I do not understand why in the current time period, 2023, there are interventional radiologists doing VERY Painful procedure on patients, that while they must be done, Can certainly be made less painful.
I can’t tell you the number of people who tell me they had an agonizing procedure they were not prepared for.
I take responsibility for this, and I think our interventionists should, too. If I was doing painful procedures on patients all day every day, and saw the agony I was causing, I would do something about it.
So, if you are having ANY Of the following procedures - Prostate Biopsy, IUD inserted, Breast biopsy that is scheduled, Sentinel Lymph node biopsy (done for women with breast cancer to assess the status of the draining lymph nodes on the side of the breast cancer), Transvaginal US, especially in Post Menopausal women, Please contact your physician.
For Breast biopsies, and Sentinel Lymph node biopsies, purchase EMLA numbing cream, a 5 gram tube over the counter at any pharmacy, at the price of around $12.00, and apply thickly (like cupcake icing), to the area where the breast biopsy will be, or the areola, the coloured area around the nipple (in case of a sentinel lymph node biopsy), 1.5 hours PRIOR to your procedure.
A study by Cope in 2009 described women who rated the pain of a Sentinel Lymph node biopsy to be 10/10. With EMLA applied properly 1.5 hrs prior to the biopsy, the Pain can be reduced to 4/10. Still painful, but not blow your brains out painful.
For women getting IUD’s inserted, I prescribe Misoprostol vaginal tablets, 2, to be inserted the night prior to the IUD insertion, to gently and painlessly open the cervix, to make the procedure less painful. One hour BEFORE the procedure, I prescribed Toradol (an oral painkiller) so that you do not cry your eyes out.
For men, having Prostate biopsies, I would prescribed an oral painkiller to be taken 1 hour before the procedure. Having prostate biopsies is reported to be VERY painful by men, and it does NOT need to be agonizing.
Why is this so very important, both for the patient and for me? If you have a potential diagnosis of prostate cancer or breast cancer, or any cancer requiring invasive biopsies, you are already very very anxious, to say the least. If you have a horribly painful experience with a Biopsy, can you imagine your terror at the thought of more procedures? With this severe anxiety goes sleeplessness, inability to take in information, and potentially Post Traumatic Stress Disorder.
What I would wish for patients is that they experience Post Traumatic Growth. While the situation cannot be changed that the patient requires a biopsy, it can certainly be made less traumatic with simple measures.
Shame on us as medical practitioners if we do not assist our fellow humans with pain control!!
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