Nuclear dye injection

yellowrose

My MRI biopsy wasn't really that bad BUT it could be due to the area that was biopsied.  My MRI biopsy was on the outer side of the breast, a much less sensitive area. I was also given cream and numbing shots.

Lories

You know I read a lot of posts about how painful it was before my procedure last Monday.  I have to tell you I was terrified, and worried.  The nurse even warned me that it would be painful. 

I went there thinking, I don't have to brave I just have to show up (thanks to a lovely post I read on this site). 

So I tried to relax, and you know, there really is not a lot you can do about it, you do the dye or you lose all your nodes, which I understand can be even more painful.

But I have to tell you when the Doc said he was done I honestly said, really?  It did not hurt that much. 

I realize it is tough, but just try and relax - things always hurt less that way. 

rdrake0

Did they give the injection directly into the nipple or off to the side where the cancer was?  Mine was 3 shots into the areola the last big one into the nipple.  Ouch!

Lories

Into the nipple.

Sukiann

OMG!  My surgeon just mentioned that I was going to have this done.  After the core biopsy (which hurt like heck) I am terrified.  I am not a baby and that procedure was not supposed to hurt (so they said) I can only imagine how I'm going to get through this.  Well, at least I know and I am going to ask for the Emla cream and a xanax (is that how you spell it??).  Anyway, thanks for the heads up.  Just joined you all and I am happy to connect with people who know how I feel.

Lories

Hi Sukiann - I did not have xanax, just lidocaine. 

There was a very sweet article that Britt posted that I enjoyed reading.  If you google NYT and xanax you can find it.  http://www.nytimes.com/2008/12/28/fashion/28love.html

It is about a few women sitting together waiting for wire placements - that was what I was worried about, having a wire sticking out of my boob. 

The doc put one in and that was ok, then he said, oops that one pulled out a bit, and he had to put in a second wire - well that had me worried, but it was all ok.  I was most worried that the surgeon would dig in at the wrong wire.

I really hope you are not going to be terrified, just remember many many thousands of women have gone through this procedure plus more. You will be okay - you are on the way to getting better.

Remember attitude is a very important factor in this little cancer adventure of ours.  I am not saying I always have the right one, but I do right now, so its my turn to pep you up.  (don't worry you can pep me up another time)

webwriter

Geez, Lories! That's the best description I have read so far. My psychological reaction to the wire placement that I didn't understand beforehand was SO much worse that the actual proceedure!

I did get a local for that. I AM thinking it should be done before the SNB dye. I AM thinking the cream thingie would be the right thing to do. If I'd had that, and some warning (education is everything in this fight) I'd have been fine.

It was the blindsided feeling that really got me. 

I THOUGHT the worst would be the IV. Been there, done that (BTDT) and wasn't worried except for the thought of the whole wire thing. I'm a needle phobe anyway. SO! I just didn't WATCH! It was fine. No big deal. I got the local for that and didn't even feel it. I even had time to marvel at the way they make sure it's accurate with the whole grid mammogram thing. Then they put tape over the wire so I wouldn't "catch " on anyting, which was a big fear for me, and that was that.

So yeah, if you go in blind, not knowing what is about to happen it's shocking and painful. If you know going in, I don't think it would be so bad. I just wasn't READY for it and that made the whole thing worse. 

I STILL think there should be a "Standard of Care" which includes the cream and the local. Without that, it sucked. But those having it, even tho it sucked, were far better off and those who knew it was coming were better off yet. 

Forewarned is forearmed. I'm obviously still here, and obviously over it. No big deal in the end. Just an other thing we gotta do compared to what? Yeah. In those terms--minimal.

All My Best,

Webbie

(Sorry if that's incoherent. Hubby just came out to the shop in his robe and said "Um, are you busy?" HELL NO! Gawd, I love that man!)

Sukiann

Lories, thanks so much for that link.  It was great!  Webwriter and Lories, I didn't even know about the wire placement.  What?????? Ok, I'm fine.  I've been really good about this, really.  I have an icd (defibrillator - don't ask) that needs to be moved before I can even have these procedures (well, probably could have the nipple thing before).  Of course the defibrillator is impeding on my breast and the surgeon said no way was she going to operate because she could go into the pocket where it is located and that just wouldn't be good. So...... have to have that surgery first.  Dr. can't take it out and let me have treatment - I can't go without it or tragedy could ensue (like sudden cardiac arrest).  I am so glad I found you all.  You seem like you have a great sense of humor and are a wealth of knowledge.  BTW - I get through EVERYTHING with humor - I just can't help myself (my 14 yr old daughter said I'm really not that funny but I crack myself up!).

QueenK

I am sure that mine hurt, but my surgery was the next day so I was thinking about that.What terrified me was the PET scanner, no one told me anything and they left me in the dark with this lying saucer above me head.

AccidentalTourist

It hurt a lot but mercifully it did not last very long.  In the end it is worth it as it saves us loosing all our lymph nodes.  I liked the way it was described in the Cancer Vixen book - off the scale.

Sassa

I had four injections around the nipple.  I have a high threshold for pain and I nearly didn't make it through.  I asked for a 20 minute break between shot 3 and 4 to recover a bit.

After I was finished, the radiologist told me that the two other women he had before me didn't get past the first injection.  They both left.  I asked why pain medication wasn't given.  He told me the hospital had strong policies about the use of pain drugs.

As I found out, after my mastectomy, this policy extended to the use of pain medication after surgery.  I had to beg for pain meds (the first night it took me two hours to obtain my ordered meds after I asked for them).  My room mate who was in for a gall bladder attack (and I have had gall bladder problems so I know she was in extreme pain), also couldn't get her pain meds.  I wondered if our nurse, "Valentina," was taking the drugs to sell.

So, folks, if you are ever in Hernando County, FL, do anything you can to avoid Spring Hill Hospital (and since Brooksville Hospital is run by the same people, I would also avoid it).

AnnNYC

I think people experience HUGELY different levels of pain -- and it is NOT necessarily about whether you are relaxed or "tough" or brave!  Makes me so mad when I hear anyone's experience dismissed or discounted!

I had a bunch of different things done to my breast before it was finally removed.

My "palpable lump" was at the edge of my left nipple.  Nothing showed up on diagnostic mammo or ultrasound, but the lump was obvious and painful to the touch, so the next step was:

Fine needle aspiration.  VERRRRRYYYY painful.  Long needle into my nipple.  Three passes.  The doctor put lidocaine on the surface (and maybe it would have hurt worse without it!) but still the biopsy was excruciating.  As he said, he could have injected an anesthetic, but that was an even bigger needle, and the injection would have hurt!  This doctor was an absolute doll, though -- I said, "I can handle this if you let me make a lot of noise" and he said "of course!" -- which was a huge improvement over the labor/delivery nurse when I had my son!

[Excisional biopsy -- out cold.]

Then I had an MRI of the right breast to make sure nothing was brewing there -- something looked suspicious, so I had to have an MRI-guided biopsy.  The radiologist said "okay, I'm injecting the anesthetic -- you'll feel a little pinch -- don't move" and suddenly a needle felt like it was inches deep into my breast and I involuntarily jerked about 3 inches up off the MRI table!  The radiologist was pissed!  But jeez, it was a REFLEX!

From that point on, when anyone came near a breast with a needle, I instructed them -- "touch the point of the needle to the surface of the skin so I can feel where it will go in, and then ASK ME IF I"M READY and inject when I say so!"  That's what I did for the SNB injection (no numbing cream) and it worked very well -- was among the least painful of the procedures I experienced.

One thing that I think may be going on is that we probably all have changing levels of inflammation in response to the tumors/cysts/fluid(even seromas)from previous procedures, etc. -- in addition to inherently different levels of sensation -- I had an ultrasound between excisional bx and mx that just about KILLED me, and of course ultrasounds are "supposed to be painless" -- but I had a huge seroma and it just hurt like hell, and the US tech (a woman) acted like I was completely insane and making it all up!

All these doctors and techs should be prepared in case the procedure is painful and should LISTEN TO THE PATIENT!

(I know, what a concept...)

Okay, I'll stop yelling now!!!

sccruiser

I don't know what was worse for me--the guide wire insertion or the dye insertion shots for the SNB--both in the am before the 1 pm surgery. My BS did prescribe some diazepam, but that wore off by the time the dye injections were scheduled.

The wire insertion hurt like heck, and the radiologist would not even look me in the eye. The nurse just held my hand and kept saying supportive things to me.

The dye injections was like this surreal experience in a Twilight Zone episode. I check in. I waited and waited. The receptionist ignored me. My husband went up twice to find out what the long wait was about. After 2 hours the receptionist finally took me into the back room--the delay was because my surgery time had been changed. Well, golly gee, and i couldn't know that because, what, I would leave the building?

Turns out the receptionist is also the radiology aide, which left me more unsure of what was going on! I just hoped she was qualified to assist him! The radiologist came in, and without speaking a word to me proceeded with four injections around the nipple. The aide told me I could squeeze her hand as hard as I needed to; and she talked to me all through it. The radiologist finished and turned and left the room. I might as well have been a piece of meat he was inserting marinade into!

I believe that the radiologists know how much it hurts women to have these 2 procedures--and that's why they could not look me in the eye or even acknowledge my presence in the room--other than to start and finish the procedures in silence!!

At least the aides were kind and caring.

it turned out that once I was under for surgery, the BS had to insert more dye to find the SNB before beginning the surgery. So, if I ever have to have this again, i'm going to insist this is done during surgery.

And the silence of the radiologists made me feel like I was a big baby and embarrassed me when i consider their silence and body language. i should have written a letter to the clinic and the hospital about my experience. I still may do that, now that these experiences have resurfaced wit this thread! 

lisettemac

Interesting how everyone had such different reactions to this!  I, too, was given absolutely NO explanation of what was going to happen (whatever happened to informed consent?).  However, they put some kind of numbing cream on my breast and then made me wait in the waiting room for almost an hour.  Then, I think there was a shot of lidocaine.  The only clue I had that the dye injection was supposed to be painful was that the nurse grabbed my hand and told me to squeeze as hard as I needed to.  As they injected me, I felt nothing at all.  She seemed shocked.

The wire localization, OTOH, I found to be absolutely barbaric.  Not so much in terms of pain, just in terms of what they were doing.  In fact, after the tech explained the entire thing to me and shoved the consent form at my face, I looked at her and said, "Admit it, this is barbaric."  She looked shocked.  I told her that I would ultimately sign and comply, but I wanted her to admit that what she was proposing was crazy.  She agreed and I signed the consent form.  The notion of having 6" of wire sticking out of my body as I walked around the hospital from dept to dept was insane to me.  I swear to you I could have hung Christmas ornaments off the thing!  The pain for me was the mammo that followed with this thing hanging out of me.  UGH.

otter

The more I think about it, the more I think these stories ought to be reported to the hospital ombudsmen where we're being treated.  My hospital/cancer center made a huge deal about their "pain management team" at the time of my mastectomy ... and then the nurses refused to give me the Percocet that my surgeon had ordered for post-op pain.  I didn't get any until the next day, 3 hours before they discharged me to go home.

This blase' attitude toward the pain (and they need to stop calling it "discomfort") with the injections for sentinel node biopsy has to change.  For pete's sake--people have published medical articles about it.  It's not like nobody knows the injections are painful.

I'm sorry if my little essay on page 1 of this thread made it sound like I was discounting the pain.  It really was as I described it--but I only had one injection.  I cannot imagine having had to lie there for more than one.  I, too, would have been out the door.

BTW, my nuclear dye procedure was done the afternoon before my surgery, and it took all of 45 minutes, total.  So in that case, a general anesthetic, or even "twilight anesthesia", would have been overkill.  But, again, that's IMHO. 

otter 

Artemis

Welcome, Sukiann ~ I'm with you:  I know nothing of this "wire placement"!  This is the first I've heard of it.

Would some of you ladies tell us just what this is and what it's for?  I gather it had something to do with the radioactive dye injection and SNB and all that, but what it it exactly?  

Artemis

AccidentalTourist

Wire gets inserted into your breast to guide the surgeon to the tumour in cases when it is not palpable (because it is too deep inside the breast).  I had this done on the morning of the surgery and have to say that mine did not hurt at all (at least not physically) as I was injected with pain killers.  I then had to have a mammogram which again was not painful but by the time I got to another hospital to have the dye injected pain killers wore off and it was very painful.

JulieC

Sukianne and Artemis - I had the wire localization done prior to my excisional biopsy/lumpectomy.  They used the mammogram machine to locate the lump and the radiologist inserted the wire through the breast to the lump.  They did numb me before, but it only seemed topical.  I don't know how to describe the sensation but it was managable.  Then they went high tech and covered the exposed wire with a styrofoam cup taped to the breast - think Madonna's pointy cones.  I had already been admitted so I was transported around the hospital in a wheel chair.  I couldn't get into too much trouble that way. I had the IV sedation during the biopsy and felt things.  They told me I was only feeling the numbing, but I thought it was the actual cutting.  I think they gave me more sedation after that.

I had my SNB a month later and had the radioactive marker injected the afternoon before.  One of the techs called me at home a few days earlier and told me what to expect and how painful it would be.  She gave me the numbing cream to wear under plastic wrap for an hour before.  When we got there I went to use the rest room and she followed me and waited outside the door. I shoul have known then that it wasn't going to be pleasant.  I couldn't reach my husband's hand, but he could have easily lost a few fingers that day.  I just asked to have a rolled up sheet and put that over my eyes.  They even had someone down by my feet just in case. I had the shots on either side of my lumpectomy scar and two more around my nipple.  The paid was bad, but didn't last long.  I do consider this to be the worst thing, painwise, in this process and I even did chemo and radiation.

By the way, does anyone still have the stain from the dye on their skin?  My SNB was done in April (almost 9 months ago) and I still have a large area that looks like a turquoise bruise.  Just thought I'd ask.

Take care,

Julie

rdrake0

JulieC, my cancer was deep and in the center of my breast, so after they put in the wire they put those goofy cups on me, too, and taped them down.  Then I was transported by gurney the rest of the time until surgery because they didn't want anything to jiggle or move!  I thought the wire placement, like my biopsy, was a piece of cake compared to the SNB. 

So that's why my areola is still a dark color.  (Wonder how safe that stuff is in our bodies!!!)

I thought the SNB had to be done just before surgery so that the doc could find the sentinal node during surgery.  Or did you have 2 surgeries, one for cancer and one for the node(s)?

JulieC

Rdrake - I had the excisional biopsy which ended up being a lumpectomy in March.  The results were positive for cancer so I had to do the SNB a month later so I did have 2 separate surgeries.  They told me the coloring might last 6-9 months but it hasn't faded much.  I guess these were the nipple piercings and tatoo that I would never have gotten on my own.

Where do you live in Illinois and where did you go for treatment?

Julie

rdrake0

I'm in the middle of the state.  Where did you go?

JulieC

I'm in Charleston and was treated by Dr. Hoppin and Dr. Cho at Sarah Bush Lincoln Health Center's Cancer Center.

slmdavidson

Wow, I am shocked to read these.  I had my injection and surgery on Tuesday.  I am going through a second diagnosis after bilat mastectomy 15 months ago and I could barely feel the injection.  I think having cut all the nerves in the past surgery did me a favor here.  I didn't think it was bad at all.  What a surprise that could have been.  They did tell me that it would hurt a lot but it didn't.  I guess that's the pay off for all that I went through in 2007.  This absolutely needs to be addressed though.  It's crazy to put women through that!!!!  

Artemis

AccidentalTouris and JulieC ~
Thanks for the explanation of the wires.  I believe that's one procedure I won't have to go through because my tumor is most definitely palpable and very near the skin beside my nipple.

I'm getting more and more concerned about this dye injection.  I can take pain (I've had a broken arm, 13 kidney stone attacks, 1 major abdomenal surgery and a baby!), but this thing is making me very nervous.  

Artemis

AccidentalTourist

Artemis, I have not had kindey stones and broken bones but having a baby I can relate to.  While dye injection pain may be intense it really is quite quick and I recon labour was more painful if you take into account all the hours of it.  [But then again you are a goddess of childbirth so maybe you won't agree.]  Just think of it as a trade off for keeping most of your lymph nodes.  It is worth it - just like labour.  With best wishes Nena 

JulieC

Nena,

I like your thinking - it's a trade off for keeping most of your nodes.  I wanted to know what was involved with everything I had done.  I was still stressed beforehand, but at least I knew what I was up against each time.  The skin bubbled up for a few minutes (as told to me by my husband), but I couldn't tell much within 15 minutes.  It was very painful, but wore off quickly.  I'm a girl scout troop leader and I kind of looked at all of these events like earning a badge for each one.  Also, the staff was very thorough and told me everything that was happening and that they were trying to be gentle.  I guess I would rank this up there with child birth and a root canal I had.  But I survived all of them and am stronger from them.

Julie

Artemis

Hi, Nena ~
Thanks for your kind words.  Your perspective on the time it takes to have a baby versus the time to get these injections is helping me. When I started to cry and have a panic attack when they put me in the tube for the MRI, I calmed myself by thinking, "I've had a baby; I can do this.  I've had a baby; I can do this...."

There are times when dreading a thing can be worse than the actual experience; I hope this is one of those times!  And, heck, I have no idea if I'm even going to have these injections!

Thanks again,
Artemis

sschmidt

Hola Ladies...I went to Stanford and it was done while under general.  Thank goodness.  I ahd no idea that there was an issue until reading about it on these boards.

Shirley.....I am so sorry for all of you that have had to experience this.

ekyn

hey everbody..ım new in here.ı ve just learned that my mum is a breast cancer..she was diagnosed about a month ago and doctors determined that it was invasive ductal carcinoma on a 3 millimeter area...according to the treatment,doctors determined that 25 seance of radiotheraphy and tamoxifen for 5 years..or subcutan mastectomy..we are from turkey in izmir..and we are looking for a second opinion about this....

Anonymous

Oh goodness -I won't ever forget how painful that was - Mine felt like bee stings too. Almost unbearable!!