J: Biopsy completed. Results in a few days.

Short version: My CT guided lung biopsy was completed today without any side effects. No fluid was drained as they use fine needles, so my cough will remain for now. The results will be available in a few days.

Long version: Following calls with the lung nurses on Friday I was provisionally booked in for a CT guided biopsy today. They asked me to get blood screening done at our local surgery who were able to squeeze me in on Monday just minutes before the noon blood-run to Bath hospital. The lovely nurse who took the blood assured me that if she missed the van she’d drive the samples up to the local hospital so they could go on another run from there. We do get good service from our local surgery.

By 4pm on Monday we’d still had no confirmation, so I rang Bath hospital and a helpful receptionist was able to get up on her a computer a letter sent that day telling me to report to a particular ward at 0700. So we were confirmed, even if it meant an early start.

We arrived at the ward to be met by blank faces and were told go to an Admissions ward where, after some minutes of doubt, it was indeed established that I was booked in for the biopsy which was scheduled for around 11am.

By good fortune the urologist, Simon Evans, was seeing patients in an adjacent room and he saw me and came over, realising that my biopsy at Bristol had obviously not gone ahead. I was able to discuss with him that Dr. Maskell in Bristol had said that he thought I was fit enough for a major operation, whereas previously Evans had said not. Evans said there was a reasonable difference of opinion and he’d rather wait for the biopsy, but he could see I was rather frustrated with the delays. It’s a month tomorrow since I was first admitted to Bath. He kindly agreed to put me on his operating list and to have an appointment with the anaesthetist, whose decision this would ultimately be. Good man.

The biopsy took place as scheduled. I was not sure how this would work as the CT scanner is a ring about 1 metre across and I could not see a surgeon straddling me and needling me in the back while watching live pictures. Indeed this is not how it works. The radiologist, Mr. Andrews, first put me in the scanner to get an idea of the layout and to work out the best ways in to get tissue samples. He had me lie flat on my front then gave me a local anaesthetic in the back (same as for the lung drain). He then marked up the entry points and popped in the needles. I was moved in and out of the scanner about ten times as (I surmise) they were checking the positioning of needles. I thought they had put in about 5 but he said 3. Once he was happy, there were little punching sounds when I think the samples were extracted.

It was all about as painless as going to the dentist i.e. hurt a bit and you feel quite vulnerable, stressed and uncomfortable, but nothing major. The nurse on duty was very kind and helpful. There is about a ten percent chance of damaging the lung in this procedure. Most of this is minor and self-healing but a few cases need more attention. I was advised that for this reason they would keep me in for 4 hours after which I’d have an X-ray so they could check all was fine.

I was taken to the Short Stay Surgical Unit and told I had to stay on my back (to keep the puncture area pressed against the bed). The ward was run by a lovely nurse called Donna who was very cheerful but also very efficient – chasing down my X-ray when it looked like it might have been forgotten. I was taken down for the X-ray a little late but whizzed straight in and given the all clear so we left the hospital about 4:30pm.

The Respiratory Multi-Disciplinary Team meets on Thursdays so I am hopeful that they will have the biopsy results by then to discuss them. Andrews, the radiologist, kindly said he’d flag them as urgent for that purpose. There is a 15% chance that the tissue samples won’t be the right ones and they will have to perform the procedure again, but let’s hope not. I am unclear right now what will happen about the fluid still in my lung. Whether Dr. Walters, who I saw originally, will put in a permanent drain as discussed, or whether that won’t work because it is now all in pockets (loculated). I’ll just wait for feedback from the MDT meeting and can discuss it then. Fingers crossed in the meantime…

24th March 2015

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