Painful mammogram, painful biopsy - any suggestions?

Anonymous

Painful mammogram, painful biopsy - any suggestions?

Gusta

I just had a painful mammogram (because of scar tissue and whatever from lumpectomy and radiation) and I'm scheduled for another biopsy next week. I'm getting anxious about it already. The last biopsy was very painful, and and I panicked a little at being 'pinned' in the machine. If this recent mammo is any indication, it's going to be a rough ride! Any suggestions?

leaf

Do tell the people that you had a horrible time with the last mammo and/or biopsy. (I did too. At the next mammogram-guided biopsy, I instinctively pulled out of the squishing panels, which I assure you hurt a LOT.) My big problem is that I did not communicate well enough about the pain I was in. If you suspect you may not be able to speak when you are in pain (like what happened to me), then set up some non-verbal system such as a rattle or bell or something, and explain to them what that means beforehand, so you can communicate to them when you are in pain. (I had some early childhood trauma.) For me, they told me I shouldn't 'move a muscle' during the procedure. I knew if I talked to them I would cry, and if I cried I would move, so they wouldn't be able to find the correct spot.

You may also consider applying some lidocaine used for teething babies (such as Orajel (R) or generic ), and although it may be messy, at least the outside of your breast may be more numb. Wipe it off just before your procedure.

The next time they gave me more injectable lidocaine (or another local anesthetic), and it was MUCH better.

Unfortunately, there is an ongoing shortage/difficulty getting a supply of injectable lidocaine and other injectable local anesthetics. (I work in a hospital pharmacy.) I have heard that some places have refused to do some procedures because they can't get enough of a supply of lidocaine. But I was prepared to tell them that if I was in utter pain DURING the procedure, and if I communicated this to them, AND my pain wasn't addressed during the procedure, to a tolerable level, I was going to walk out of there. I didn't have to do this. They were able to give me enough lidocaine so it was a tolerable procedure.

P.S. They usually don't treat classic LCIS with radiation. Maybe you have other diagnoses too?

Gusta

Thanks for the ideas, Leaf, and for sharing your perspective.  I'm a stress talker, but I can imagine that it would be exponentially scarier to be in pain and unable to speak.  

I do remember them injecting an anaesthetic last time they did a biopsy, but I'll ask for more this time.  And I spoke with my NP, who is amazing, and she suggested taking codeine before the procedure.  Even if it's a placebo effect, I'll take it!  I feel better going in with a plan.  

There's the actual physical pain, and there's the anticipation of it, and I need to get a handle on both.  

I like the Orajel idea, too.  Thank you!
(And yes, I have pleomorphic LCIS, so that's why the radiation came in.)  

leaf

In my situation, I was having a wire insertion before a breast excision (with conscious sedation), so I wasn't allowed to have anything orally. They do that to avoid aspirating anything from your stomach into your lungs. You could also consider trying acetaminophen suppositories (which are over the counter) if you couldn't take anything orally. They don't want you to take any NSAIDs because they can increase bleeding, which is not good if you're having an incision of some kind.

Gusta

Biopsy done! This one was done with ultrasound, which the technician said was usually less painful than with mammogram. Still a core needle biopsy, so that's nasty, but they used plenty of local anaesthetic, hooray hooray. Thanks for the suggestions, Leaf, it all helped. I felt much less anxious for having a plan (including some proactive pain meds.) Whatever works.

leaf

A plan definitely helps. Best wishes for a big NOTHING on your biopsy report.

Sara536

Bringing the subject up abead of time really does seem to work. Before my last biopsy, I told the radiologist (different doc) how much the last one hurt. He said that he never lets his patients be in pain and checked with me as we went along. When I said it hurt, he gave me more lidocane. Also, some people seem to be less tolerant of pain than others and I'm one.