Surgery versus Needle Biopsy. Hospital Infections. Who Saved Whom??? Prophylactic Antibiotics and the Unexpected Involvment of Pet Therapy.
Tag Archives: needle biopsy
Surgery versus Needle Biopsy. Hospital Infections. Who Saved Whom??? Prophylactic Antibiotics and the Unexpected Involvment of Pet Therapy
Please read this post if you’re interested in the UNEXPECTED TURNS offered us as we walk on the path of life. Truth be told, all we know for sure is the NOW, but the temptation to peek into the possibilities of future is great! It is also true that “knowledge is POWER!!!”
A few weeks before, when I was told I needed a biopsy, the first thought which came to my mind was, “no big deal,” a procedure, so insignificant I wasn’t even going to mention it to my friends. In truth, I feared those around me might think I was a hypochondriac, seeking attention for the wrong reasons…
It started boring, most events in life start like that and the excitement picks up as one continues to walk… The annual mammogram showed the two lymph nodes located in my right arm pit enlarged significantly and so many new, small ones, too many to count, were present too. Yeah, I could not deny it, a biopsy was necessary, just to make sure everything was okay. Oh, the chance of a “real problem was slim.” Well… not that slim…I had a rare malignant tumor, nine years before. It was misdiagnosed four times because “sarcoma type of malignancies,” were so rare.
When my doctor suggested a biopsy, I was grateful that a needle biopsy would be performed and equal attention given to something which potentially could be rare and not as significant as a “common” type of cancer. Before I was personally “attacked by this Monster, I didn’t know there were many types of IT!!! and one is “lucky” to have a common type of cancer. More money and research takes place on common types of cancer, because more people would be saved if a cure is found. It makes sense, but not in one’s heart, if the person is the “owner” of a rare type of cancer.
The fine needle aspiration procedure, is called “clean biopsy” The doctor assured me, technically, was not even considered surgery!!! So insignificant, a prophylactic antibiotic was NOT given 30 minutes before the procedure, and generally, ONLY local anesthesia was used. In other words, they numbed your skin at the site of the procedure, which, in spite the fact that your skin was penetrated, was NOT considered surgery. I vaguely, or not so vaguely, recalled from my classes taken to prepare for my esthetician license in PA, that when the skin was penetrated, there was a risk of infection. I chased the thought away, as I could self-advocate for ONE cause at a time, and decided the most immediate “cause,” was that I needed proper anesthesia. I suffered with Generalized Anxiety Disorder and Major Depression, I argued.
The doctor assured me, he “performed hundreds of those,” with just a local (anesthetic!)
I assured him, that was fine, however, in all fairness, I felt responsible to inform him that I was under the care of a therapist, I suffer from Generalized Anxiety and I was ASKED by the hospital to prepare for anesthesia. I didn’t eat or drink since before Midnight and also I was on treatment of anti-anxiety and depression medications. I suffered serious traumas, and mention just one: my ex-husband’s suicide. In conclusion, I assured him that the chances to “freak out on him,” during the “procedure which breaks your skin, but was not classified as surgery,” were NOT minimal.
After more serious consideration, the decision was changed. The nurse anesthesiologist started the IV and I felt relaxed. NOT asleep. Relaxed! That was all I needed, to be CALM!!! Everything felt human and not barbaric.
The pathologist entered the room and stated his name. Another God, I should say, in the family of God doctors. By the order they enter the room, the Pathologist was the most important.
Yes, this was important knowledge, graduating from medical school, places one right next to God (I guess even God might have some insignificant medical conditions) and it is best to have doctors close by! I learned this “secret classification,” because my mother was a M.D. and one of my daughters is a M.D. The reality of their majestic positions, placed me far, far behind them and their world of Gods. I only earned a Master’s in Counseling and Clinical Psychology. This degree placed me far behind, but it also gave me the empathy necessary to understand the human race and its shallowness.
Okay… back to the biopsy. In spite of being relaxed, they could not stop me from speaking. Advocating for myself.
… and I talked, and I talked and explained, and every time I open my mouth with new details, the pathologist asks for another “sample!” May be… well over 10-12 samples…
As I clearly remembered, under the arm pit, there was a cluster of nerve endings and blood vessels. In short, the chance of pain was great, touching a blood vessel was another danger, and I was grateful the handsome doctor performed hundreds of “those,” before mine but congratulated myself for asking for a type of humane anesthetic. It was painful, but worth it!
I knew each time I was in excruciating pain and I thought, “this is it, now I shall experience fainting,” another good, relevant sample was “grabbed” from that monster, whom no one invited in my body. The thought that IT will be analyzed and diagnosed by the pathologist brought me joy! The moment of extreme pain passed, it diminished, I was convinced the doctor took the samples from the correct places to add to the collection of the core of the uninvited visitors in my arm pit. I felt a sense of satisfaction; I imagined these “thieves” the uninvited visitors, running away at the thought of another large core needle chasing them!
I assumed, judging by the degree of discomfort, he used the large core needle, not the “fine aspiration one.” Whatever he was using, it was for the first time in my life when I was grateful someone put me in pain. No, I could NOT read Fifty Shades of Grey past the second chapter, that’s how poorly it was written. Sorry, but good for you, I mean, the author!
Back to the boring part of this post, the biopsy.
The pathologist left the room, the doctor did too, and all nurses, except one who transported me to the first room where I left my purse with no money.
The very nice nurse reminded me the room had a window, facing the river and some ducks were floating around the water, peeking in the room. Just in case, I was worried about my privacy, she said. Oh, well, ducks, if you have nothing better to do … go ahead!
My friend picked me up and we got home. After a few hours, the pain worsened. All night I took tylanol as if it were chocolates!!! At least the chocolate would have been yummy, unlike the tylanol which just messed up my liver!
I was sweaty. I was cold, I was hot. A ridiculous, unreasonable thought stabbed my mind: What if I had an infection!!! Most definitely I had a fever! I checked, using a very accurate CVS brand termometer and indeed my temperature was passed 100.00
At 7:00 AM sharp (and it’s Saturday!!!) I called the number the hospital gave me to call if there were any problems. In my foggy mind I considered that increased pain as compared to 8 hours before, and temperature over 100 could be considered problems. I seemed to be wrong!
The temperature MUST be over 101!!! the pain… can’t remember why didn’t qualify either.
Then, a miracle happened. I must have said something that qualified, was significant, could be coded? Honestly, they might have gotten sick of me insisting I wanted an antibiotic!First, the hospital sent me to Emergency!!! I refused. They insisted. I refused again and at last I was prescribed the wide spectrum antibiotic which in my narrow mind, assumed was routinely given BEFORE any procedure which BREAKS the skin.
I was wrong! I Google and discover the nuances among the various procedures.
I found reading the article in ” American Family Physician- Current Guidelines for Antibiotic Prophilaxis of Surgical Wounds,” by Woods and Dellinger (1998) more relevant than the Shades of Grey. At lease I managed to finish it.
I found fascinating that the MOST efficient time to give the patient a prophylactic antibiotic was 30 minutes before the procedure to prevent an infection. Oh, the stats did show that “clean procedures” have only a 2% incidence of infection. Clean procedures constitute 60% of ALL surgical procedures and accounted for 40% of ALL wound infections. The estimate was that Prophylaxis for CLEAN PROCEDURES would reduce the overall incidence of wound infections by 17%.
The bottom line was that approximately ONE million patients had wound infections in the USA every year. The annual cost of taking care of these infections is approximately 1.5 billion dollars.
The consequences range from increased pain to sepsis and possible death.
Given these statistics, wouldn’t perhaps make sense to administer prophylactic antibiotics to all patients if they undergo any procedure in which the skin is penetrated by any instrument. Wouldn’t it make sense to re-THINK and re-CLASSIFY and consider the enormous negative effect on the quality of life of ALL patients affected by infections, regardless of HOW the procedure was classified?
I’ve been taken an antibiotic for two days. I still have a slight fever and am depressed!
What helps me wish to get better? What if the cancer returned? I have to acknowledge fear, then a feeling of peace…
At my back I feel the warmth of a living being, in the front, I delight my sense of touch and caress my puppy and her silky fur. I listen to their perfect, calm breathing and try to synchronize mine with theirs. They are both rescued dogs, but the truth is, I AM the rescued one. I feel loved. I feel needed… I feel ME!!!
I finally managed to synchronize our breathing and dare not move.
I wish to stay in THIS MOMENT FOREVER and feel LOVED!!!
60% of all surgical (this is me!!!)