Hello everyone!
Well these are getting harder and harder to write! And it’s
not for lack of inspiration but more lack of having a coherent theme or object
of one post when I have about 8 floating around in my head. I am also
struggling with the egocentric nature of blogging... so I apologize with the
delay!
Last week I was able to share some amazing news with everyone
and the response has once again been overwhelming. It was also the first day I
truly cried! And I cried for about 5 minutes which is a really long time for me.
I was so overwhelmed with a sense of relief and joy that it poured out of me in
big gobby tear drops and a gushing nose! I genuinely hate crying... I feel very
“uncomposed” that even if I start crying I control it very quickly so five
minutes is an extremely long time for me to cry. The other more interesting
reaction I had was a sudden onset of extreme back pain in the area of the
biopsy. Man did it hurt! My best guess
is that this was a psychosomatic release of stress and tension as the first
time I allowed myself to be “exposed” enough to acknowledge the discomfort the
biopsy had caused. It took about 4-5 hours for the pain to start to go away,
but the reaction was real and marked and therefore very interesting.
A lot of people have asked me what the biopsy was like. So I
shall tell you the tale. J
I had a CT scan done which showed something suspicious in my
spine. Because I have copies of most of
my images and a really awesome friend who showed me how to use the viewing
program I can show you the suspicious area which is pretty cool. So the image
that you see below is a side view of my mid section. The top of the image is my
neck and the bottom of the image is my torso. Disregard all the organs and
tissue and look for the spine. Once you
locate the spine start at the top vertebrae and count down. It is the third whole vertebrae from the top.
As you may notice all of the other vertebrae look pretty white where the 3rd
from the top has a big “grey cloud”. That grey cloud is the suspicious area. It turns out that it is just a bunch of
inflamed tissue. Now I know your next question. Why do you have that much inflamed
tissue? The answer is I don’t know but am interested to find out. However, I
blame my inability to stay on horses and or the inability to always stay out of
their way when on the ground. LOL! In short, I’ve never been so happy to say I
was schmucked into by a horse in flight in January, and then I “gracefully”
took an unscheduled dismount in February, got conked in the head without my
helmet on later in February etc etc etc J
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| This is the real image of my actual spine. All other images are googled and are not actually me! |
Anyways when the doctors looked at this image and my
understanding of what they said is that it was very likely cancer but they wouldn’t
discuss what that means until it is confirmed due to the nature of that discussion.
Then the next thing they said is that the location of the tumor (yes they
called it a tumor) was very difficult to access and they would need to discuss
the best plan of accessing it. They then brought me my scheduled biopsy time told
me to take my painkillers before and after (I had permission to take the strong
stuff J) and
I was on my way.
So the night before my biopsy I packed my “hospital bag”
found my missing kindle and then started stressing about not being able to eat
or drink anything because clearly that is the most important thing in this
situation(oi!). But in reality it
actually was a pretty big deal. You see, I wasn’t going into this biopsy at the
top of my game. As you may remember Wednesday
we had to decide whether or not to continue ahead with treatment due to the
delay it may cause my “if the biopsy was positive treatment” and we decided to
go ahead. Then Friday was a bit of a gong show because my blood counts were
lowish and they cancelled and rescheduled my chemo for Monday, and after all of
that (about 1.5 past my treatment time) I ended up going ahead with the
treatment on Friday.
Another thing we decided on Wednesday is that I wasn’t going
to take my anti-nausea drugs to see if they were triggering my migraines as I
suspected. Therefore my only line of defense against the nausea was to drink an
obscene amount of water (4 Litres) and always have food in my stomach.
Therefore not being able to eat or drink after midnight was in my opinion a rough
deal but I promised myself I could eat by lunch. HAH! I was so wrong. So
feeling pretty thirsty and hungry I loaded into the car with my pit crew (Steve,
Mom and Dad) and we headed to the hospital. We got there went up to
admitting and was then sent to Medical
Imaging where they promptly re-directed us up to day surgery (dear lean
system... room for improvement). I got to day surgery and they gave me a bed to
lay down in which was lovely because at this point I was pretty green around
the gills. My biopsy was scheduled for 10 am however you are supposed to arrive
by 8:30 am so I had plenty of time to get comfortable. The nurses explained to
me as best as possible what was going to happen which included waiting 2 hours with
nothing to eat or drink after the procedure.
So we got comfortable and settled in to wait for my turn.
The day surgery room I was in had 3 beds. The gentleman in the first bed was
quickly whisked away for his appointment. Shortly after an absolutely adorable
senior citizen came in with his wife. They were pretty sweet but he got to eat
right away and him and his wife discussed his toast and coffee for what felt
like at least a half hour which along with the smell of his coffee and toast
was my own special kind of torture. It seems silly, I understand, but really I
was hungry and thirsty and really nauseas. So 10 am (my appointment time) came,
10 am went. 10:30 came, the nurse popped in to tell me that they were a bit
behind. I said not to worry! I know that it’s a good thing to be the person who
get’s bumped or delayed because that means you are not the person with the most
imminent need. Due to the nature of my
diagnosis I know I have bumped to pretty high on the list myself so it felt
good to push over and let someone in front of me! It’s a give and take. Then 11:00
came and went. At this point the nurse brought me a few sips of water because I
was getting increasingly nauseous and thirsty.
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Finally around noon someone came
to get me and I took a tour on one of the hospital beds down to the CT scan
room. It was pretty busy down there. There were 3 beds and a lady in a wheel
chair in the waiting room. One of the techs came out and told mom, dad and Steve
that they should wait in the main lobby as it was pretty crowded in the CT
waiting room. Steve stayed anyways and mom and dad went on their way. Then a
guy came in with some EMT’s and had to wait with us shortly after his arrival so
at this point the room was more than “pretty crowded”. Then one of the rooms
opened up and with some fancy manouvers on those steering the beds there was a
clean exit and entrance of the emerg patient into the lab. Suddenly
it was my turn... eek! At this point I will admit I wasn’t feeling too hot but
remember thinking... at least I’m not the guy on the stretcher!
The tech that brought us in this time said that Steve could
come in to the room with me for a while which was nice. So he came in and
explained to me what was going to happen and that the doc would come in and
answer any questions and sign consent. At this point I asked if there would be
general ( knock you out) or local anaesthetic (like dental freezing). Because
up until this point I had no idea whether I was going to be conscious or not. You see I had decided for this treatment I was
going to roll with the punches because, well truth be told... thus far having a
mental plan was turning out to be more stressful because the plans kept
changing and for a type A control freak thats pretty stressful. SO I was going
in blind, hoping that would be less stressful. I found out that there would
just be local anaesthetic which was a relief that at least that way the anaesthetic
wouldn’t make me more nauseas after waking up. I wasn’t sure how much more nausea I could
take without keeping it together, or more importantly in. Then we met the
doctor. I have to say I was impressed. He was very honest, to the point and professional. Here is what he told us from my perspective.
- Due to the location of the tumor this is going
to be very tricky. In fact we may not be able to go ahead.
- If we have to cancel I am pretty much SOL, they
could try the surgery but the chance of a successful surgery was just as
likely.
- They had to come in from above and down at an
angle to get into the vertebral body.
- The vertebrae rests beside the lung, so there
was a chance my lung could be punctured or damaged, this would not be good. But
I am in a hospital and they are well equipped and prepared to deal with that
event.
- They had to go through a forest of nerve to get there so there was a risk of
nerve damage.
- There is a chance that the biopsy process can
crack the vertebrae. Which as you can assume, is also not very good.
- This procedure would take about 30 minutes to
get set up and another hour to complete.
- He explained that at any point they may have to “abort the
mission” but this is my best chance and he would do his best to make this happen
for me.
I signed consent then we discussed the use of local
aneasthetic. I told him that my experience in the past month leads me to
believe I seem to absorb lidocaine like a sponge and I suggested he use as much
as possible. He explained that lidocaine was hard on my heart; I explained how
I could feel the last half of my first biopsy and felt the stitches going in on
the PICC line. We discussed the difference between feeling pressure and feeling
the procedure. We also discussed him
taking as many samples as he felt he needed. The more the merrier for me. As I
had to do my breast biopsy twice (not due to lack of samples but damaged
samples) and would like to avoid doing this one twice.
I then hopped off the bed and onto the table. I am a pretty
narrow person so I fit on the table fine! This is a perk because I remember
thinking... this is one small table! The cushion on the table is also not
really designed for long term comfort. Its a 2 inch mat and I don’t provide
much padding myself. I laid on my
stomach and they put a wedge pad under my forehead so my head was perched about
4 inches higher than the bed. Then myself and the tech’s mcguivered some
blankets to provide some neck support for me as that wasn’t a position I could
hold for an hour and guarantee I wouldn’t cramp up or move. We then tried to
figure out what to do with my arms and determined the best place was to have
them over my head and crossed sort of like a relaxed diving position and we
were ready to roll.
They prepped me for the procedure. And I got another one of
those aweful fake tans the health region keeps giving me J. They use a cleaning stick
that dyes your skin orange (sort of like betadine for my horsey friends). Then
they took the prelim image and did the landmarking where they wanted to go. The
Doctor then showed me the image of the vertebrae, where he wanted to go, how he
had to get there and just how close he was working to my lung. Let’s just say,
I had a lot of trust in this doctor! He gets 10+ points for building rapport in
5 minutes!
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These are not my images. But the black blobs are the lungs. The needle is pretty obvious and the light bulb shaped thing the needle is in is the vertebrae. The angle on mine was a bit different but this gives you an idea.
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| Another image that shows where they had to go. |
The most painful part of the whole procedure was the
freezing going in. And that is because as I have expressed before, I have
hypersensitive everything strangely combined with a high pain tolerance. So
when it is your job to tell the doctor if you feel any discomfort I have a hard
time discerning what is normal and what is bad. You are lying on the table face
down and feel a needle traveling through your shoulder and into your vertebrae
and then when it gets there you started to feel some discomfort below your
neck. And you lay there thinking do I say something or do I not. You don’t want
to be a baby, but he is working blind
with a needle in your spine, he can’t see where in my neck the needle is... do
you say something? He said to say something? But what do you say... it doesn’t hurt
per say but with your neck cocked back and towels surrounding your face and
neck conversation is limited. What do you say... ummmm “owe”. Doctor freezes, “what
do you feel?”, discomfort right below the spine, more ache, not sharp”. He says
“thats just the freezing going in.” And you say “Ok sounds good”. All the while
thinking damn I was a baby and said owe when I didn’t need to. Ugh!
So we moved on. And
that my friends was the most painful part. Now I can only describe what I felt
as I didn’t see what was going on, my face being buried in wedge pad and a
blanket and such not. But I think what happened next was they took a really
sharp really strong metal straw and put it in my spine into the location that
they were trying to access and it stuck out of my back what I can guess was at
least a couple inches. Although there was no pain, it was a little nerve
racking as he was pushing through bone so it wasn’t a gentle process. I found
myself wiggling my fingers and toes periodically just to ensure they hadn’t
cracked the vertebrae and I was paralyzed. Throughout the entire procedure the doctor
stopped and CT scanned to check his location etc. I knew I was in competent and
experienced hands. Once “the straw” was in it was pretty smooth sailing for me
mentally. I still had lungs and I could wiggle my toes. Win!
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| This was what it would have looked like to a spectator, except I was laying face down. The big Donut is the CT. They take a picture to check location. Pull you out. Do procedure. then put you back in to check . Do procedure... etc etc |
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Inserting the "Straw"
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So the next step is to insert what felt like
a mini hand auger but I have no idea what it actually was. And voila the first
sample was extracted. The doctor was pleased to inform me that we had 1 sample!
He asked if I minded going in for another sample.
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| Ready to extract a sample... I have no idea if this is the equipment they used... but it "felt" like this. I found these images after writing this blog. |
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| bone biopsy sample.(Not mine) |
By this point I was getting
pretty sea sick! You see everytime the CT was taken they had to move the table
into and out of the CT machine. I am sure that if I was not on Day 4 post chemo
which is one of more nauseas days and had I been able to take my medication or
eat or drink water I would have been fine. But, alas that was not the case and
this was the hardest part of the process. I felt like I was being rammed in and
out of the machine with reckless abandon! Is this fair, probably not. But to
all my friends who work in the health region, please note that if some one is
coming in nauseas those beds are like hell! Lol! It’s kind of funny that the
most uncomfortable part of a spine biopsy was the rides in and out of the CT
but it was the truth in my case. That aside a “heck yes take as many samples as
you can” was muffled through my neck roll. A few minutes later he happily informed
me he had an additional 2 samples from me taking him to 3! At this point he
asked if I was okay to continue on for a fourth so that they could test for non
cancer stuff as well. I said most definitely.At this point I was pretty relaxed! Honestly I was, no sedatives or anything.Things had gone so well, the doctor was clearly very skilled and it was the first procedure I have been to where there wasn’t any pain involved so I was a happy camper. The doctor took his 4 th sample just
as a slow ache was returning to my back, so however much freezing he used was
perfect. Then the extraction proceeded a
few more trips in and out of the CT to ensure my lungs were good to go and
voila. I got to move. I sat up and had a bad case of the shakes. I seem to get
the shakes when I have lidocaine. It’s funny because I think I always look
worse than I feel. I moved over to the hospital bed and was whisked off to
XRay. We ran into a friend in the medical imaging que and chatted with them for
a bit before heading in for another chest XRay. I passed muster and was sent
back to my bed and waited for a porter to take me back up to our room. I was
able to meet one of Steve’s work friends who I had never met before and he was
so kind as to wait with us and chat. I know how busy their days are so really
appreciated it!
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| Another room with view! |
It was back up to day surgery for me and I was pretty
excited to see that I had the room to myself.
Even better news was that I was allowed to eat and drink relatively
shortly after arriving as it had been long enough after his orders. Let me tell
you apple juice and toast have never tasted so good! I then spent the next
while resting and texting my family and friends letting them know I was okay.
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| never far from my phone! |
Around 4:00 I was given the nod to go home so I stood up to
get dressed. And promptly re-seated myself. I stood up again... and decided to
reseat myself again. At which point we tried adding some fluids in me (more
apple juice! Woot woot!). Unfortunately that wasn’t enough and I was still wobbly
like a newborn foal. So Steve ran and fetched one of the wheel chairs to
transport me.
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| Sitting up ready to go home!!! |
I was pretty annoyed but at the same time realized that it was a
necessary thing as I knew i wasn’t going to make it all the way to the parking
lot without going down. And lets be
realistic, falling after having metal rods jammed through your spine and
4 chunks of bone removed is not an ideal
situation. So I had my first trip through the hospital in a wheelchair.
What’s interesting is that although I am bald and was
rolling through the hospital in a wheel chair I don’t feel like a “sick person”.
I am sure I looked like a sick person but I feel strong and healthy and ready
for battle just a little banged up from the lidocaine.
After a few days of “bed rest” ie) me sleeping for awhile
and then my parents chasing me around the house trying to get me to sit or lay
down I was back at it. The pain in my back was minimal. It wasn’t until a few
days later that I remembered I was supposed to be taking advil and Tylenol and
whatever pain meds I needed. I had forgot to take them the day of the biopsy
and then completely forgot afer the fact. There was a bit of muscle twitching
in my shoulder, and my back still aches if I sit or stand for too long, and
driving along our beautiful Saskatoon spring roads caused a certain degree of
torture but other wise it wasn’t too bad. That said my first biopsy(breast) had me travelling across the world and then I spent the day battling the winds at
the helm of 40 ft boat.... so.... relatively
I was doing a grand job of resting.
My feelings on bone biopsy is that they are another miracle
of science! It is amazing what medicine can do! Thanks to the Doctor, and all
of the staff at RUH involved in my biopsy, you were all fabulous and made the
experience much better!
To top it off, as you know the results came back clear!
Which means I do not have cancer in my spine. So I get another kick at the can
:D I am now happy we went ahead with the 4th biopsy sample as it
will help determine what is causing the inflamed tissue.
In conclusion the biopsy was much better than I expected and
I came out no worse for wear!
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| Celebrating the good news with the most delicious coconut cheesecake in existence at Alexanders! |
So till next time,
Left Foot , Right Foot!
Alyssa & Steve
