stevenpiziks (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
stevenpiziks) wrote2023-04-29 10:54 pm
stevenpiziks) wrote2023-04-29 10:54 pm
Entry tags:
Biopsy 2023
I have cancer, but I'm "only" on cancer watch, which means every other year I have to get a biopsy to see what my intruder is up to and see if it's ... intruding elsewhere. This year is a biopsy year.
Last time I had this done, the doctor said, "We can do this in the office without anesthesia, or we can do it in the hospital with anesthesia."
"You want me to be AWAKE when you pop a needle into my prostate twelve times?" I said. "What kind of fool do you think I am?"
And so I had the anesthesia. But anesthesia comes with its own complications for me--the crippling terror that comes when I'm forced into unconsciousness and have no idea what a roomful of people are doing to me or saying about me. (See: shoulder surgery rape jokes, December 2021.) I got through it with lots of Valium beforehand and by sneaking a recorder into the operating room so I could listen to everything that was said. (Unlike the shoulder surgery team, this group was professional at all times.)
When I moved, I changed medical providers to UM Medical, but my records transferred, so when it came time for the biopsy, the doctor's office called and said they set up a lab order for me to get a PSA test first. I did this, and when the results popped up on my patient portal, I saw that my PSA levels had gone way down, from a 7 to a 4.7. Well, cool! Maybe I wouldn't even need the biopsy.
But when I talked to the urologist, he said, "Remember, you're on medications that reduce PSA levels. You have to double your score. It's actually 9.4." It had gone up by more than two points in the last six months.
Now I was in anxiety overdrive. The cancer was likely getting worse. I would need treatments or a prostatectomy or I might even die.
The urologist said, "No, no--this isn't anything serious. I'm not worried. You shouldn't be either. We'll do the biopsy just to make double-sure, but you shouldn't worry."
Easy to say.
I set up an appointment for the biopsy, put it in my calendar, and tried without success not to think about it. A week before the appointment, a nurse called me to give the "what to expect" talk. When she mentioned that I should eat a light meal beforehand, I said, "Oh--did they get rid of that stupid rule about not eating before anesthesia?"
"This operation isn't performed under anesthesia," she said.
Fuck me. Since I'd had anesthesia last time, I assumed I'd get it this time automatically. Clearly not. This news made my chest tight.
"Can I get anesthesia for this?" I asked, trying to keep my voice even.
"You'd have to reschedule, and that would probably put the biopsy farther out by six to eight weeks."
Six to eight more weeks of worry. Again, fuck me. Reluctantly, I agreed to keep the appointment.
When I thought about this, I realized I was perfectly balanced between two shitty choices, like Odysseus sailing between Scylla and Charybdis. If I got anesthesia, I would face the anxiety of being unconscious while a roomful of people shoved a probe into my rectum and stabbed me while potentially making rape jokes or other commentary, but I would feel no pain at the time. If I didn't get anesthesia, I would face the pain of being repeatedly stabbed by a probe shoved into my rectum, but I would be awake and in control of the situation. Which was better? I couldn't actually decide, so better to go without anesthesia and get it over with.
I demanded and got a scrip for pre-op Valium, though. I took that and a mega-dose of Xanax while Darwin drove me to the clinic.
At said clinic, they put Darwin and me in an examination room. I changed into the gown and stared down at my hands, trying to tamp the anxiety down while the drugs went to work. At last the doctor--not my urologist--came in to explain the procedure. When he was done, he asked if I had questions.
"Before we get started," I said, "there's something I need you to know. I'm twice a survivor of sexual assault. Also, four years ago I underwent a long, painful, humiliating series of operations on my genitourinary system and also a shoulder operation during which the surgery team made jokes about the surgeon raping me. During THIS procedure, you're going to insert a rectal probe and use it to cause me enormous pain. You can probably see what this is doing to me. I'm scared, upset, and barely holding it together. This isn't you. It's them. But you need you to know why I won't take this procedure well."
He nodded thoughtfully, then said, "I understand. We'll help you here by explaining every step in detail so you know exactly what's going on. Most men feel no pain anyway, so I'm sure you'll be fine."
"I hope so," I said. "Also, last time I had this done, I had bloody urine for several days and bloody ejaculate for six weeks. If there's anything you can do to avoid that this time, I'd appreciate it."
Another nod. "Last time, your doctor probably pierced one or more seminal vesicles, which caused the extra bleeding. I'll try to avoid them this time."
He and the nurse took me to the lab, which was right across the hall while Darwin waited in the exam room. They got me on my side on the table. A huge monitor was mounted on the wall above me with my most recent MRI on it as a guide.
And they went to work.
"Most men feel no pain." Right. I don't get how that would work. The probe was bad enough. Then came the lidocaine shot. It felt like being stabbed with a sword. They waited for the meds to take effect, lined up the first biopsy sample, and hit the trigger.
The pain that punched through me was so awful I screamed.
"It hurt that much?" The doctor sounded surprised. "Let's give you another dose of lidocaine."
He did, and that hurt enough to make me scream, too. Only the Valium and Xanax kept me from either punching one of them or just fleeing the room entirely.
More waiting, then another biopsy hit. This one hurt, but not as much. The next one, though, made me scream again.
This went on. And on. And on. Every other shot was painful enough to make me howl. I couldn't help it. And they took a total of SIXTEEN samples--twelve random samples and four samples from the cancerous lesion. That's sixteen biopsy shots and two lidocaine shots, for a total of EIGHTEEN shots. And most men don't feel pain for this? Maybe the next person who says that should go through it and see if they still say it. Why the HELL it's not standard to have anesthesia I don't understand. Sadism? Malice? Lack of empathy?
In all, it was 45 minutes of pure hell. And after it was done, I felt like they had left a hot needle inside me. Still, the doctor didn't want to prescribe strong pain meds. "You can take Tylenol for the--"
"No," I said forcefully. "Tylenol will not help this. I need something more powerful. Write it, please."
He finally did.
Never ever ever again without anesthesia. Never.
Because the Valium was making me wobbly, Darwin wheeled me to the car in a chair. On the way back home, he was very quiet. Finally he said, "It hurt a lot?"
"Yeah."
"I ... I heard you screaming from the exam room."
I was shocked. "You did?"
"Yeah. It was awful. I wanted to run in there and make them stop."
Jesus fuck.
When I got home, I took the pain meds and conked out for about two hours. I was sore, but the painkillers stop me from caring.
The first time I went to the bathroom, I had blood and blood clots. But the second time I went, there was no visible blood. So I already like this doctor better than the previous one. I'm still getting bits of blood now and then, though, and it's been six days. Hmm.
Now I just have to wait for the results.
Last time I had this done, the doctor said, "We can do this in the office without anesthesia, or we can do it in the hospital with anesthesia."
"You want me to be AWAKE when you pop a needle into my prostate twelve times?" I said. "What kind of fool do you think I am?"
And so I had the anesthesia. But anesthesia comes with its own complications for me--the crippling terror that comes when I'm forced into unconsciousness and have no idea what a roomful of people are doing to me or saying about me. (See: shoulder surgery rape jokes, December 2021.) I got through it with lots of Valium beforehand and by sneaking a recorder into the operating room so I could listen to everything that was said. (Unlike the shoulder surgery team, this group was professional at all times.)
When I moved, I changed medical providers to UM Medical, but my records transferred, so when it came time for the biopsy, the doctor's office called and said they set up a lab order for me to get a PSA test first. I did this, and when the results popped up on my patient portal, I saw that my PSA levels had gone way down, from a 7 to a 4.7. Well, cool! Maybe I wouldn't even need the biopsy.
But when I talked to the urologist, he said, "Remember, you're on medications that reduce PSA levels. You have to double your score. It's actually 9.4." It had gone up by more than two points in the last six months.
Now I was in anxiety overdrive. The cancer was likely getting worse. I would need treatments or a prostatectomy or I might even die.
The urologist said, "No, no--this isn't anything serious. I'm not worried. You shouldn't be either. We'll do the biopsy just to make double-sure, but you shouldn't worry."
Easy to say.
I set up an appointment for the biopsy, put it in my calendar, and tried without success not to think about it. A week before the appointment, a nurse called me to give the "what to expect" talk. When she mentioned that I should eat a light meal beforehand, I said, "Oh--did they get rid of that stupid rule about not eating before anesthesia?"
"This operation isn't performed under anesthesia," she said.
Fuck me. Since I'd had anesthesia last time, I assumed I'd get it this time automatically. Clearly not. This news made my chest tight.
"Can I get anesthesia for this?" I asked, trying to keep my voice even.
"You'd have to reschedule, and that would probably put the biopsy farther out by six to eight weeks."
Six to eight more weeks of worry. Again, fuck me. Reluctantly, I agreed to keep the appointment.
When I thought about this, I realized I was perfectly balanced between two shitty choices, like Odysseus sailing between Scylla and Charybdis. If I got anesthesia, I would face the anxiety of being unconscious while a roomful of people shoved a probe into my rectum and stabbed me while potentially making rape jokes or other commentary, but I would feel no pain at the time. If I didn't get anesthesia, I would face the pain of being repeatedly stabbed by a probe shoved into my rectum, but I would be awake and in control of the situation. Which was better? I couldn't actually decide, so better to go without anesthesia and get it over with.
I demanded and got a scrip for pre-op Valium, though. I took that and a mega-dose of Xanax while Darwin drove me to the clinic.
At said clinic, they put Darwin and me in an examination room. I changed into the gown and stared down at my hands, trying to tamp the anxiety down while the drugs went to work. At last the doctor--not my urologist--came in to explain the procedure. When he was done, he asked if I had questions.
"Before we get started," I said, "there's something I need you to know. I'm twice a survivor of sexual assault. Also, four years ago I underwent a long, painful, humiliating series of operations on my genitourinary system and also a shoulder operation during which the surgery team made jokes about the surgeon raping me. During THIS procedure, you're going to insert a rectal probe and use it to cause me enormous pain. You can probably see what this is doing to me. I'm scared, upset, and barely holding it together. This isn't you. It's them. But you need you to know why I won't take this procedure well."
He nodded thoughtfully, then said, "I understand. We'll help you here by explaining every step in detail so you know exactly what's going on. Most men feel no pain anyway, so I'm sure you'll be fine."
"I hope so," I said. "Also, last time I had this done, I had bloody urine for several days and bloody ejaculate for six weeks. If there's anything you can do to avoid that this time, I'd appreciate it."
Another nod. "Last time, your doctor probably pierced one or more seminal vesicles, which caused the extra bleeding. I'll try to avoid them this time."
He and the nurse took me to the lab, which was right across the hall while Darwin waited in the exam room. They got me on my side on the table. A huge monitor was mounted on the wall above me with my most recent MRI on it as a guide.
And they went to work.
"Most men feel no pain." Right. I don't get how that would work. The probe was bad enough. Then came the lidocaine shot. It felt like being stabbed with a sword. They waited for the meds to take effect, lined up the first biopsy sample, and hit the trigger.
The pain that punched through me was so awful I screamed.
"It hurt that much?" The doctor sounded surprised. "Let's give you another dose of lidocaine."
He did, and that hurt enough to make me scream, too. Only the Valium and Xanax kept me from either punching one of them or just fleeing the room entirely.
More waiting, then another biopsy hit. This one hurt, but not as much. The next one, though, made me scream again.
This went on. And on. And on. Every other shot was painful enough to make me howl. I couldn't help it. And they took a total of SIXTEEN samples--twelve random samples and four samples from the cancerous lesion. That's sixteen biopsy shots and two lidocaine shots, for a total of EIGHTEEN shots. And most men don't feel pain for this? Maybe the next person who says that should go through it and see if they still say it. Why the HELL it's not standard to have anesthesia I don't understand. Sadism? Malice? Lack of empathy?
In all, it was 45 minutes of pure hell. And after it was done, I felt like they had left a hot needle inside me. Still, the doctor didn't want to prescribe strong pain meds. "You can take Tylenol for the--"
"No," I said forcefully. "Tylenol will not help this. I need something more powerful. Write it, please."
He finally did.
Never ever ever again without anesthesia. Never.
Because the Valium was making me wobbly, Darwin wheeled me to the car in a chair. On the way back home, he was very quiet. Finally he said, "It hurt a lot?"
"Yeah."
"I ... I heard you screaming from the exam room."
I was shocked. "You did?"
"Yeah. It was awful. I wanted to run in there and make them stop."
Jesus fuck.
When I got home, I took the pain meds and conked out for about two hours. I was sore, but the painkillers stop me from caring.
The first time I went to the bathroom, I had blood and blood clots. But the second time I went, there was no visible blood. So I already like this doctor better than the previous one. I'm still getting bits of blood now and then, though, and it's been six days. Hmm.
Now I just have to wait for the results.