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A Positive Liver Biopsy Experience
from Rose S.

I would like to comment on Stealth's letter, Liver Biopsies, MTX Dosing, and Tabloid Update.

I have been taking MTX for about a year now. The derm told me that I had to go and get a liver biopsy, and I asked two other docs if this was necessary. It was unanimous — I had to go. Believe me, I was not a happy camper about this.

I just had my liver biopsy yesterday, and I'm happy to say that my experience was NOTHING like brother Stealth had. Here's what happened:

At 8:30 AM, I arrived at the hospital with a walkman, a bunch of new CDs, a new book and a supportive husband. This was my first time being actually admitted into the hospital, and the admittance clerk was very nice and told me that I had the best doc to do my biopsy. She put a plastic bracelet on my wrist and I then sat with my husband to start my first wait. As you can guess, there's a lot of waiting in the hospital.

First, they sent me to Radiology to do an ultrasound of my liver. I went into the dressing room, donned two gowns (one to tie in front, then one to tie in back for added privacy), and waited to be escorted into the examination room. Believe me, the ultrasound was actually the worst part of the whole day. The tech pushed that sensor really hard! She told me to exhale and hold my air out. We went through that a couple of times while she jammed the sensor into my ribs. Don't get me wrong, she was very apologetic: "Sorry honey, but we need to do this to get a good image." After the tech's quick consult with the radiologist — "Yeap, that's her liver alright" — the tech put an "X" on the side of my ribs and told me to change back into my street clothes while she printed up the images. At this part I started giggling, thinking of pirate hepatologists plundering the treasures of my liver... She gave me my pictures and I headed back to the main waiting room.

After more time in the waiting room, I was sent to an exam room for some prep. They took some vitals, asked some questions, stuff like that. Then I was led into the ambulatory care room. There were 4 gurnies in there, separated only by curtains. I got the creeps thinking the Doc was going to do my biopsy in here, in front of all these other patients (even though there was a curtain for privacy, I still like the privacy of a WALL). The nurse drew the curtains around me and told me to don another gown and go to the bathroom ("If you can't hold it for four hours, you'll have to use a bedpan"). I did as I was told and came back to my gurney. The nurse gave me some nice warm blankets. My husband, who was sitting in the chair next to the gurney, waited with me some more.

Here's where it got interesting. I have a terrible phobia about needles. When I was 12, I needed a blood test and I fainted at the sight of the needle. So needless to say, the whole concept of a BIOPSY with a NEEDLE had been making me pretty anxious. I was told that I could be sedated throughout the whole ordeal, so I asked for it. Funniest thing: My veins are so small they couldn't get the IV in me! They had to stick me SIX TIMES before they got the needle in for the sedation. By the sixth stick, I was ready to just go with the local. I was sweating heavily from all the needle pricks!

When the IV started flowing into me, it was like a wave of happiness hit me. I was still very conscious and very awake, but someone pulled the plug on my anxiety circuit. I was one happy girl. At this point the Doctor came in, laughed at me and said, "If you weren't such a wimp this would have been over by now!" We all started laughing and he proceeded to start the biopsy. He gave me a local, told me to exhale, and before I knew it he was DONE. Whoosh. Fast. No pain. Didn't even know that he started. Didn't even know he finished.

By this time it was noon, so they pulled my curtains back and brought me a lunch. I then spent the next 3 hours lying on my BACK, not my side. They had the pressure cuff on me, and took a blood pressure reading every 15 minutes. I spent the rest of the time relaxing, listening to tunes, and talking to the gentleman across the room from me. He was aways away, so I couldn't really hold a conversation, but I did get the gist that he just had a liver biopsy, too. He was looking like he handled it well. The doctor came by twice and asked how I was doing, and I was happy to report honestly that I was doing' just fine.

After the three hours, I was able to get up (off to the restroom!) and I spent my last hour sitting in a chair. The nurses were so confident that I was OK they let me go about 10 minutes early while they cleaned up my area.

So, that was my experience. To all my brethren out there, according to my hepatologist, 50% of the people who get a biopsy experience no pain, 5% experience severe pain, and the rest experience something somewhere in between. So try not to fret too much. Even if you do have pain, you can always ask for something. As I write this it has been about 24 hours since my biopsy, and I am doing fine. But I am glad it's over. -Rose S.

*****

Ed’s Response: Thanks for sharing your biopsy story with us, Rose. Yours is a counter-balance to Stealth’s less-than-pleasant experience and Shawn’s near death experience (Rejection & When the Dr. DOESN’T Know Best). As one who probably has the liver biopsy experience to look forward to, I was relieved by your experience and reassured by the statistics your hepatologist shared in your last paragraph.

Just before the holidays I had the painful (and ignominious) experience of a prostate biopsy. This pretty much soured my disposition towards anything with the half-name "biopsy."

Hopefully these invasive diagnostic procedures are another medical practice that will go the way of bloodletting in the next few decades. -Ed

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