cabbage, rice and other things. She told me to be sure to eat as much as I possibly could to make sure I got enough anaesthetic. Because I wasn’t so hungry this made me anxious – I asked why I couldn’t just have an anaesthetic in the usual way. She fobbed me off. The hospital was huge, old and dirty – not unlike Whipps – started off daylight but then became night. I waited for whoever it was who was going to do the biopsy in a waiting room filled with other silent people on wheely beds or in chairs. They were old and poor.

Sonja was there and we decided to kill time by going for a walk. We bumped into Bijan and Babak, who had grown up a lot – Bijan was about 13. He wouldn’t let me cuddle him, but Sonja stole a kiss, which embarassed and pleased him. A reversal – Babak was happy to see me, but Bijan was reserved.

Back at the hospital, a brindled old surgeon eventually arrived and entered the waiting room. Considering the number of people in the waiting room when I first went in, I thought I’d have a long wait, but mine was the first name called. That’s all.

In reality I arrived at the hospital and reported to X-Ray as instructed on my letter. They’re very friendly there. I was sent straight to Ultrasound, which was odd because the breast nurse had said I’d have to choose (one of many choices I was supposed to make, but subsequently demurred on) about whether to have the biopsy with or without ultrasound. Anyway, out came an HCA, Romford’s finest at a guess, call her Sandra. She gave me a gown and a branded hospital carrier bag for my stuff and sent me off to change. I asked why I was having another US when I had counted on seeing the breast nurse, to which she replied that hadn’t I’d already seen the breast nurse? I had, for just about long enough for her to introduce herself and tell me she’d see me next time.

Then after about 2 minutes wait (sat opposite an ancient, frail and by all appearances dying man in a wheely-bed whose mouth was permanently open to breathe, whose eyes sometimes opened, sometimes fell closed, completely motionless apart from his heaving chest) I went into the US room and Sandra told me to lift up the gown and get on the bed thing. She asked me if the lubrication was too hot – it wasn’t. Then things got a bit strange. Sweet, kind woman, but indelicate. After introducing herself, she put a cuddly toy into one hand (which I dropped to the floor as soon as I decently could) and promised she would be holding my other one all the way through. Previously unworried, I became suspicious and made the mistake of asking her what was going to happen. I had to drag it out of her bit by bit. Here’s what I pieced together. I had 3 lumps so there would be 3 biopsies to do. Each biopsy would involve a sharp scratch at first and then pressure – if I felt pain I must tell the radiographer (my immediate thought was that it was probably going to hurt but they wouldn’t know in advance). Oh, and each biopsy had to be done 4 times because it sometimes doesn’t go right first time. So12 biopsies, each with a sharp scratch and pressure. Then she described a big “gun” with a “very long needle”, and that did it for me. My period was due, and what with the bad dream, tears began to roll down my cheeks. She patted and clucked and reassured me that they were the A-Team, so I told her about the circumstances of the bad dream and imminent period, so that she would understand that these were freak tears which should be ignored.

In came the radiographer, who I’ll call Dr Ajaykumar. He had done my last US, nice man of between 60 and 90. In came a nurse, African woman, not as young as she looked (I know because she said later she had 8 grandchildren). Meanwhile I was silently weeping on the bed. Sandra offered to take my glasses – “Sometimes it’s better not to see”. Then I definitely wasn’t about to part with my glasses. Dr Ajaykumar tried to rally me, I kept saying brightly “I’m fine”, which I was really – especially after he offered to inject me with a double dose of anaesthetic (hello, placebo?).

He found the first lump by ultrasound and then, as Sandra pressed my left hand to her own breast, Dr AK gave me an anaesthetic injection in the top of my right one which he asked Sandra to massage in for a minute or so. I had stopped crying by then and commented that the massaging was an interesting job – she replied hastily that she was married with children and not a lesbian :-). They asked me if I could feel sensation, I thought I maybe could – but IN went the big one (I averted my gaze to the wall, while the women cracked jokes – it was convivial and relaxed in there). Dr Ajaykumar warned that the first biopsy was harder because it had to make a track. I felt the skin resist, then give, and he had to press pretty hard to get to the lump – there was a grisley sensation. Taking a biopsy did indeed involve pressing a trigger to try to shoot a hollow needle through the lump, which made a loud click but nothing else. I was vastly relieved.

I had 4 biopsies in that one, all throught the same hole I think. After about the third one I started to look at the monitor, completely restored. I observed that trying to do a biopsy without the scan (a choice I’d been offered last time) must be like searching for a needle in a haystack, and how on earth did people do it? Uncomfortable silence, Sandra and Dr AK met eyes, followed by slow but heartfelt nods of agreement. Then more scanning in my other jubbly, another anaesthetic injection and 4 more biopsies, with reassurance that they were far enough from the nipple for me not to experience discomfort (god save me from nipple lumps – they sound dreadful).

Then came the next choice. I see about this choice business – they only give you choices where there’s an opportunity to save themselves money with your blessing. I was supposed to tell him whether to take a biopsy from my 3rd lump. I told him I wasn’t in a position to do that. They discussed it amongst themselves – lots of dithering, lots of trying out ideas and looking at my response while I remained noncommittal. First they said hopefully I’d probably had enough of the experience by now. Then they said that the third lump was the same character as the other two and didn’t need to be tested. Then they said they really should go ahead or the surgeon would want to know the reason. So they decided to go ahead and I had another anaesthetic injection, but when he locked the (now horribly gorey) scanner onto it Dr AK decided it was too small to bother with. So I was dismissed.

In total I was in there for about an hour. Each biopsy took about 2-4 minutes, and in between they referred to the scanner. Then, after politely refusing their kind offer of tea or coffee, I sat for 15 minutes at the nurses station on an automatic BP monitor (thought I might flake out after all – yawn after yawn after yawn). Then walked back to the tube (very slowly, I realised, as I kept being passed by amblers) and went home.

It’s been about 5 hours now – some bleeding through the dressings but almost no pain.

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