[If you didn’t read my last post, regarding my thyroid, you’ll want to read that first.]

My needle biopsy for my thyroid was on Friday. I wasn’t dreading it–I was actually looking forward to it, so I can get all of this over with as quickly as possible. And because I am the type of person that wants to know everything I can expect going into something, I read as much as I could about it ahead of time.

Essentially, the doctor inserts several small needles (one by one) into the mass, which collect samples to send to the lab. Sounds simple enough. Not pleasant, but it’s not like having surgery.

Jerry wanted to go with me, so we went to the hospital’s radiology department. It’s done in radiology because a tech uses an ultrasound for the doctor to be able to see where to guide the needle during the procedure.

First, the tech did the usual ultrasound to get pictures of the mass (again). It took a little while for the doctor to come in–the tech called someone a couple of times on the phone, asking if so-and-so was available for a biopsy. I should have seen that as a red flag (and my intuition was definitely telling me so, but it being my first time for something like this, I just assumed everything was normal).

Finally, a physician assistant (PA) came in and started prepping my neck. I had to lie on my back with my head tilted back, a pillow under my neck. After everything was prepped, she injected lidocaine to numb the spot that she would be inserting the needles. The lidocaine was definitely the most painful part. I’m not at all afraid of needles, but I wasn’t expecting the lidocaine to burn so much. After that, though, I didn’t feel much at all.

The PA took the first needle and inserted it into the mass. Then she moved it all over–if you’ve ever seen how liposuction is done, it’s like that–about 20 times. Pulled it out, got a new needle, and repeated that five times. After the last one, she put a gauze pad on my neck and left the room for the tech to bandage me up.

The tech was about to replace the gauze with a bandaid and when she lifted the gauze, she immediately pressed it back down and said something like, “Oh! You have a pretty big hematoma.” She told me to hold pressure with the gauze, as much pressure as I could without choking myself. I did that for about five minutes, and asked her some questions in the meantime.

[Side note: A hematoma is where blood pools in a space outside of a blood vessel, but since there is no opening for it to come out, it just sort of collects in the location, forming a lump.]

She had seemed a little alarmed by the size of it, which made me nervous. I asked her if that happens often and she said something like, “Not too often, but it happens and it will be fine.” I just needed to hold pressure and ice it for 20 minutes every hour. She replaced the gauze with a bandaid and then gave me an ice pack for the ride home.

Over all, it wasn’t a bad experience. It wasn’t fun, but it wasn’t painful (other than the lidocaine shot). When I got home, I was STUNNED when I looked in the mirror. The lump on my neck was huge. This made me really nervous, so I googled it. And naturally, that gave me even more anxiety about it. It said that having a hematoma in that location is serious because it can press against your esophagus and trachea (the tubes for eating and breathing, respectively).

I’d already had difficulty swallowing (that was the main symptom of the large mass in the first place), but I noticed that it had definitely gotten worse since the biopsy. I had a hard time deciphering whether it was also affecting my breathing as well, but the best way I can describe the feeling is like wearing a very tight turtleneck. I kept reaching up to pull my shirt away from my neck, only to realize my shirt wasn’t there–it just felt like it.

Since the tech said it was fine, I just trusted that she knew what she was doing. I sent a picture of it to my sister, basically to show her the size of this hematoma. I thought she would have the same sort of “holy cow!” reaction, but not because of it being dangerous–just impressive. She told me she doesn’t think that’s normal and that I should go back to the hospital.

I figured she was overreacting, so I sent the picture to Becky as well (she’s an RN). Becky is always calm and somehow has this magical way of making me less anxious about things. I was expecting her to tell me it’s okay and maybe give me some advice for reducing the size or whatever. Instead, she (gently) told me that I really need to go to the emergency room. She said that if it’s still bleeding (the bleeding is inside–you don’t really know if it’s still bleeding or not without a CT scan) it can get bigger and push against my airway rather quickly.

The roads had gotten terrible because it was snowing really hard. The expressway was even closed at one section because of accidents. (Remember the last time I drove to the ER during a snow storm?) I really didn’t want to go. I really felt like it was an overreaction to go to the ER over it and I thought for sure they would send me right back home, but I figured it would be better to be safe and just go get it checked out. I’d had the biopsy at 1:30 pm and Jerry and I arrived at the ER at around 5:00.

[Also, this just reminded me of the time I went to the ER for a suspected hematoma after my skin removal surgery… the bump on my hip seemed foreign and when the doctor examined me, I learned that it was my hip bone. BAHAHA, I’d never felt it before!]

Instead of sending me home, they took me back to triage immediately, bypassing the crowded waiting room, because it could apparently be pretty serious. As the numbing wore off, it was getting more painful. But the pressure on my neck was really starting to scare me.

From triage, they put me in a room to wait for a doctor. A nurse set up an IV and took some blood samples. At this point, time seemed not to exist anymore because it’s so mind-numbing to sit in a small room with nothing to do. Jerry was with me, thankfully, so we talked while we waited. 

The doctor and her med student came in and WOW–this was literally the nicest, most caring doctor I’ve ever met. She was not at all rushed, she explained everything really well, she told me I did the right thing by going in (I know people tend to abuse the ER, and I had felt like maybe I was doing that). She even sent her med student out of the room for a moment so she could ask me privately how I was feeling mentally/emotionally about all of it. She could see how nervous I was because I tend to wring my hands and fidget a lot.

I explained to her the events from earlier and she stopped me when I mentioned the wait for the PA to come in and do the biopsy. She said, “Wait a minute–they had a PA do the biopsy, not the ENT doctor? Are you sure?” She exchanged a look with her med student, and I could tell that something wasn’t right. She wanted to know the details about who did the biopsy and what instructions I was given. She said that it is NOT common to get a hematoma from a thyroid biopsy, especially one as large as mine. And it certainly IS a big deal. The PA never should have left without checking it and the tech never should have let me leave without calling the PA back in to look. (At this point, I don’t know whether it’s routine for a PA to do the biopsy, but from the ER doctor’s reaction, I’m guessing not.)

The ER doctor said she wanted to get a CT scan to see if it’s still bleeding and that she wanted to keep me overnight for observation, just to be safe. 

When she left and I had time to process all of it, I felt so let down and angry about it all. I should have listened to my intuition when the ultrasound tech was looking for someone who was available to do the biopsy. I should have seen the red flag when I noticed that the tech seemed kind of surprised and alarmed by the hematoma, while trying to seem like it was pretty routine. I felt a little uncomfortable with the fact that a PA would be doing the biopsy rather than a doctor, but I know that PA’s are very qualified in their jobs, so I assumed it was normal.

At around 9:00 pm, I was taken for a CT scan. I’d had one before when I broke my jaw, but I didn’t remember anything about it. I know they didn’t use contrast (where they inject something in your IV during the scan and it helps them get a picture of blood vessels). I wasn’t worried about the CT at all until I was told about the contrast.

I don’t know why it freaked me out so much, but the CT tech explained that when they injected the contrast, I would feel a sensation of getting really warm/hot from head to toe, feeling kind of like a hot flash. And that it would probably feel like I peed myself, but it was just the contrast doing its thing. It was at this point that I started to have a panic attack. Not from the biopsy, not from the hematoma, not from going to the ER, not from the CT scan, or any of that… it was simply being told about the contrast.

I really didn’t think I’d be able to go through with the CT. She called my nurse, who was able to give me some ativan and hopefully get me to calm down. The scan only took about five minutes and the worst part was the anticipation of what the contrast would feel like. It felt just like the tech had described, but it was over with very quickly and ended up being no big deal at all. (If I ever need another, I’m not going to worry about it.)

I was taken back to my room in the ER to wait for the results. It wasn’t very long (maybe 30 minutes) before we got the results–the bleeding appeared to have stopped, but they still wanted to keep me overnight for observation. They said they just had to wait for a bed to open up but it should be long. Then we waited. We waited and we waited and we waited. At this point, I was drained. I hadn’t eaten since Thursday, and I hadn’t had any water or even peed since just before I’d left home (I wasn’t expecting all of this or I would have planned better).

I usually go to bed at 9:00 and it wasn’t until 1:00 am that I finally got a room. I was kind of delirious with exhaustion and I don’t remember if the person who transported me explained anything before they left. But once they were gone, I realized I didn’t know where the bathroom was or if I could get some water or even where the light switch was so I could turn off the light. I couldn’t find a call button. And I was too exhausted to do anything but try to sleep. I had asked for a xanax to help me sleep, so that, along with the ativan from earlier, made me really sleepy.

I didn’t know how to turn off the lights (there are a lot of switches and I didn’t want to start messing around) so I just pulled a blanket over my head and managed to fall asleep. At some point, I remember someone asking me if I wanted them to turn off the lights and I said “yes! please!” and I fell back asleep. At around 5:45 am, I woke up. Again, couldn’t find the light switch, so I opened the curtains in the room to get enough light to look around.

I finally saw a small sign on another door in the room that said “patients only” and I was so happy to see that it was a bathroom. I picked up my purse from the bedside table and discovered that there was a styrofoam cup of water there–it had been behind my purse, which is why I didn’t notice it before. I was so ready to get out of there. I was starving! Since I couldn’t find a call button, I walked to the nurse’s station to say that my husband was going to come pick me up.

They told me that the ENT doctor had to sign off on my discharge papers but he wouldn’t be there until 10:00 am and that my nurse would be in shortly to talk to me. I waited in the room for a little while and even took out my IV.

My nurse finally came in, and was extremely kind and caring. She’d had the “house doctor” come with her to explain why I should stay. They weren’t planning any other tests or treatments, but they felt it would be best to let the ENT doctor make sure I was good to go. I showed them how the swelling in my neck had gone down quite a bit (I had pictures for comparison) and the tightness was back to “baseline” (still trouble swallowing, but it was back to what it was before the biopsy). The nurse apologetically told me that I would likely be there most of the day because the doctor had over 60 patients to see.

I knew I would be leaving against medical advice (AMA) but by that point, I’d stopped being so blindly trusting. I had had a bad biopsy, I hadn’t eaten in like 36 hours, I was completely sleep deprived, sore, anxious, and just emotionally drained. How can anyone make good decisions in that state? If my neck had still been as big as it was the night before, I would have stayed. But it looked quite a bit better (even the nurse and house doctor said so). I ended up signing the AMA papers and heading home at around 9:00.

As expected from the biopsy, my neck is bruised and ugly and the hematoma is still there (it should go away on its own but it can take days or even weeks). There is NO way that I would feel comfortable getting the thyroid surgery at that hospital or even in the Henry Ford system. After Noah’s foot incident, Jerry’s horrid lumbar puncture, and now this biopsy complication, I’ve lost all trust. I don’t have the results of the biopsy yet, but I know I won’t be going back.

My cousin, who I was very close with when we were kids, is actually a nurse practitioner in the ENT department at the University of Michigan hospital. In retrospect, I should have just gone there from the beginning. But it’s not the same healthcare system (Henry Ford vs. U of M) and I figured it would be easiest/best to stay within the same system while seeing different specialists. Especially considering the biopsy was “no big deal”.

I asked my cousin if there is a particular ENT doctor that she really trusts and she said the ones she works with are fantastic–she gave me some names and said that if she or her family needed an ENT, that’s who she would go to. I really trust her and and decided to make an appointment with one of them for a consult and plan moving forward. I really do need the surgery to relieve the symptoms, whether it’s cancer or not.

I’ve always taught my kids how important it is to listen to your “gut feeling” (intuition), even if it makes you seem like you’re overreacting. If you feel like something isn’t right, there is a reason for that. I had that feeling tug at me throughout the biopsy but I convinced myself that I was just anxious about the procedure.

I’m not saying it was anyone’s fault. It’s possible I would have gotten the hematoma no matter who did the biopsy. But I never should have been sent home with a large hematoma on my throat, especially without a doctor looking it over first.

I realize this post is super long, but just one more thing… when I was being wheeled to get my CT scan, I thought I heard Jerry talking to someone outside of my ER room. I didn’t think anything of it, but when I got back he told me that he’d run into Kelly, one of my roommates from college that I hadn’t seen since 2001! My freshman year was so much fun and I have great memories with her.

I was bummed that I missed seeing her, but she ended up coming into my room a little while later because she is a nurse there. Years after I’d last seen her, when people were starting to get on Facebook, I found her and learned that she had a son on July 13, 2004–which happens to be Noah’s birthday as well. Isn’t that wild?

Anyway, my neck is looking and feeling better today. You can still see the hematoma bump and bruise, but hopefully that will go away soon. Next, I should get my biopsy results. Tomorrow, I’m going to call U of M and make an appointment with one of the doctors my cousin recommended. And just pray that everything goes well from here on out!