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Liver biopsy
Last Monday I had a liver biopsy, the final test before discussing treatment on the 27th. I had expected it to be "anti-climatic" as I saw one lister post here, but that was not the case. It was far from being painless, and almost immediately beside the chest pain a crushing pain ensued in my shoulder, and my blood pressure fell for most of the day. Supposedly the liver feels no pain, but I swear I felt that needle go acrossed it. It is not an experience I look forward to repeating. Since then I have researched the net and found that between 10-20% of people have this sort of reaction, called a vagel response with blood pressure falling and pain. The treatment is pain medication which I recieved (2 percosettes). I was fine by the wee hours of the morning, the pain finally subsided. I am assuming with my diagnosis, possibly early cirrhosis now, I will more than likely be looking at another biopsy down the road. I am wondering if anyone has had this experience, but were brave enough afterwards to go back and have another biopsy and maybe the experience changed? For the better I hope. Is it true that a cirrhotic liver feels no pain? Can I possibly hope this will be the only liver biopsy I will need in the future? I only had a local at the injection site, is it possible to pre-treat for pain or use a sedative? I am thinking the next time I would need to be knocked out to be able to stay on the table.
thanks,
LD
thanks,
LD
Assuming you begin treatment and it is successful on the first try it is likely that you will not have need for another biopsy,
I think my biopsy was a little different. Everything that i had read said they go in on your side. Well they did an ultra sound biopsy on me and went thru the top of my stomach right between my rib cages. I was awake but they had gave me some meds that made me really loopy.
They numbed the spot supposedly and when he stuck the needle in I said ouch! so he pulled it back out and re-numbed again. Second time sticking the needing in.. Came out empty HE DIDNT get it! Third time needle went in again and I felt the piece of my liver being taken. 20 minutes later I was sitting up and they had brought me a tray of food. I was sooo hungry I ate it all. That night the soreness kicked in and lasted a few days.
Dont let this scare those of you that are facing a biopsy. Just MAKE sure you have someone that knows what they are doing. Im beginning to doubt if any doctors in myrtle beach are compitant at this point
They numbed the spot supposedly and when he stuck the needle in I said ouch! so he pulled it back out and re-numbed again. Second time sticking the needing in.. Came out empty HE DIDNT get it! Third time needle went in again and I felt the piece of my liver being taken. 20 minutes later I was sitting up and they had brought me a tray of food. I was sooo hungry I ate it all. That night the soreness kicked in and lasted a few days.
Dont let this scare those of you that are facing a biopsy. Just MAKE sure you have someone that knows what they are doing. Im beginning to doubt if any doctors in myrtle beach are compitant at this point
You wrote: "It has this same capsule surrounding it and therefore they will feel the same pain if the capsule is injured as anyone else with a less damaged liver. Transplant recipients do not have one, however."
Do you have support for that statement?
I ask because I have read several articles regarding liver transplant recipients that clearly refer to the Glisson's Capsule - post liver transplant.
Mike
Do you have support for that statement?
I ask because I have read several articles regarding liver transplant recipients that clearly refer to the Glisson's Capsule - post liver transplant.
Mike
Jim – I think you are right, even though Looks4Path had a bum experience from an experienced hep guy. When I had my bad experience, like I said, it was performed by an anesthesiologist surround by goofy residents. I think the issue had to do with sufficiently numbing the capsule around the liver prior to injecting the biopsy needle. On the first pass, I had a searing pain but also it was unsuccessful at obtaining a sample so he had to do it a second time. At that point I almost screamed at him about numbing me sufficiently before trying again. He did apply more anesthetic and the second attempt was not painful.
It was two years ago but I remember it like it was yesterday. Funny thing about trauma.
It was two years ago but I remember it like it was yesterday. Funny thing about trauma.
Just for reference, the person that did my biopsy is not only the Head of the Liver Disorder in the hospital but the state as well. A very well known Hepatologist and I have seen several quotes from him on Janis and a few other Hep C websites. According to him he is about the best there is doing one, and done hundred's and hundred's, (I question thousands). According to the nurse in the biopsy room with me, they do as many as 5 or 6 a day, so no intern here, it was him who did it.
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Sounds like you had the right person. In my case -- 3 or 4 biopsies -- the first was done by a resident (quite painful) and the others by someone similar to your doc -- quite painless. I've heard similar so the point is still vaild. That said, an equally important point is that biopsies are not without risks and complications (including death in rare cases) and should not be treated lightly. For example, some here talk about getting a post treatment biopsy for "curiosity". Personally, this is not a valid reason for me considering the risks versus rewards.
-- Jim
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Sounds like you had the right person. In my case -- 3 or 4 biopsies -- the first was done by a resident (quite painful) and the others by someone similar to your doc -- quite painless. I've heard similar so the point is still vaild. That said, an equally important point is that biopsies are not without risks and complications (including death in rare cases) and should not be treated lightly. For example, some here talk about getting a post treatment biopsy for "curiosity". Personally, this is not a valid reason for me considering the risks versus rewards.
-- Jim
jjmjm530, Just for reference, the person that did my biopsy is not only the Head of the Liver Disorder in the hospital but the state as well. A very well known Hepatologist and I have seen several quotes from him on Janis and a few other Hep C websites. According to him he is about the best there is doing one, and done hundred's and hundred's, (I question thousands). According to the nurse in the biopsy room with me, they do as many as 5 or 6 a day, so no intern here, it was him who did it. I just was not lucky on this one. I do however intend to insist on the zanex and demerol the next time around, if I indeed do need another. I do plan on discussing what occured with this biopsy with him when I see him on the 27th, and hopefully be reassured that this will not happen again.
Mr. Liver makes sense what you are saying, I kind of felt like there was not enough time after being given the local to the time I actually got the biopsy, something else to discuss with him. Am I correct in assuming I would at least not need another one for a period of 2-1/2 yrs.?
Marc1955 I know what you mean about being shouted down in the past, I hesitated to relay this experience myself, but needed some answers here. No one should feel their experiences are insignificant, had I known that the possiblility of that kind of pain, I would not have been so frightened afterwards. Of course the thought of pain is a big deterent as well, but at least I would have not worried so much about internal bleeding.
I recieved a call from the nurses on the floor the next day inquiring about me then, and one of the nurses said maybe they should explain to patients that it can sometimes feel like you have been kicked in the chest, I agree with her.
Newleaf09, thanks for the great suggestion as to how to do the next one, and ouc, thanks for letting me know all biopsy's are not created equal.
Nygirl, thanks for your sympathies, and for sure I was scared to begin with, but then from what I am reading, most are. Yep! I am hoping I have used up my bad luck cards and in fact this biopsy say's that I do not have early cirrhosis and we can go from there! I know the hepatologist is souly basing his suspicion on the low platelet count, but the sonogram looked perfect, and the CT scan was great, and yes I know, the biopsy can still say something different.
thanks,
LD
Mr. Liver makes sense what you are saying, I kind of felt like there was not enough time after being given the local to the time I actually got the biopsy, something else to discuss with him. Am I correct in assuming I would at least not need another one for a period of 2-1/2 yrs.?
Marc1955 I know what you mean about being shouted down in the past, I hesitated to relay this experience myself, but needed some answers here. No one should feel their experiences are insignificant, had I known that the possiblility of that kind of pain, I would not have been so frightened afterwards. Of course the thought of pain is a big deterent as well, but at least I would have not worried so much about internal bleeding.
I recieved a call from the nurses on the floor the next day inquiring about me then, and one of the nurses said maybe they should explain to patients that it can sometimes feel like you have been kicked in the chest, I agree with her.
Newleaf09, thanks for the great suggestion as to how to do the next one, and ouc, thanks for letting me know all biopsy's are not created equal.
Nygirl, thanks for your sympathies, and for sure I was scared to begin with, but then from what I am reading, most are. Yep! I am hoping I have used up my bad luck cards and in fact this biopsy say's that I do not have early cirrhosis and we can go from there! I know the hepatologist is souly basing his suspicion on the low platelet count, but the sonogram looked perfect, and the CT scan was great, and yes I know, the biopsy can still say something different.
thanks,
LD
While your experience is one of the rare rare occasions that doesn't make it any less painful for you so I just wanted to say i'm sorry about it all.......I was so scared when I went to get mine that I almost lost it completely - but then it was very anticlimatic and still I was a wreck. The fact that you were one of the very few that would feel the 'shoulder' pain is just very bad luck.
Let's hope that that means you've used up all the bad luck cards and it's smooth sailing for you from now on!
Let's hope that that means you've used up all the bad luck cards and it's smooth sailing for you from now on!
As far as I can tell, the single most important factor re biopsy is not the technology involved (guided or not) but the person doing the biopsy. Go to a large, teaching hospital and get someone who has done HUNDREDS of them. And do not be afraid to ask how many the person has done in the past year and then request that you only want that person to do the biopsy and not to supervise a resident or intern.
Mr. Liver has given a perfect explanation of what happened. I've had two biopsies. The first was totally without incident, just like everyone here says it should be. During the second, I experienced the most searing pain of my life. Pain like this is truly traumatic, and there's no question it creates an aversion to repeating the procedure. But I know from the former biopsy that it's not inevitable.
I fully expect I'll have a biopsy again in future years and hope for the best. My first, which went fine, was conducted by a surgeon and hepatologist. The second was conducted by an anesthesiologist in a teaching setting. When and if I do it again, I'll request that my hepatologist do it.
(Note: when I have posted this experience to this board in the past, I've been a bit shouted down. One of the party lines on this board is that liver biopsies are easy and routine. The reality is that they are normally so, but not in every case.)
I fully expect I'll have a biopsy again in future years and hope for the best. My first, which went fine, was conducted by a surgeon and hepatologist. The second was conducted by an anesthesiologist in a teaching setting. When and if I do it again, I'll request that my hepatologist do it.
(Note: when I have posted this experience to this board in the past, I've been a bit shouted down. One of the party lines on this board is that liver biopsies are easy and routine. The reality is that they are normally so, but not in every case.)
As your own research shows, your medical reaction is not a common occurrence but does exist as a possibility. Biopsy does carry real risks although serious medical conditions arising from a liver biopsy are not that common overall as you noted.
The liver is surrounded by something called Glisson's Capsule. It is very rich in nerves and if not deadened first it will hurt like hell when the biopsy needle passes through it. Pain this excruciating can be a solid ten no doubt. I had 2 biopsies without a local 10 minutes apart so I know all about this subject. A cirrhotic's liver is no different. It has this same capsule surrounding it and therefore they will feel the same pain if the capsule is injured as anyone else with a less damaged liver. Transplant recipients do not have one, however. Ultrasound-guided biopsies substantially reduce the likelihood of negative events from occurring but even with this method it can happen.
It can't be known with certainty whether you would have the need for a biopsy in the future. This said, based upon most probable scenarios the odds are that you wouldn't have a need for another. Best of luck on your report.
ML
The liver is surrounded by something called Glisson's Capsule. It is very rich in nerves and if not deadened first it will hurt like hell when the biopsy needle passes through it. Pain this excruciating can be a solid ten no doubt. I had 2 biopsies without a local 10 minutes apart so I know all about this subject. A cirrhotic's liver is no different. It has this same capsule surrounding it and therefore they will feel the same pain if the capsule is injured as anyone else with a less damaged liver. Transplant recipients do not have one, however. Ultrasound-guided biopsies substantially reduce the likelihood of negative events from occurring but even with this method it can happen.
It can't be known with certainty whether you would have the need for a biopsy in the future. This said, based upon most probable scenarios the odds are that you wouldn't have a need for another. Best of luck on your report.
ML
I had a zanax waiting for the the pt-ptt to come back then just before biopsy thye injected demerol into the line and nurse blocked my view and talked to me. Wore off quickly afterward and I could have driven home. It was fine. Be sure and request sedation. Who needs to act tough, the whole thing is scarey even if it goes perfectly.
do not worry, as android said, not everybody has the same experience. I have had 3 biopsies already. The first two /I was given a local anesthesia ,felt a slight pressure during the procedure and have to stay about two hours in the bed afterward . The 3rd /they knocked me down and I didn't feel a thing. And in all three cases I felt normal after procedure. So go for it and don't be scared.
Don't panic, from what I have read on this list most people do not have the experience that I had. Most just breeze thru it, I was just unfortunately one of the unlucky ones. Probably made the experience worse with my own anxieties.I had a nurse who helped me thru the experience after I freaked when I heard about the possible complications and almost got up from the table then, but she said to me "that has never happened that I have seen, you came here to get yourself together". And I realized she was right,so I went ahead with it and am glad now I did. If I hadn't I would have always wondered where I truly am at with my liver disease, now I will have all the info next Monday. Good luck to you, I am sure you will probably not have anywhere near the experience I did.
LD
LD
wow...wish I hadn't read that ...now I am really freaking I have one in 4 weeks....gulp
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