I was in the middle of juggling four work-related items when Nurse Christy called - her voice commanded respect with its no-nonsense crispness. Today is the day we should draw your blood for next week's biopsy. I am here till 1 p.m. Can you make it by 12:30. Do you have your prior films? I have the CD and paper report of what prompted this procedure. Please bring it with you.
Sure, I am always a push over for a crispy nurse.
I get run through the rigmarole of hospital check-in. Complete with wrist band that reminds me that I am 49 years old for only three more months.
Nurse Christy is as crisp and efficient as her vocal chords promised. You have your reports? All I have is the PetScan CD and report. I do not have the films from the alleged breast ultrasound done in March. And, to be candid, I don't know what good the March films would be - it was the PetScan that prompted the upcoming procedure.
This is going to be an ultrasound guided biopsy. We need an ultrasound. We need the pictures from an ultrasound to help locate and compare the biopsy location. I can't draw your blood unless we can see the area of concern on an ultrasound. Insurance will probably deny the charge. We need to know if an ultrasound guided biopsy is the best way to proceed.
I explain to Nurse Christy and her supervisor that the questions she raises are the same ones I raised with the scheduler. The March 2010 breast ultrasound (if it occurred...I have no memory of it) if it is available did not identify the nodes in question. Nurse Chrsity and her supervisor get this incongruous situation - on the first round. (This is not to be disparaging toward Nurse Christy...it is just that I had tried to explain this ad nauseum to the scheduler weeks ago. Its nice when there is an immediate mutual firing of synopsises.)
Nurse Christy calls my onc and within 10 minutes has orders to complete an ultrasound on the left breast and axillary nodes....right now. (I am not the only one who responds to crispness.) And...there they were...in their full pronounced glory. NODES...readily identifiable in size and activity. Oops...it appears the one of most concern is overladen with blood vessels. Need to get the radiologist in to view and determine if it is even viable to do the biopsy.
I lie there for 10 minutes (not bad in med-time) thinking about a collage of the number #2 and its related symbols.
Dr. Wall - yes, there it is. Very apparent. Squeeze your left hand (that is lying prone behind my head). There is a great deal of blood flow. It is do-able, but....hmmm....I don't know.
Excuse me Dr. Wall. You do not know what...exactly?
Sorry...I feel that I can handle working around the blood flow as it is not the main axillary artery. But I am going on vacation for 2 weeks starting today. The other radiologist is....(the tech chimes in) ...is very conservative. She would not opt to do the procedure. Dr. Wall. Hmmm...yes, but I am confident I can, I will just ...blah-blah-blah. You need to know, however, it is going to be a bleeder. Lot's of compression will be needed afterwards.
Whatever. Let's just do this. (I would rather have a confident arrogant prick than a conservative milk-toast -- and absolutely no political implications intended what-so-ever!)
Monday, July 25. You need to be prepared to bleed. I am presiding over two settlement conferences in the civil division that afternoon anyway. Hemorrhaging is already on the menu.
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