It was bound to happen. All those diagnostic imaging studies were bound to discover something strange. I am pretty sure that my doctors have found an incidentaloma. When I had a CT scan of my thorax, it showed a small lump in my liver. An incidentaloma is an unsuspected abnormality detected when looking for something else. It is usually innocuous, but it can result in more diagnostic procedures and treatments, which may entail a certain level of risk.
A CT scan of my chest and abdomen detected a small lump in my liver. This prompted a liver ultrasound with contrast, which detected multiple small lumps in my liver, but did not give a clear enough picture to determine the nature of the lumps. The pathologist thought that they might be granulomas and may be related to what I have in my breast. All my doctors across the different specialties agreed that I should have a liver biopsy. I wasn’t thrilled, but I decided to err on the side of caution.
The liver biopsy, July 10
A liver biopsy is a relatively simple outpatient procedure. I had blood work done the day before the biopsy, to make sure that my blood clots normally. (It does.) If you are slow to clot, you risk excessive bleeding which could necessitate a blood transfusion. I showed up at Rigshospital at 9:00. The doctor explained everything he was doing and pointed out the lumps and bumps. He agreed with me that it’s probably nothing. His guess is that I have liver hemangiomas, which may have been present since birth and probably won’t cause any problems. The two samples he took were bright red, which he said is a good sign.
The procedure was uncomfortable and a bit painful. It didn’t hurt on my abdomen. I was one of the 15-20% of patients who experience referred shoulder pain. The right side of my neck and my shoulder hurt. A LOT. Enough for me to ask for some painkillers. At 9:45, I was wheeled to recovery at the breast clinic, where the nurses took my blood pressure and checked for bleeding every thirty minutes for four hours. I drifted in and out of sleep and had to stay completely still for those four hours post-biopsy. I was released to my husband’s care at about 16:30.
The first day post-biopsy was pretty uncomfortable. My mom kept me company that first day, and I barely moved. The whole family was instructed not to make me laugh, as this brought on a pain in the neck so intense, I ended up in tears. Unfortunately, it seems that everyone and everything is funnier when you’re trying to avoid laughter. The kids wanted to see my incision, and they wanted to learn all about the liver. I couldn’t do much, but we snuggled up on the couch and surfed the web for kid-friendly liver info.
Now, I have an embarrassing confession. I freaked out just a little close to bedtime. My normally flat belly had swollen so that it looked like I was five months pregnant. At the top of the list on my post-op instructions, it said to contact the doctor immediately if I experienced abdominal swelling. Prudent patient that I am, I called the after hours clinic. They told me to go the ER right away. The doctor palpated my abdomen and took my blood pressure to rule out internal bleeding. She looked at me with a straight face and said, “Your large intestine is full of gas because of fasting followed by inactivity. You need to go home and fart. Can you stand to walk a bit? Yes? Then, walk around and fart. Just walk and fart. Doctor’s orders.”
Relieved that it was just gas, and embarrassed to have contacted the doctor when it was just gas (I should have known!), I asked my dear hubby to drop me off a kilometer away from home, so I could follow the doctor’s orders. Humiliation aside, it took almost a week for the neck pain from the liver biopsy to fade. I couldn’t watch Big Bang Theory reruns for four days for fear of laughter-inflicted pain.
Liver biopsy results
It’s exactly what I thought it was. Nothing. Harmless abnormality. Wonky manufacturing. I wish I hadn’t had the biopsy done, but I suppose it was the only way for my doctors to be sure of what I already knew. My liver’s fine! There is no sign of malignancy or inflammation, just some harmless “abnormal” lumps and bumps. Incidentalomas.