Blessing in Their Hands

The breast biopsy that I wrote about in my last post had to be postponed due to a problem with insurance approval. I didn't find out about it until nearly 5:00 last Monday, on the night before the scheduled procedure. I spent Tuesday morning on the phone with the doctor's office and the hospital trying to cut through the red tape. The hospital scheduler tried from her end as well, but we had to admit defeat about 45 minutes before my appointment time. 

At first, the scheduler said I'd have to wait until December 21 for the next available appointment, which put my total waiting time at 7 weeks from the date of my repeat mammogram. While we were on the phone, though, an opening came up for yesterday, December 4. 

I arrived at the hospital at 11:58, two whole minutes early, only to find a sign on the door stating that the staff were off for lunch until 12:45. Mystified, I sat down in the hospital lobby and laboriously logged in to the patient portal on my ailing phone. It turns out that I'd read the instructions incorrectly, and I was actually supposed to arrive at 12:45. At first I was aggravated with myself, but then I decided to go buy some Tylenol, which I would need after the procedure. 

Then I spent a relaxing 20 minutes in the car listening to an audiobook, only to realize that I'd gotten confused again, and now I was late!

I arrived at the desk, breathless and apologetic, at 12:52. The receptionist was very gracious, but I felt pretty frazzled. In the waiting room, I settled myself with some deep breathing and silent prayer. 

I was disappointed to find that my usual mammogram technician was not the one who would be taking care of me, but the woman who ushered me back was equally kind. I soon learned that she was the one who'd helped me the week before with obtaining insurance approval, so she wasn't quite a stranger. She introduced herself, but I promptly forgot her name. I'm going to call her Lynn, but that probably isn't right. 

We sat in a small room where Lynn went over all the details of the upcoming procedure, including the risks. "After the biopsy, we'll do a quick mammogram to verify the placement of the titanium clip," she concluded. "If the biopsy shows cancer, that will mark the spot for the surgeon." She touched my knee. "But let's hope it will just be calcification, like last time. Remember, 80 percent of these biopsies are benign." 

Next, the radiologist came in to see if I had any questions. I didn't. I was just ready to get it over with.

In the procedure room, another tech named Beth joined us. I relinquished my cozy gown and climbed the little staircase on trembling legs. I clambered onto the shoulder-high table and crawled into position with my left breast over a circular hole about six inches in diameter. Lynn gently draped the gown over my back.

While Beth adjusted the camera, Lynn gave me instructions. "Scoot down a bit... Put your left arm down by your side... No, your other left." 

"Get as comfortable as you can," Beth advised. "Once we've entered the coordinates, you won't be able to move at all until the biopsy is over." 

On my previous tour of the room, I'd been so relieved to find an actual table instead of the so-called bed from my previous biopsy, which had actually been a very uncomfortable chair.  Now, struggling to find a position that wouldn't hurt my neck, I realized that this arrangement might not be quite as comfortable as I'd thought. Also, I felt oddly vulnerable with my breast dangling through a hole in a table!

I kept my left arm at my side as instructed and bent my right arm so that my hand was level with my face. When I closed my eyes, the bright light shining through my eyelids almost felt like sunlight. I tried to imagine that I was lying on a towel on the sand and listening to the waves rolling into the shore. 

Lynn tugged and tugged at my breast, but Beth said the calcifications were not visible on the screen. 

"On the mammogram report, it said the calcifications were against the chest wall," I said, and then I felt silly because of course they knew that.

"Yes, it's really posterior," Beth agreed. "Let's try the thinner pad," she said to Lynn. "It won't be quite as comfortable." 

"It's okay," I said as I helped slide the new cushion into position. I settled myself facedown for the second time, and Lynn resumed tugging at my breast. I prayed silently that they would be able to visualize the area; I did not want to come back for a surgical biopsy!

At last, Beth was able to lock in the coordinates. "The radiologist will be here in just a moment," she said. "He'll cleanse your breast with Betadine, and then he'll numb your skin with a lidocaine injection. That will be the most painful part because breast tissue is very vascular. Then, when the needle goes in deeper, it will deliver more numbing medicine. At that point you should feel only pressure. If you feel pain, let us know right away."

I swallowed awkwardly, careful not to move my body a millimeter. Remembering my other breast biopsy, I thought of how the technician had held my hand during the injection. In my peripheral vision, I could just see Beth standing by the computer screen. I wanted to ask her to hold my hand, but I wasn't sure whether she would be in the way.

I closed my eyes again and went back to the beach in my mind. I heard the door open and the rustling of the radiologist settling onto the low stool. "Hello," he said. "I'm going to cleanse your breast. It will feel wet and a little cold."

I wanted to breathe deeply, but it was hard to take in a good breath due to my awkward position. My neck already felt stiff. "Quiet me with your love," I prayed silently. Just then, I felt pressure on my hand. I opened my eyes to see Beth's blue gloved hand on top of mine. I opened my fingers, and she clasped them. "I was hoping you'd hold my hand," I murmured, and closed my eyes again.

"I've been through this before," she said. "I know it helps. Squeeze my hand as hard as you need to." 

"I'm going to start the lidocaine injection now," the radiologist said. "You'll feel a sharp pinch." 

Beth rubbed her thumb over my knuckles, and I had to admonish myself sternly not to cry over her kindness. The last thing I wanted was to lie perfectly still for 10 or 15 minutes with a dripping nose. 

The pain was shockingly sharp as the needle went deeper into the tissue.

"Are you doing okay?" Beth asked.

"Yes," I said through gritted teeth. 

Although I'd expected to wait a minute or two for the anesthetic to take effect, the radiologist said, "Now you'll hear some mechanical sounds while I collect the samples." I wanted to ask if we should wait, but I figured he must know what he was doing. I remembered having the same worries the last time I'd had a biopsy, though I did think that there had been at least a minute or two in between the lidocaine and the rest of the procedure.

The burning intensified. "I am feeling some pain," I said. "It's burning quite a lot."

"The needle is delivering more medication," he said. "As it takes effect, you should only feel pressure."

Beth squeezed my hand and let go. "I have to take a picture," she said. Moments later, she was back, and I squeezed her hand gratefully.

I heard a lot of sloshing noises and then felt an odd sensation that I can't think how to describe. 

"I'm irrigating the area," the radiologist explained. "Now I'm going to place the clip." I heard and felt a click, almost like a stapler. 

He walked over to the screen. "The biopsy was a success," he announced. "I collected six samples." 

"Oh, that's good!" I said, and took in a shuddering breath.

"I'll call you with the results, probably on Thursday or Friday, or maybe Monday," he said.

And then it was just me and the two techs again. "You did great!" Beth said.

"Thank you," I said. "Holding your hand really helped." 

"Would you like to see the image?" she asked, gesturing to the screen on my right. I squinted at the dark image, which seemed to show a cluster of perhaps six or eight white dots. 

Weren't there only three before? I wondered, a little alarmed. No more worrying, I told myself. I wasn't wearing my glasses, and the image was probably taken from a different angle. Who knew what I was really seeing? 

Meanwhile, Lynn applied steady pressure to my breast until the bleeding had stopped. Then, she crisscrossed two Steri Strips over the wound. 

Beth then led me to another room. "We have to do a mammogram now, just a couple of images to verify the placement of the clip," she said apologetically. "It may be a little difficult because the site is so posterior." 

I glanced down at the spot of blood near my cleavage and fervently hoped the lidocaine was still doing its job.... It was. Beth quickly captured the images she needed, and then Lynn wrapped an ACE compression bandage around and around my chest. "Try to leave this in place until tomorrow," she instructed. 

"And take some Tylenol as soon as you get home to get the pain medicine on board before the anesthetic wears off," Beth added.

"Here's your goody bag," Lynn said. "There's some water and a few snacks, and your care instructions."

In the car, I opened the pink bag and smiled over a little loop of pink and white beads with the pink ribbon emblem and this message printed on a tiny square of paper: 

"Our prayer beads are a reminder of God's presence... a gift to you to remind you of God's love, comfort, and presence with you.... a gift from someone's heart created and made by the blessing of their hands." 

Now I let the tears come, the embodiment of my relief that the procedure was over and of my gratitude for the comfort of divine kindness expressed through human hands. I dried my eyes, swallowed two Tylenol, and drove home.

Thanks to the excellent care I'd received after the procedure, I had almost no pain, unlike after my first biopsy. The ACE bandage itched like mad, but I was so exhausted that I slipped easily into sleep moments after I sank onto the couch. I slept most of the afternoon, with Arwen snuggled around my waist. 

Now, I wait. Thank you to everyone who has been praying for me. I can really feel your love. I'll let you know as soon as I get my results.