Thursday, May 23, 2013

My Kidney Biopsy Experience

I just had my second kidney biopsy. Beforehand, I decided to document as much as I could and then write a blog entry so that others facing a biopsy would have a first-hand account of my experience and would know what to expect. Sure, there is a lot of information online, like this page from Johns Hopkins, but I wanted to provide a real account from an actual procedure. Big thanks to my Mom for being there and helping me track the details.

May 22, 2013

7:30 a.m.
Arrived at hospital.

7:48 a.m.
Gave urine sample and changed into gown.

7:52 a.m.
Warm blankets delivered. Yes!
Vitals taken: temperature 98.6; blood pressure 103/59

8:10 a.m.
Blood drawn and IV port put into right arm.

8:20 a.m.
Researcher came to ask me to participate in a study of kidney disease patients in Ann Arbor, Detroit, Chicago and Philadelphia. I agree. (More on this in a future blog entry.)

8:40 a.m.
Research interview ends. Paperwork is signed.

8:55 a.m.
Taken for kidney ultrasound. Hospital staff expresses some confusion as to why I'm having a separate ultrasound; say it's mostly done on transplanted kidneys, not native. They roll me down the hall anyway.

9:20 a.m.
Ultrasound done; back in original prep room. And then I wait. No meds. No IV in port.

10:05 a.m.
Taken to 7th floor for kidney biopsy.

10:15 a.m.
In procedure room. Blood pressure taken. Signed several forms giving approval to do the procedure and acknowledging that I know the risks. I am asked to roll over onto my stomach as they prep and wait for the doctor.

10:25 a.m. (THE ACTUAL BIOPSY)
Procedure begins. I'm on my stomach. Doctor verbally walks me through each step. Says he has viewed my ultrasound and things look good. Then he uses ultrasound machine again to find my left kidney and determine where he wants to make the incision. He makes a mark on my back. Then he cleans/sterilized my back. Then he again uses the ultrasound to make sure he still likes the spot. He does. Then he puts dressing around the area he will be working. Now comes the Novocain. He warns this will "feel like a series of bee stings" and he makes several pokes. Then he gives it a moment to kick in and numb the skin. It does. He makes the incision in my back and I don't feel a thing.

He then goes back to the Novocain again, going through the incision and pushing the drug deeper into the muscle. We wait a few minutes.

He is now ready to make a series of punctures in order to extract kidney tissue. So far, this has been just like when I had a biopsy in 2010. So I'm anticipating some pressure, a few punctures, and it would all be over. Only it didn't go so smoothly this time.

The first puncture was typical. I hold my breath when instructed so that my body stays steady. Some pressure but no pain. But the second puncture was awful. I felt every part of it, gasping in pain as the tool burrowed into my back. The rest of the procedure is a bit of a blur. There's some scurrying as the medical team tries to figure out what happened. The doctor first guesses that we may "have strayed outside" the Novocaine area; he then uses the ultrasound and notices a hematoma (bruise). I am bleeding, a typical complication of a kidney biopsy.

I am crying, the pillow under my face wet from my tears. I'm trying to keep my composure so that we can finish the procedure, but I am completely freaked out. The first biopsy didn't feel like this. At all. I am in pain. I am scared. And I'm so upset that this is part of my life.

I don't have a clear memory of what happened next, but the doctor did do three more punctures and took a total of five samples. He then checked the samples under the microscope to make sure that he got what he needed. During this time, I continued crying. Nurses put pressure on my back to stop the bleeding.

10:50 a.m.
When he knew the tissue samples were good and I was done, he came over and sat in front of me so I could see him. As he talked, and I knew I was done with the procedure, I completely lost it and started crying really hard -- the hyperventilating type of crying. I pride myself on my pain tolerance and my ability to be stoic, but this was just a complete meltdown.

Bandage was applied. I was rolled back onto my back. The nurse gave me 650 mg of Tylenol for my pain and gave me some water.  Everyone left the room. I sat and sobbed.

11:20 a.m.
In recovery room; try not to cry when I see my Mom for the first time.

11:35 a.m.
IV fluids started.

12:10 p.m.
I fall asleep (thankfully).

1:15 p.m.
I wake up. BP is 110/55.

2:35 p.m.
Blood is drawn again.

3:20 p.m.
I am allowed to get out of bed to use the bathroom. There is no bleeding.

3:35 p.m.
Doctor visits. He explains to me what happened during the procedure, although I still don't totally get it.

3:50 p.m.
Given more Tylenol; moved to another recovery room.

4:15 p.m.
BP is 120/73

4:30 p.m.