Thursday, January 14, 2010

If I Had A Hammer, I'd Hammer Out My Marrow

Today I feel like someone rammed a 13-gauage needle several times into my left pelvic bone - at times forcing it through the bone with a surgical hammer and coming back out with samples of my marrow. I guess that should be expected, because someone did.

As long as I keep popping ibuprofen and don't put pressure on the area it's really not all that bad. The needle biopsy went well yesterday according to the Physician's Assistant who performed it and he said he got two solid samples. He was not the doctor that I expected to be doing the job, but he was thorough and damn strong.

Pre-procedure, the nurse in the Imaging Center accessed my port so that they could draw blood and send sedation drugs into me via my lady lump. I figured I may as well use it if I have to keep it in my chest. I've been shy about having non-oncology nurses access it after the experience with the nurse saying her "Hail Marys" as she yanked the sucker back and forth trying to get the needle out. This nurse however was fantastic and got the needle in without a problem. She was also careful to build up a lot of support around it noting how skinny I am up there and that there's not much fat to hold in the needle. I appreciated that as once I was hooked up to all the tubes I was very nervous
about ripping it out.

My mom and I peppered the PA with questions. Because he was young and approachable I knew he would give it to me straight. He was pretty certain that there's some cancerous activity going on. But he helped to affirm my own outlook that in an odd way, we want this biopsy to come out positive as Hodgkin lymphoma because a) that's better than a less treatable cancer b) that avoids the need for what would otherwise be inevitable further biopsies done in riskier areas.

With that in mind I went into the procedure. I rolled into the CT-Scan room on a stretcher. Lining the halls were paintings by Ken Kahn, my former director at the Arts Council. This immediately made me smile and put me at ease.

I was placed on a CT-scan table face-down on my belly with a couple pillows to cuddle under my head as I nestled into the shallow dip that was the table. I was covered with sticky monitor squares all over my back, an oxygen tube was stuck up each nostril, and my port was connected to medicinal fluid that would supposedly put me in a "dream-like state" from which I would be in la-la-land and wouldn't remember anything after the procedure.

All the cords were laid out in front of me coming over my head so that I felt like one of the humans in Avatar being hooked up to sync in with my big blue Avatar body. In true Avatar fashion my back was scrubbed with a blue antiseptic. But unlike the Avatar transformations, my ass was in the air flapping in the breeze. The majority of my back and all of my legs were covered in blankets but my entire rump was bared for everyone in the room to see. Not sure why my ass had to be out to access my pelvic bone ... I think the PA liked me ;). At this point in treatment I have no shame. I've dropped my drawers so many times and have had so many people palpate my lymph nodes that modesty is long gone.

So there I laid. But this "dream-like" state never came. I felt the local anesthesia needle which stung like hell then felt all the pressure of the needle stabbing that came next. It wasn't painful, just an uncomfortable pressure surrounded by sounds that I did not want to hear. I just laid there transporting myself back to the Whitsunday Islands in Australia and singing myself lullabyes in my head. As I had been warned, because I am young, my bones would be hard to enter. Out came the surgical hammer and I could hear and feel it banging an opening in my pelvic bone to get the needle deep into my marrow. The banging would progress then I'd be slid under the CT-Scan area for some photographs of my ass, I mean pelvic area, and come back out for more needle pressure. The cycle happened a few more times. I heard him talking about coming at me at a different angle and I'd feel the pressure again. But I didn't really want to say anything because I found it fascinating. I got to watch as they would print pictures of my PET-CT scan to line up the hot spots with where the needle was entering my body. I got to hear all the conversation about the samples and the strength of my bones. However, I probably could have done without hearing the sound of the hammer.

Finally I said, "Is that the last sample you need?"

"What the hell, we all thought you were asleep," the PA said.

"What were you meditating or something?" the nurse asked.

"Yes, isn't that what I was supposed to do?" I said, amazed at the poor showing of the meds that were supposed to knock me out. He had told me that I wouldn't be completely unconscious so I just thought my level of awareness was normal. Again, my high tolerance came back to bite me. I thought back to how shocked the anesthesiologist was at how much it took to knock me out when I had my surgical lymph node biopsy. Little girl. Big tolerance.

I had to stay there for an hour to recover afterward though I really didn't need it. They rolled me back to my mom on the stretcher.

"This girl tricked us all into thinking she was sleeping," said the PA as he parked me back into my recovery cubby.

So hungry after having to fast all morning I wolfed down an egg salad sandwich that was offered me. When I remarked as to how good it was and the PCA told me there were more and that they only go to waste at the end of the day, I figured I'd help them out. I downed a second with a couple Fig Newtons in between as my mom laughed at my ravenous appetite.

As the local anesthesia started to wear off, the soreness and wooziness set it. But my mom was there to drive me home - and not only that, but to tuck me into blankets on the couch and proceed to clean our entire home (toilets included) while I cuddled and slept with Sammy. I am pretty lucky. Then Craig came home and my Dad came over to add to the pampering. My mom and I made a delicious, healthy dinner together and we all shared some laughs that balanced out the serious talk about what's to come.

Today I've been sore and bruised but not too bad, considering. It's the mental tool that is much worse than the physical. But I worked from home for half a day as I nursed my bum which was great to keep my mind off things. Then the afternoon was spent on an easy walk with Sam in the beautiful winter sun, some reading and relaxing and a long visit with my baby brother (baby as in more than six feet tall and 20 years old). Mindless chatting and a good dose of Ferris Bueller's Day Off made what could be an otherwise daunting day much more bearable. Even Sammy loves when he comes over to visit.

Tomorrow Craig and I head in for an appointment with Dr. Dailey to get the results. I'm ready ... whatever they may be ... Bring. It. On.

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