Getting a lung biopsy

After lung nodules popped up on my routine pancreatic cancer CT scan in March, a PET scan, which had three nodules that lit up, and lung biopsy were scheduled. Why both? To be super sure we knew what was going on and how to proceed.

Like everything involving cancer diagnosis and treatment, I’m sure everyone has a different experience with a lung biopsy, but here’s how it was for me.

Mentally preparing

The thought of someone poking my lung was super scary, to say the least. Puncturing lungs is a bad thing, right? But the medical group that has been helping me has been stellar. I felt like I could trust them, while still being well aware of the possible risks.

In addition to lingering little thoughts of a lung collapsing was the concern about the anesthesia. When I had the bilirubin drain installed and redone back in 2021, I was partially awake, but given some sedation through an IV. And it was freaky as hell. It was tempting to be put completely under. But when I saw the estimate to have that done, I decided to put on my big girl pants and deal with it.

Physically preparing

As with several other procedures, this one started the night before and morning of by washing with some special surgical soap. When we got to the hospital, I donned the provided haute couture of a hospital gown and no-slip socks. The nurse provided some lovely accessories in the form of an IV and several monitors stuck to my skin.

Getting the biopsy

A staff member wheeled me in the room for the procedure. This biopsy was CT scan-guided, which meant there was a huge machine in the middle of the room. Thankfully, I’ve had enough CT scans that it the machine felt more familiar and, dare I say, friendly than frightening.

I had to lie down on my stomach, because the nodule they chose for the biopsy was easier to reach through my back. At least I didn’t have to see what was being done. But I did have to cross my arms to make a pillow and turn my head to the site—then hold still like that through the whole thing.

Note to CT scan manufacturers:
Please add one of those attachments to put your face through, like on a massage table. This will make a much more comfortable patient experience. And we can pretend we’re getting a massage instead of checking to see if we have cancer. It’s the little things…

The numbing shots were the most painful part of the process. As the meds spread, there was a stinging sensation. I also felt the pressure of the needle and let the doc know. He said something to the staff after I mentioned this to him, and I’m pretty sure they kicked up the sedation meds.

Now things got a bit hazy. 

Once everything was numb, I recall the bed I was on being moved in and out of the CT machine. Like I mentioned, I’ve had more of these than I care to count. I’m used to hearing a voice say, “Breathe in. Hold your breath. Breathe.” And I dutifully comply. There was no voice this time. I started panicking that if I breathed at the wrong time, I’d mess up what the doc was trying to do and my lung would pop and explode like a balloon. I really didn’t need the sedation meds amping up my overactive imagination like that, especially when I could feel a gentle click a few times, which I assume was the sample being taken. Fortunately, my lung never exploded.

Recovering, which was interesting

A staff member wheeled me back to the prep and recovery room. Someone was supposed to come take an X-ray like a half hour after the procedure. An hour later, no one had arrived.

I was coming out of the sedation and the numbing meds were starting to wear off. I told the nurse I could feel that nausea was going to hit as soon as I sat up. She put in a request for anti-nausea meds. A few minutes later, before we could get the meds, the X-ray tech arrived. Naturally.

For the X-ray, I had to sit up super straight and have a board put behind me. On top of the meds wearing off and my tendency toward nausea and suddenly sitting up after lying down for a good while, I hadn’t eaten in like ten hours. Guess where this is going.

Within seconds of sitting up straight, everything started going white. Again, this all got a little hazy, so I’m not totally sure what was in my head and what I said out loud. My awesome husband was there to help and support me, as always, and could probably confirm if you really want to know.

As everything was going white, I thought, “Oh, shit! This is not good. Please, Rhonda, stay conscious long enough to get this X-ray and make sure your lung is okay.”

A split second later, I realized I was about to drop. I managed to say, “Please hurry. I’m about to pass out.” I could see long enough to notice a look of panic on the tech’s face. I felt bad for her, but couldn’t help it. Thankfully, they got some semblance of an image and laid me back down.

But wait! There’s more! (skip if squeamish)

I started getting that pre-puke salivation. When our son was little, he referred to this as “gray water.” I was about to tell whoever was near that I had gray water. Then I remembered no one other than my husband would know what that meant. Not being able to see clearly yet, I wasn’t sure if he was within earshot or if he had to move away during the X-ray. Instead, I went with a short, universal word that I figured anyone would understand.

“Hurl.”

Then my stomach decided to help communicate the situation by lurching. Within seconds, I heard someone shout, “We need a barf bag over here!” And just in the nick of time, two sets of hands grabbed each of my upper arms and thrust me into a forward-leaning sitting position with my face in a barf bag.

They cleaned me up as I regained full consciousness and eventually I got some soda and crackers, along with anti-nausea meds. 

Props to that whole team for taking care of me and their quick response. And to my husband for always being a rock star and helping however he can.

The final X-ray went much better and showed that my lung was still good and there were no issues from the biopsy.

Getting the results

I was told it would take up to a week to get results. So when the results were ready two days later, I knew it wasn’t going to be good news. And it was not.

The biopsy confirmed the nodule was indeed cancerous and consistent with metastatic pancreatic cancer. It hit me hard and took a few days to process. That process will get its own post because it was a lot to take.

Finding the silver lining

Not gonna lie, it was hard because this situation is scary and sucks massive ass. But here was the silver lining:

We had an answer and could move forward with treatment.

I’m writing this almost six months after the biopsy and am happy to report that the treatment is going well. Resection wasn’t an option because there were three nodules across both lungs—two in the right and one in the left. So I’ve been on an aggressive chemo. As I type, I’m sitting here with my take-home chemo pump. And this chemo will get its own post, too. It has been an adventure.

Thankfully, I have continued to live my life during treatment and am grateful for every single day.