Shannon was NPO since midnight last night (latin: “nil per os”… a.k.a. nothing by mouth). They didn’t want her to eat just in case a spot opened up on the surgical schedule. Surgically removing one of the affected lymph nodes provides a better sample for the lab to determine a diagnosis. The other option is a needle biopsy which is performed in IR (Interventional Radiology). They can use imaging like fluoroscopy (basically video Xray) or ultrasound to make sure the needle hits the right spot to get a sample of the lymph node. Her oncologist, Dr. Diamond, said that having a whole lymph node removed provides a 98% chance of accurate diagnosis on the first try versus 92% with a needle biopsy.

A transportation stretcher showed up at 7am to take her to IR for the needle biopsy. However, we questioned this because we thought the plan was to try for the surgical option. Of course this is right at shift change so day shift and night shift were in the middle of giving shift change report. They contacted the attending and the surgical teams to figure out the plan.

Shortly after, a resident from the General Surgery Team showed up to talk to us. He assessed Shannon and felt like we should remove the largest lymph node for a good sample, plus it would provide some pain relief for Shannon. The only issue is that General Surgery doesn’t typically mess with the neck and head region. So, he said he would get in touch with the Head and Neck Surgical Team and discuss with them. The surgical schedule was pretty full and Thursday is July 4th. He said it might be Friday at the earliest before surgery could happen.

A little while later, Dr. “G” Showed up. She’s Shannon’s Attending Physician here at the hospital. (Her main doctor). She said she wanted Shannon to go ahead and get the needle biopsy today so that we could at least have a sample in the lab that they’re working on versus just sitting the bed for 2 days waiting for surgery. They picked her up around lunch time and she was gone for about 2 hours.

They only used a local anesthetic to do the biopsy; no general anesthesia. (They numbed the area versus putting her to sleep) She said a radiology resident and an ultrasound tech (both girls) performed the procedure. They biopsied a lymph node in her left inguinal/groin area where the leg meets the trunk. There’s just a small bandaid where they poked her and they took 5 samples.

She came back from the procedure and ate lunch, showered and went for a walk (several laps around the unit). No complaints of pain from the procedure. She said they were laughing and having a good time down there, they were all friendly and professional in IR.

Her oncologist, Dr. Diamond, stopped by and said it would be a couple of days before he knows anything. He said sometimes they can give him some preliminary results from the fluid portion of the samples within a day or so. With tomorrow being July 4th, that might cause a delay. He said if she’s stable and feeling ok, they might send her home in a couple of days and then continue everything via outpatient visits at his office.

Overall, Shannon had a productive day and she’s in good spirits. The RN’s and PCA’s (Patient Care Assistants) here on the 16th floor have been great so far.