Breast biopsy--patient comfort around anxiety

[Anonymous]

Because of dense breasts, Washington Radiology recommended that I start having breast MRIs. I went for my first one last week, and they found an abnormality that now needs a hollow needle biopsy under MRI guidance.

I am in the process of scheduling the biopsy and getting my pre-procedure instructions. I have a history of medical trauma--a procedure that was done with inadequate anesthesia and a separate medical error that led to a great deal of short-term pain and the need for a follow-up surgery. I therefore have a great deal of anxiety about procedures and surgeries, especially when I do not have a prior relationship with the medical provider. It's not ideal, and I would prefer just to put on a brave face. Unfortunately, it's not that easy: When readying for an epidural injection for pain management, a nurse almost canceled my procedure and sent me to urgent care because my blood pressure was too high. I do not have generalized anxiety. It's just medical anxiety that I haven't been able to overcome with mindfulness or CBT.

I would like to take a benzodiazepine prior to my procedure. Unfortunately, Wash Rad requires consent on the day of procedure and won't allow me to complete the consent process after taking meds. The only option they are offering for anxiety management is to arrive 90 minutes early, complete the consent form, take the meds, and then sit in their waiting area until they reach efficacy 60-90 minutes later. It's stupid and embarrassing, but I am afraid that I will just openly sob in their waiting room or run out the door in that time. I'm also afraid of the aforementioned blood pressure spike and being sent home without completing the procedure. They refuse to do the consent process on a prior date, they don't offer IV meds other than contrast, and I am not permitted to leave the facility between taking meds and the procedure.

Are there other radiology facilities that are a bit friendlier to those with medical anxiety? Has anyone with anxiety had a calm and successful experience with Wash Rad? If so, how did you manage things?

[Anonymous]

No anesthesia needed.

The procedure is virtually painless and takes seconds.

[Anonymous]

I am sorry you are going through this. I too have sometimes crippling anxiety, and a breast biopsy a few years ago fit the bill. I had a friend drive me to the appt. and wait with me. I took a 1/2 Xanax tablet (prescribed by my regular doctor) as that is enough to take the edge off, for me. I nearly fell asleep on the table awaiting my procedure, but I was very calm. Best of luck to you.

[Anonymous]

I would go to the waiting room, excuse yourself to the bathroom or pretend you're walking out to take a phone call, and just leave for an hour. Im so sorry they are being so obtuse.

[Anonymous]

Anonymous wrote:Because of dense breasts, Washington Radiology recommended that I start having breast MRIs. I went for my first one last week, and they found an abnormality that now needs a hollow needle biopsy under MRI guidance.

I am in the process of scheduling the biopsy and getting my pre-procedure instructions. I have a history of medical trauma--a procedure that was done with inadequate anesthesia and a separate medical error that led to a great deal of short-term pain and the need for a follow-up surgery. I therefore have a great deal of anxiety about procedures and surgeries, especially when I do not have a prior relationship with the medical provider. It's not ideal, and I would prefer just to put on a brave face. Unfortunately, it's not that easy: When readying for an epidural injection for pain management, a nurse almost canceled my procedure and sent me to urgent care because my blood pressure was too high. I do not have generalized anxiety. It's just medical anxiety that I haven't been able to overcome with mindfulness or CBT.

I would like to take a benzodiazepine prior to my procedure. Unfortunately, Wash Rad requires consent on the day of procedure and won't allow me to complete the consent process after taking meds. The only option they are offering for anxiety management is to arrive 90 minutes early, complete the consent form, take the meds, and then sit in their waiting area until they reach efficacy 60-90 minutes later. It's stupid and embarrassing, but I am afraid that I will just openly sob in their waiting room or run out the door in that time. I'm also afraid of the aforementioned blood pressure spike and being sent home without completing the procedure. They refuse to do the consent process on a prior date, they don't offer IV meds other than contrast, and I am not permitted to leave the facility between taking meds and the procedure.

Are there other radiology facilities that are a bit friendlier to those with medical anxiety? Has anyone with anxiety had a calm and successful experience with Wash Rad? If so, how did you manage things?

Have someone drive you and take a benzo before you go in. They are not going to drug test you. I could not have an MRI without multiple benzos.

[Anonymous]

Anonymous wrote:No anesthesia needed.

The procedure is virtually painless and takes seconds.

I don't think her issue is the biopsy pain. It's being in the MRI machine which takes much longer than "seconds".

[Anonymous]

You don't go IN the machine. You lay ON the MRI machine. No claustrophobia.

[Anonymous]

Anonymous wrote:You don't go IN the machine. You lay ON the MRI machine. No claustrophobia.

I have had two MRI guided breast biopsies and I did go in the tube.

I wouldn't worry about the blood pressure, they don't even take your BP at these appointments. Have a friend take you and just don't tell them you took a benzo.

[Anonymous]

Take a 1/2 xanax before you go in the building. Your doctor will prescribe it.

[Anonymous]

Anonymous wrote:Take a 1/2 xanax before you go in the building. Your doctor will prescribe it.

This. And have someone drive you.

[Anonymous]

Anonymous wrote:You don't go IN the machine. You lay ON the MRI machine. No claustrophobia.

I have had several breast MRIs and one MRI guided breast biopsy and I was most definitely IN the machine and very claustrophobic.

Would love to hear about the MRI machine you go ON.

[Anonymous]

I would either take the meds in advance and not tell them or go their route and tell them that you will need a private location to be in while the medication kicks in and it's not negotiable.

I have had full-on meltdowns in medical facilities before and nobody really cares. It's kind of freeing to realize this TBH.

It isn't your fault that their procedures are so patient-unfriendly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Take a 1/2 xanax before you go in the building. Your doctor will prescribe it.

This. And have someone drive you.

+1. I usually take 3 .5 mg of Xanax prior to the MRI. One at home, one in the car, and one upon arrival. Of course I have someone drive me.

[Anonymous]

I had a WRA image guided needle biopsy. It was a punch needle. It did hurt, honestly, but instantaneously. Not trying to,scare you but don't be afraid if it startles you .
Now the interesting thing is I was taking prescription benzos regularly then and it was even in my med list. I never asked, they never said not to. I showed up, signed the form, got the biopsy. Drove there and home like always.
Are you planning on taking a whopping dose such that you will be obviously sedated and can't drive? Not a good idea honestly, Take what is prescribed.
If so have someone come with you to drive.
Just take it, go, sign and have it done. Don't complicate things.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Take a 1/2 xanax before you go in the building. Your doctor will prescribe it.

This. And have someone drive you.

+1. I usually take 3 .5 mg of Xanax prior to the MRI. One at home, one in the car, and one upon arrival. Of course I have someone drive me.

Wow. That's equivalent to 3 mg of lorazepam. I took 1.5 mg a day, split morning and evening. That's quite a dose.