Worried stereotactic biopsy pain

So sorry to hear you are going through all of this! I had my first stereotactic biopsy with no problems - they numb you up pretty well. The positioning on the table was the worst part. Unfortunately I had 3 more biopsies at once after my 2nd lumpectomy. No pain at the time, but it was really sore afterwards. Icing every hour and pain meds around the clock helped. But, I had two hematomas and excessive bleeding - that is not the norm. Too bad we can't be asleep for these tests- surgery was way easier! Prayers for you next week!

Maybe they can give you something to calm you before the test or some stronger pain block - make sure they all know your pain level is so high! It is a very uncomfortable, stressful experience to begin with, you could check with your doctor beforehand and see what they can offer you. My breast center did not even have Advil to give me before I left - luckily my SIL had some in her purse.

My first stereotactic biopsy was not fun but bearable. They found classic LCIS (not common), so then I had to have bracketing (insertion of a needle with a fish-hook like end so the surgeon knows where to excise) prior to the excision. This was over 10 years ago. They told me before the procedure I had to promise not to move a muscle before the procedure. They did the equivalent of 3 seconds with an ice cube, then the insertion. Then he saw my face, and made a local injection of lidocaine, which was just as painful as the bracket insertions, and didn't help the pain. Then they had to tear out the bracket several times because they hit the wrong place. The radiologist and tech also went in and out of the room all the time (without announcing who they were, and I couldn't see them), which would have been OK except the room opened onto a waiting room, and of course my breasts were exposed and I was in utter trauma- la la land, and I didn't know if someone in the waiting room was trying to find a bathroom. I also work at that facility. So there was shame involved too. Once an anesthesiologist got involved (for my excision), everything was fine. But for my next stereotactic biopsy, I pulled out of the mammo machine, and they had to hold me in the machine while I was silently crying the whole time.

I have a history of trauma, so I'm sure that made it worse. I did a survey here at the time, and the average pain score was <5/10. Mine was 9/10. It wasn't a 10/10 because I'm sure that tearing off my arms would have been worse. I'm not trying to say what your reaction will be, but for me, I couldn't say a thing without crying, and if I cried I would move. Everyone is individual. I contacted the radiologist who did my biopsy beforehand, and he said 'he'd have to use sodium bicarbonate' to make things better. I guess lidocaine is acidic, and the pain of injection can be eased with sodium bicarbonate. (One current problem is there has been a shortage of injectable sodium bicarbonate - I work in a hospital pharmacy - so your facility may or may not have sodium bicarbonate.) Onset, extent, and duration of skin anesthesia were not statistically altered by pH buffering. The pain of local anesthetic administration can be dramatically reduced by buffering the local anesthetic prior to its infiltration. https://www.ncbi.nlm.nih.gov/pubmed/2827545. FOR ME, I don't think he hit anywhere near the area with the lidocaine injection - in any case the lidocaine injection didn't do anything at all for me. Another women who had the same procedure at the same time called it 'barbaric', and I agree. I don't know if things have changed in the past 10 years.

I'm actually going for an MRI-guided biopsy in the next few weeks. What I am going to do is to buy some over-the-counter lidocaine (either topical lidocaine, or, if that's not available, then Orajel or its generic equivalent,) and slather my breast with it before the biopsy. I know this will only dull the surface pain, but that's better than nothing. I'm also going to bring a bell so I can ring it if I can't talk. Since I won't be having an excision immediately after, I may or may not take some pain meds (not NSAIDS or aspirin) I got for other procedures beforehand. I haven't decided about that yet.

I am have a particularly low pain threshold due to my physical/psychological trauma, so I'm sure I'm not the Average Jane. Obviously, I don't have an allergy to lidocaine, or have cardiac arthymias which could interfere with lidocaine.

Everyone's experience is different. Just because my experience may be VERY different than your experience doesn't mean my experience didn't happen.

But I am NOT going to endure that kind of pain (9/10) again. If I have that level of pain again, and they don't take care of it, I will advocate for myself and walk out of there if necessary.