Who can help me through a liver biopsy?

I'm booked in to have a liver biopsy next week and am pretty freaked out. I'm scared to death and have asked to be sedated but have been told I need to be awake, but I can have valium to keep me calm, but it's a BYO sedative deal.

It will be done at a radiology place, guided by ultrasound and that's about all I know, other than the fact that I'll be there for "several hours" after the procedure.

Can anyone tell me what the day will look like? The what happens before and after stuff, I'm not quite sure I'm ready to face what happens during the actual procedure.

BW

I'm sorry you're going through this.

My mum's had one. She said she was a little sore for a couple of days after it, but appeared to cope okay. I was quite far away at the time, so I didn't see close hand and am just going by what she said on the phone.

My stepfather had a liver transplant a couple of years ago and he's going great guns now.

I hope someone can be of a little more help.

Good luck with the procedure and results.

It depends on the facilities policies and procedures. But I can tell you what we do at work.

Rock up at a pre-appointed time to be admitted. Be asked about fasting, allergies etc. Have any necessary bloods taken, get changed. Wait in waiting room and then go to imaging.

In imaging they will use the ultrasound to find the liver and the right spot they want to biopsy. I'll stop there but if you want to know more, let me know.

Afterwards, you'll have a clear dressing (tegaderm) over the site. Sometimes they put a small wad of gauze as well. You will have to lie flat (usually on your back) for a period of time. The time depends on the facility. Our protocol is 4 hours. Again, depending on the facility, you will have to stay on the trolley/bed until about 15-30 minutes before you go home.

You may get some left shoulder tip pain - this is considered to be common although I can count on 1 hand how many patients I've had with that. The most common complaint is discomfort breathing in.

At my hospital, we say that you must have someone stay with you over night, can not drive for 48 hours, can not operate machinery for 48 hours, drink alcohol for 24 hours.

Hope that helps. Let me know if you have any questions.

MG

Thanks, MG. It's happening in a radiology place rather than a hospital and I've been told I don't need to fast. I asked about it, they said no. They said I could have a sedative, but had to organise that myself through the GP. I have diazepam... The anxiety attacks I've been having are pretty severe - feeling like I want to pass out when I talk about it kind of severe, so I know there's no way I can get through it without something to keep me calm.

DH is taking the day off work and Sam's in day care. We've got someone on standby to collect Sam from day care if things take ages. All I've been told is that I will need to remain at the radiology place for "several hours" after the procedure. I've also been given no instructions regarding medications I should or should not take that morning. My GP looked at my list of meds and said none of them effect clotting so I should be fine.

What about heavy lifting after the procedure? Will it be a good idea to organise friends to come over to help with Sam and/or collect Sam so I can rest?

And thank you for stopping where you did. I may ask about it eventually, but that's only going to happen if I can get myself feeling a lot calmer about the whole thing. I guess it doesn't help that I don't clearly understand WHY I'm having the biopsy and what sort of information they hope to gain from it. I have a diagnosis of non-alcoholic steatohepatitis and my LFTs aren't showing improvement (elevated GGT, AST, ALT, all others within normal limits) for the last few months despite withdrawing all medications that could be causing liver issues.

BW

Just make sure they know exactly what sedation you've had, the dose, and time you took it. We don't make people fast either but still like to know when they last ate.

For your medications, anything that interfers with clotting should be stopped including aspirin unless there is a specific reason you can't (such as heart valve issues). They may not want you to alter your meds so they can see exactly what is happening and if it's because of your meds. Stopping them now would give a false result if that makes sense.

You will need to avoid heavy lifting. Again, it depends on the protocols of the venue but we say 72 hours.

Often they say "several hours" to account for if there are any set backs. For example, if you had pain that couldn't be controlled, you'd need to stay longer. You'd be surprised how many people go "I was told 3 hours and it's been 3 hours - I'm going!" when they are in no condition to leave!

The biopsy will reveal more than the bloods and they can also test for things bloods don't reveal.

Is there anything in particular you're worried about for the test? They will put local anesthetic into the site first so you shouldn't feel anything other than pressure.

I have an anxiety disorder, MG. This is an unknown and I have major anxiety issues with unknown medical procedures. The first time I had to go under a general anaesthetic I ended up hyperventilating so badly that I ended up paralysing myself and could not feel my extremities - they had a lot of trouble getting a canula into my hand. I'm fine with a GA now, and if I'm under a GA for a procedure I'm ok. I've always had major fears about having things done with a local anaesthetic and this - shoving a needle into my liver - has such a massive freak out factor that my GP has had to put me on valium to get through the week before it.

I'm just trying to find out as much as I can about the before and after so that there's less unknown about the day and it is reducing the anxiety a little. Just a little - nothing changes the fact that they are sticking a needle into my liver, and I just can't see much to be happy and calm about in terms of that!

Also, this is the deciding factor as to when/if I get to take my other arthritis medications again. I'm doing a bit better now that the weather has warmed up, but Winter was one big struggle... Trying to manage RA flares when you can't take any prednisone or NSAIDs is bloody difficult!

BW

Far out!

The first time I spoke to the radiology place I was told I would remain there for "several hours" after the procedure. I rang them today to ask specific details of the rest and recovery period afterwards... And have now been told I will only need to stay there for 10-15 minutes afterwards and only need to rest for the remainder of the day it happens.

I don't know what's stressing me out more - the inconsistency in what I've been told on the phone just now compared to everything else I've read and heard, or the fact that if I do need someone to help for those few days afterwards, I'm really stuffed. DH doesn't have enough annual leave or sick leave, my parents will be in Perth, my sister has her son booked in for swimming lessons in the first week of the school holidays (and they can't be moved to the second week, they are only run in the first week) so can't come and help. Can't even come and help after swimming lessons as they are two hours away. Everyone from church has their older kids with them and has stuff already arranged for the holidays... If I do need help, there's not many people I can ask because it's just so damned inconveniently timed and the anxiety is bad enough with it being a week away, I certainly don't want to put it back another week and stew for even longer!

BW

Hey BW.

First things first. Take a big deep breath in and let it out slowly.

Inconsistency sucks donkeys balls. Get your GP to call the place and get specifics. If he gets a different story, he can question it. Then he can tell you the go. Keep in mind that sometimes the recovery period is altered based on the complexity of what they're doing, your general health and so forth. We have sent people home earlier than normal. I also know other hospitals that have a much shorter recovery time than us. I can't say what is right or wrong, just what we do.

You may not need anyone to help out with Sam in the following days. I won't lie, you will be a little sore. But more like a bruising. You should be ok to hang around home. Have some premade meals in the fridge/freezer and try to set yourself up to take the pressure off.

I completely understand wanting to find out as much as you can beforehand. I'm very similar. And I do understand about trying to manage the flare ups. I suffered a lot over Winter this year as well. It sucks big time. As much as I dislike Summer, I welcome it because my body copes better.

Do you know where you are on the list for the day? See if your GP will write a letter to try and get you first on the list so you can get it over and done with - less time to think about it.

If you think of more questions, feel free to ask. I'm not on here as much as I used to be but will answer questions when I see them.

Hang in there. :hug:

MG, just want to thank you for all your help on this.

My GP gave me some diazepam to get me through and I had half a tablet that morning and the other half of the tablet in the waiting room when I started to feel the freak out coming on. If anything, some of the local anaesthetic injections were more painful than the biopsy itself... But afterwards, when they stuck the dressing on and rolled me over on to my side... There are no words for that pain! I'd give birth again ten times over without gas rather than go through that again!

Felt a bit better when they let me sit up and spent the rest of the day not moving... the day afterwards with Sam was pretty difficult - but he knew Daddy hadn't gone to work the day before and something different happened and he didn't understand and felt all left out.

Still have moments of pain - most recently triggered by Sam driving his elbow into my chest while climbing around on me and that's triggered the right shoulder pain again... I recover slowly, I'm used to that.

Results on Tuesday - nervous as all hell!

BW I am glad you managed to get through it ok, despite the pain afterwards. Hope the results arrive swiftly and it's all good news :hug:

Well done! Very proud of you :)

Hopefully you will be completely pain free soon. And I hope you get the results you want and need. :hug:

I missed that it was happening this week but sending you lots of :hug: i'm glad its over. I hope the results are good. Thinking of you.

Sent from my phone.