ANGRY ENOUGH TO EXPLODE !!!!!!!!!!!!!!!!!!!!!!!!

EbonyEyes

Went for the biopsy today and they would not do it because my blood pressure was too high. Now I'm supposed to wait some more, take more blood pressure medicines, put me on tranquillizers, stay off my blood thinner(which puts me at risk for a stroke which is what they claim they are trying to avoid), etc.... Blood pressure medicines don't tend to work immediately, they can take years -- how long am I supposed to wait? This lump is the size of a tennis ball. Are they going to make me wait until I die? If they would just get me on that table and start the procedure all my anxiety would disappear and my bp would drop. But try telling that to some stupid male doctor. "Yes, I know just how you feel". Oh please! I'd like to stick this lump in his breast. They claim they are only worrying about my well being but we all know the truth: they are worried about a lawsuit. The patient never counts. I have never been so angry in all my life, I'm about to explode!!! I don't know how to deal with this. Any suggestions?

BTW, when I had open surgery on my knee a few years ago my blood pressure was much higher(the doctor said it was from the pain). In this procedure they're just going to stick a needle in my breast so what's the big deal? CYA? This doctor is more gutless? What?

BarredOwl

Hi EbonyEyes:

Argh! I was hoping you'd get that biopsy done, so you could get some answers.

Stress certainly can change your blood pressure in a short term way. I've had the opposite happen with very low readings after I was left bored out of mind in the waiting area for over an hour. I also had some interestingly higher readings when my BP was taken after some hair-raising drives into Boston.

I see they've given you some kind of tranquilizer, so that may definitely help. Another thing you can try is "mindfulness" meditation. There is an excellent book on mindfulness by Jon Kabat-Zinn, entitled "Full Catastrophe Living. . ." The September 2013 revision is available in paperback or kindle on Amazon or in iBooks. Start with the first section (Chapters 1-11) on the practice of mindfulness (especially the seated meditation, body scan, and walking meditation). You can start practicing the seated meditation and body scan (lying down), and maybe it will help you be calmer at the outset when you next appear for the biopsy.

Perhaps others with high blood pressure can comment if they have had a similar experience or if this seems overly cautious.

In the latter case, a possibility would be to find an NCI-designated cancer center and see if you can transfer your care there. They have large volumes of patients and may feel more comfortable dealing with patients with additional conditions like high blood pressure.

For more on NCI-designated cancer centers see:

http://www.cancer.gov/research/nci-role/cancer-cen...

BarredOwl

EbonyEyes

BarredOwl: Thanks for your reply, I'll look for that book. And thanks for the link also. The hospital alled my PCP and told him to "fix her". PCP said they are overreacting because they are afraid of a lawsuit. He said he's never heard of anybody having a stroke during this procedure from high blood pressure, that taking me off the blood thinner for five days was a lot more dangerous. Nevertheless,to appease them, he gave me a powerful bp med, valium, and other stuff-- I hate taking unnecessary drugs. They told the doctor, but not me, I've been rescheduled for Friday. Great.Hospitals don't do anything on weekends so that's another week of waiting. Oh to be young again and not worry about these things!

queenmomcat

Nothing to add to what BarredOwl's suggested already. Just "I'm here, sympathetic, and listening to what you're going through.

ShetlandPony

I wonder if someone wrote a negative comment in your records that is causing problems. I just thought about that because in my case, when I got my clinic notes from the medical records office, because I was transferring my care, I found some inaccuracies, such as "She is afraid of hot flashes" (which I never was).

sas-schatzi

Not sure what will come out of my fingers. May end up not posting. I'm a nurse of 40 years and worked pre-op, OR, and postop. Sometimes all in one day.

Your op  team acted appropriately to cancel the procedure. This was likely not based on your entry BP to the preop area. Routine management of someone presenting with an elevated Bp, is to let them rest and a repeat BP taken. Then another rest period if Bp is still elevated. If Bp does not come down within a 1/2 hour then 1. consideration of the rest of the surgical schedule to follow. i.e. move up the next case and allow you to rest more. 2. Anesthiologist can decide to use an IV medicine to bring the BP down. This can be done by using a cardiovascular drug, or a tranquilizer, or a combination of both. This would most likely occur by moving the next case up, and allowing the drug(s) to do their magic.

You are not going to like this next part. The anesthiologist and the doc decided your anger state was potentially dangerous. Case cancelled. They understand how severe anger produces adrenaline and the dangers. Anyone that is not respectful of adrenaline is a fool.

Yes, you are fearful, but you allowed yourself to get out of control. In the previous surgery, I would guess you were not perceived to be out of control. Totally different situation. Of course, I could be wrong. Presentation adds allot.

You have no understanding or seriously deficient knowledge of how cardiovascular drugs work.

Your PCP was inappropriate and unprofessional. Problem for you is twofold 1. he has supported your anger versus calming you. 2.he gave you a very powerful BP med. Not sure how to answer that without knowing what drugs you are on and what he prescribed. Plus, your medical history for need of Coumadin. Assuming Coumadin b/c the low molecular weight heparins should be discontinued 7 days before an elective surgery and you said blood thinner d/c for 5 days. Valium is a great drug. An alternate very good choice is Ativan. Both have antianxiety benefits. Valium has a wonderful benefit of muscle relaxation.

Hospitals do all sorts of things on the weekend. Pathology though is a department that may not, depending on the size of the hospital. A standard path report on Friday should be signed by Monday 5'pm. If it were done on Thursday doesn't necessarily mean it will be signed by Friday 5 pm. A Tues sx path report, generally, available by Thursday 5pm.

Your anger is misdirected. CYA literally is cover your ass, not cover my ass. Yes, people can stroke under anesthesia either general, twilight, or local. The reason you don't hear of it often is because the team takes safety concerns above all else.

You worked your self into a tissy. You may not think you caused any of this. You did. Anger is powerful. Many decisions are made preoperatively in the PATIENTS best interest. Sometimes we can't see what others see.

In the reschedule of this procedure, take your meds as prescribed. Get a good night sleep. Taking your Valium at bedtime will help with that. Do not take Valium in the morning before procedure unless directed. Have clear directions as to what cardiovascular drugs you should take the morning of surgery. Allow enough time to arrive for the procedure so you are not rushed. Practice relaxation techniques. If you did lamaze with childbirth. Use the focused early techniques and breathing of first stage labor.

sas-schatzi

No clue why you were on a blood thinner. Ask blood thinner prescribing doc if you should be on Subcutaneous Heparin. If PCP was thinking, he would have already addressed this issue.

CAMommy

I don't think they even took my Bp before my biopsy to be quite honest. I declined sedative so maybe they didn't need to. All I was getting was lidocaine without epi. Which makes me think, most of the procedures do use epinephrine to control bleeding and if I remember correctly epi increases Bp. I decline epi because it gives me anxiety

I would have to second maybe it was an anger thing? Mindfulness is amazing for dealing with hp, anxiety, depression, etc. I second that whole heartily.

sas-schatzi

It would be outside usual practice within a hospital or surgery center to not take a BP. But interventional radiology........in 2015 it would be unusual.

If you know about getting lidocaine without epi, you have some knowledge. Your conclusion though is wrong.  Lidocaine with epi is reserved for a very select set of procedures.

Epinephrine(adrenaline) is the name for man made produced adrenaline. Adrenaline is produced by the body. The characteristic of the drug/chemical is to mimic/activate the fright or flight response of the sympathetic nervous system. One of those actions is capillary constriction. With capillary constriction, you reduce bleeding into the surgical field. The other action of adrenaline is to increase peripheral vascular resistance which increases BP by increasing cardiac force of contraction to increase  cardiacoutput.. That with the arteriolar constriction Increases BP. Also, Increases heart rate. They're many more actions of this chemical not germaine to the topic. None of these actions can be reversed without either the being returning to a pre stimulus state or a chemical intervention.

Again, Epi is reserved. Epi is risky. BUT when it is needed, for example, as in anaphylaxis or cardiac arrest. It's worth it's weight in gold. Nothing can do what it does.

Tomboy

Yikes!!! Anger is not unusual in the begining! Can I say "YIKES", again, for you? Welcome, EbonyEyes, and i am pulling for you with all my might

BarredOwl

Hi:

I read this quite differently - that EbonyEyes has indeed been very anxious, and just told them she'd be less anxious and her bp would drop if they would please commence the procedure. After she got home, it all hit her and she fully vented all of her thoughts and worries atthe keyboard.

Nevertheless, from what Sas has said, I would now guess that high levels of anxiety along with high bp may be enough for them to decide to reschedule the procedure in the interest of patient safety. Probably, because after a certain point, anxiety is unlikely to dissipate materially and the procedure itself can make one a little antsy.

Come to think of it, I unexpectedly freaked when stuck into an MRI tube, and pushed the little button to be pulled out after 3 whole seconds. They immediately offered to cease and reschedule so I could take Ativan beforehand. I said I was just surprised by the closed space, and was now ready to proceed with my eyes tightly shut, and we did.

Sas's final paragraph has excellent advice about checking carefully to confirm what should or should not be taken leading up to the procedure, so it can go off without a hitch on Friday.

I know anti-anxiety medications have really helped others on this board. Hopefully, the revised medications, plus special breathing or mindfulness will be just the ticket!

BarredOwl

EbonyEyes

@sas-schatzi:

BarredOwl is right: I was anxious but controlled at the hospital. It hit me when I got home and that's when I got angry. Don't make assumptions. That amounts to diagnosing which you are not qualified to do as you are a nurse, not a doctor, and do not know the particulars of this case or my medical history.

Please do not insult, criticize, or second guess my doctor: he also has 40 years experience and knows the particulars of this case and my medical history. He also knows how this hospital operates because he worked there. This hospital has been criticized(publicly) many, many times for letting it's obsession about lawsuits dictate patient care.. My doctor has battled this hospital for decades on behalf of the patients. To dismiss him as "inappropriate and unprofessional" is uninformed. And to say things like, " If PCP was thinking, he would have already addressed this issue"(BTW, he did address the issue) is unkind. He has done so much to help me and many others I feel obligated to defend him.

The hospital based their decision on ONE bp reading. From your own assessment of the situation, THAT seems inappropriate and unprofessional. But you should be happy to know my doctor basically agreed with your recommendation: he said they should have just given me a Valium and waited a half hour.

Another wrong assumption: no anesthiologist was present. They told me a nurse would give me a shot of lidocaine.

In the future please do not confuse me with jargon like "molecular weight", complicated dosing schedules, the workings of the pathology department, etc... Someone like me who has "no understanding or seriously deficient knowledge" finds this confusing. The words,"breast cancer" sends your head spinning enough.

Thank you for telling me what meds to take and the day-before-the-procedure dosing and preparation schedule but I will follow my doctor's instructions, which are not the same as yours.

Another assumption: I've never had any children so I don't know lamaze, and there's no time to learn it now.

"You worked your self into a tissy." What's a "tissy"? I have never heard this word and could not find it in any dictionery, online or otherwise. I've heard of "tussy"(a small bouquet) and "tassie"(here in the American South, a small pie) but "tissy? Never.

BTW, don't you think it was rather high-handed of the hospital to tell my doctor about the reschedule without telling me?

Please take this response in the spirit in which it was offered. Best to you always.

EbonyEyes

Thanks to all the big hearted and sympathetic members who understood this was just venting and showed the support and babying I really, really needed.

octogirl

EbonyEyes: just jumping in to say that I hope the next try goes better. I can really relate to your situation (not in a good way, unfortunately) because I have a 'thing' about having my bp taken. Ok, it is more than a thing: it approaches a phobia. Hard to admit but true. Which of course is a HUGE problem because whenever they take the bp, bp shoots up! Most of the time, it doesn't go up much, or even at all (when I have it taken without getting anxious it is in the normal range)...but when I am anxious...not good. And of course, bc is anxiety producing! So...one of my pre-surgery anxieties was that the bp would be too high and they'd not do the surgery!

I think venting is definitely called for....sending many gentle hugs! Let us know how it goes Friday and I will be thinking of you.

Octogirl

Leslie13

sas-schatzi,

I found your post to EbonyEyes demeaning and invalidating. Do you have breast cancer? I see nothing in your profile that shows you can relate.

But it's very poor medicine to load up someone with Benzos, extra blood pressure meds, and stop other important ones like blood thinners for a simple needle biopsy. Even a core biopsy. My biopsies were over so quickly, and I had a number of them. Give her 10 mg. of lorazepam, take the biopsy and send her on her way. Don't make a patient wait for a huge tumor to be biopsied.

So EbonyEyes is now at a much greater risk of having auto accidents or other bad events from the resulting cognitive impairment.

And more so, who are you to criticize someone's presentation when receiving any treatment for breast cancer? Waiting for biopsy results is scary. Waiting for biopsies, as I am from suspicious lymph node involvement in a CAT scan that may mean my cancer has metasized is worse. I'm a very stoic person normally, but I've hit a wall in my own ability to wait for aggressive action in my Stage 2 lobular cancer I've had 3 months without surgery because my pervious surgeon wanted me on Femara 6 months despite the fact my main tumor quit shrinking.

Let's hear your story, so I can understand why you're so hard and cold. Blaming the victim is about the nastiest thing you can do. I hope you're not working in a Breast Cancer center.

And EbonyEyes, I've shed lots of tears through my journey, and I've barely started. Luckily, my current health professionals have been more understanding. You have the right to receive treatment with dignity and respect. If there's another hospital or med school in your area, don't be afraid to get a second opinion. I switched hospitals after my surgeon lied to me about imaging results, trying to justify continued conservative action. The medical professionals work for us, although they forget that sometimes.

mkkjd60

To all, I've "known" sas for many years on this site. She has been a tremendous support to many. As she said, she has been a nurse for 40 years. No one likes to hear that maybe their anxiety has contributed to a physical state, but that may be so. I have been in mri machines and just simply lost it. Its never been part of my personality to lose it. I'm a lawyer and we are trained at control. But I have broken down many a time in the breast specialists office and during testing. It happens. We are human.

Let's try to be nice to one another. Not so sensitive that we can't hear some pearls of wisdom. We are all in this together. Blessings, Ebony.

EbonyEyes

Leslie13: I'm being lied to also. The hospital is moving so slowly and their excuse is always, "Your doctor hasn't sent the order yet". When my doctor does anything he always calls personally to let me know. When I finally get some paper work from the hospital the order date shows the doctor told the truth. I'm starting to think: the longer they wait the sicker we get and the more money they make. Crazy and paranoid? My hospital is no longer a little hometown hospital, it is now part of a massive medical center and they answer to stockholders. I'm ashamed to admit this. but I am basically a charity case. State law says they HAVE to treat me on a sliding scale. When they found out my financial status they suddenly started moving. Guess they want to get me out of the way so they can bleed some rich lady dry. Ironic, isn't it? I have a better chance to recover because I'm poor.

I'm sorry your journey back to wellness has been so long and difficult. My heart goes out to you. May things get better,you deserve a break. All the best.

Hopeful82014

I could see rescheduling a surgical procedure for the reasons Sassy outlines but NOT your typical core biopsy; that doesn't make sense to me.

When I had my first biopsies my bp was elevated but the biopsies were done anyway. They had me wait and wait a while afterwords to make sure that it had come down to a more normal level. The interventional radiologist also offered me an RX for Ativan (bless his heart) to get me through the next few weeks.

I'd be livid, too, if I'd gone through what Ebony Eyes has experienced. In fact, I'd be looking for an alternate source of care - although I realize that may be difficult given insurance restrictions, resources within the local area, etc.

magdalene51

Just FYI, Sassy doesn't post her diagnosis and treatment in her signature, out of consideration for the site, because it would take up a whole page. Let's just say she knows what she's talking about, and she's my go-to when I don't understand the medical details. And I don't think I'm a total dummy.

Grandi

Sassy doesn't know this but she has saved my butt, read sanity, more times than you can imagine. I don't post often, but I read. Thank you Sas for your expertise and compassion.

Ebony eyes, my heart hurts for what you are going through. I hope your next biopsy experience goes easily. As a fellow bp anxiety person, I totally get it. I try to put myself in my happy place when I see the cuff coming. I close my eyes and imagine myself sitting on a boat, enjoying the sun and the gentle movement of the water. I think it helps a bit. My best to you

EbonyEyes

Who is sassy? Several people have mentioned her.

CAMommy

sas - I specifically requested lidocaine without epi for my biopsy and they said, oh good thanks for telling us because we routinely use it to reduce bleeding. At first the tech wasn't even sure they could do the procedure without epi, but the radiologist said it was fine and I did bleed more.

I only know about the epi in the lidocaine from the dentist. Actually, not from the dentist, I was telling my therapist how every time I get work done at the dentist I have the worst panic attacks and she told me they put epi in the lidocaine. I asked my dentist about it and he confirmed. Now I have NO EPI in huge red letters across my chart. And whenever I hear I'm going to be numbed, I confirm I won't be getting epi.

Tomboy

She's the lady who said you were in a 'tizzy', I think she meant to say. You can find her at the 'insomnimaniacs thread. Who knows whats wrong with her, she gives medical advice.

Any way, EbonyEyes, nice to meet you, and I hope your real biopsy goes very well indeed. I see that you just needed to vent, yeah, I have been furious too, at things around diagnosis and treatment. It's good to come here and get support from others who understand.

AmyQ

Sas-Schatzi also known as sassy.

As others have said, she is a kind and very knowledgeable contributing member of BCO. And sadly, she has BC like the rest of us.

Kicks

I have never been given epinephrine when I had lidocaine.

SpecialK

In a breast biopsy - or other procedure - lidocaine (to numb) is sometimes given with epinephrine (a vasoconstrictor to reduce bleeding). I have had it numerous times - it is what makes some people shaky in the short term until the epinephrine wears off, but I imagine that it is a physician preference thing so some may not have had it when lidocaine is routinely used.

I can also attest to sas's intentions - she always would put the patient's health and well-being first. Any advice given would be to that goal. I think nuance and inflection is missing from printed words, so there is the potential for miscommunication, but I know she is a caring and uber-knowledgeable person who only wants the best for the OP.

Tomboy

She may be all that, but I don't think that's the point. Sas said ;

"You are not going to like this next part. The anesthiologist and the doc decided your anger state was potentially dangerous. Case cancelled. They understand how severe anger produces adrenaline and the dangers. Anyone that is not respectful of adrenaline is a fool.

So then Ebony stated that it wasn't until she got home that she let her feelings reign.

Then sas said; "Yes, you are fearful, but you allowed yourself to get out of control."

Then, sas stated that "You have no understanding or seriously deficient knowledge of how cardiovascular drugs work." Most of us don't! But we do know our own bodies. She said getting up on the table and proceeding with it, would have calmed her down. Plus, just the way sas said it sounded icky to me. What she posted up there just all sounded quite unfriendly to me, especially as it was aimed at a new comer. But, as I expect that post of hers to be edited also, I already made a copy of it, just to see what happens.

Sam's friends are to be commended for their loyalty, but I for one am glad that sa doesn't run the whole BCO showboat.

Tomboy

Can we get over all of this, and be welcoming and supportive?

Italychick

EbonyEyes, I can sympathize. Both my daughter and I get white coat syndrome and our blood pressure skyrockets when they first take it. Sometimes I have them wait and take it later in the visit when I have calmed down. And I'm talking like it goes to 140/85 when my normal blood pressure is 117/65.

Gentle hugs, and I hope you get it figured out.

BarredOwl

Hi EbonyEyes:

I've been googling some more and found an audio recording of Jon Kabat-Zinn's seated meditation on You Tube (free!). It is all audio. It starts with an advertisement, but after a few seconds, you can just click "skip add" and it will appear.

You can simply sit in a chair to do it. Prepare to chill out! Sometimes he is silent, which is novel for an audio recording, so don't think the tape is over just because he stops talking for many moments at a time!

https://www.youtube.com/watch?v=rGKe7b8NVWA

BarredOwl

Leslie13

I'm new here, but I'll still say that "sassy" was much more rude than the circumstances called for. Perhaps Sassy should put something in her profile so people like me understand her diagnosis. Cancer treatment can impact your judgement, and I agree that people here are looking for answers in a caring, compassionate way. If any of us say and do things hurtful to other members I would hope that the community reminds them to share in a kind and caring manner.

The excerpts Tomboy posted are not examples of how I want to ever be treated. I respect that my newness means I have no history and many of you may have benefited from "sassy, " I just stepped into the room and saw EbonyEyes being bullied. I loathe bullying, and will say something whenever I see it, however I hope being on this forum will be a positive thing. Waiting to find out whether you have Metastic cancer isn't even remotely fun and I hope I can learn some tools and give and receive emotional support whether I stay at stage II or move to III or IIII. Thanks