I arrived at the hospital yesterday morning to have a liver biopsy done. I'd already researched enough to know what to expect, talked to people in the forum I belonged to to hear their experiences. I wasn't expecting to be this surprised. Oh, but I was.. and in more ways than one.
When the radiologist came in with another doctor to talk to me about the procedure, what to expect, how it will work, etc., he mentioned HOW they were going to access my liver. Now, this is where the first surprise came in...
He began telling me that Dr. S wants things done a particular way and that the procedure I'm having is "tricky" because it involves entering the jugular vein and inserting a wire that will be able to reach the portal vein in the liver in order to check the pressure there. He began telling me the risks to the heart and lung and liver. I listened, but I was confused because I thought I was to be there for just the biopsy and didn't know anything at all about checking the portal pressure. Skipping ahead...
We talked a little about the procedure, and the radiologist reassured me that Dr. S was very specific about what he wanted done. I asked if anything bad had ever happened during the procedure with anyone he's done it on and he said that the only thing that has happened in his (long) career was one patient's heart went out of rhythm and wouldn't go back in, so they had to stop the procedure, send him to the cath lab to shock his heart back into normal sinus rhythm. Ok. Only one event. So I said.. "Ok. Let's do this."
The Dr. assisting the radiologist explained about the two medication that I'd be given, that I wouldn't be put completely under but would be unaware of what's going on and wouldn't feel anything, except perhaps the lidocaine they would use on my neck where they would make the tiny incision to access the jugular. He said I would just 'sleep' through the procedure and would not have any recollection of it at all once it's done and I'm awake. I was familiar with this because I'd had a heart cath in 2013, and ablations on my heart in 2014... so that twilight sleep I know about and have experienced.
...Off to the OR we went.
Once on the table the anesthesiologist told me she was giving me the first dose of sedation, and that it would be done in stages until they're ready to begin the procedure, then she added "The lidocaine may bring you out of this for a moment because it stings, but it will be brief." By the time they were ready to begin I was loopy as hell, but I was awake. One last dose was given, because I was awake... and I think I nodded off for a minute or two. Then I was awake again.
Awake, aware of my surroundings enough to hold a conversation.
I heard the radiologist say he was administering the lidocaine. Oh yeah---I definitely felt that. But it quickly receded and I felt nothing in that area.
I felt the cath wedge go into my jugular, and I continued to feel it go down my chest, felt something strange with my right lung, felt it proceed past my heart--to which my heart fluttered a little--and then nothing... for now.
I heard every word said, heard the radiologist talking to the doctor that was there, even remember hearing him calling out the numbers once he began reading the wedged pressure and free-flowing pressure. I remember the numbers exactly.
A couple of times the anesthesiologist raised the blue drape over my face to look at me, and I returned with a smile. Then... they changed Caths and went back in to take the biopsy samples...
The first "snap!" I heard had only a little discomfort with it. The second "Snap" was a bit more painful and I said.. "Oh, that one smarts!" This was the first time the radiologist knew I was awake.
"How much did you give her?" I heard him ask the anesthesiologist. "She's awake." She responded with the dosage she'd given me, and he said.. "Wow. I would be on a vent if I'd had that much." He has a smile in his voice, so I know he was just joking a bit. Plus I was familiar with this radiologist as he'd done the biopsy on my thyroid nodule a year ago. He's good guy, a really skilled radiologist.
So the third "Snap" I heard came with significant cramping across the entire front of my ribcage, where the liver is. And oh yeah.. THAT one definitely hurt. And folks, I have a high pain tolerance for stuff like this, having kids, etc. So when I say it hurt.. I mean it.
Once they were finished they removed the blue drape and one of the nurses told me she was applying pressure to the little hole where they'd entered the jugular. She told me there may be a bit of a bruise there and that she was sorry if the pressure she was applying hurt. It really wasn't that bad, and I told her so.
As I lay there with pressure being applied to my neck the anesthesiologist came over and apologized that I felt pain and explained she wasn't sure why I remained awake. I assured her that it was okay and that the pain I did feel didn't last a long time, that I was okay. They returned me to recovery.
I told my nurse there what happened, and she looked at me as if I'd grown a third eye. lol The other nurses turned around (my bed was right next to the little desk where all the nurses sat) and gave me a look of horror. haha Hey, no events... so to me this was a good procedure.
I'll have the results in a few days, I think. But I don't believe I have portal hypertension at all. I believe Dr. S just wanted to make sure due to some of the symptoms I was having. As for the presence of any cirrhosis... I don't believe that's the case either, or Dr. S would've seen the prominent veins in my esophagus etc. when he did the EGD a couple of months ago. What I DO expect is to see if NASH is actually present and to what extent, and if there is any fibrosis or not. I fully expect the outcome to be okay, with perhaps NAFLD or maybe NASH if inflammation is present.
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