I had a skin biopsy yesterday using local anaesthetic, standard skin puncture and a couple of stitches. I actually felt quite well after the procedure but feel like I've been run over by a truck today. I took 5mg of hydrocortisone about an hour ago and now feel slightly better. Is adrenal output taxed on such a small procedure?
Post Skin Biobsy Horribleness: I had a skin... - Thyroid UK
Post Skin Biobsy Horribleness
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Jamima
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Hi Jamima,
I can sympathise with you. It may have been called a minor procedure but it is nevertheless an assault on the immune system and your adrenals.
Your body would have interpreted the event as a potential threat and you possibly already challenged immune system has mobilised its defences, including inflammation and probably raising your stress hormones too.
With luck, the response will settle down in a few days but any concerns you have should be conveyed to the organisation that carried out the procedure and/or a message to your GP.
helvellaAdministrator
A while ago, April, I had a skin biopsy and removal of some tissue. Not that big - but required five stitches.
This was the first operation of any type - other than dental and the odd stitch.
I felt more or less as expected for the eleven days from the actual procedure to stitch removal. A bit delicate but OK. The nurse was pleasant and I have no doubt she did the removal just fine. Since then, it has been horrible. In the hours immediately after, indeed, starting more like half an hour later, I felt as if I had been hit by a truck (metaphorically)!
And in the time since then, it has been uncomfortable.
Had a GP appointment just as a general appointment about thyroid prescription and she had a look. It does all look fine. She called it neuralgia. But certainly doesn't feel fine. Even now - three months later.
I don't know of having any adrenal issues. Wouldn't anything like that be more likely when it was being done and shortly after?
Just replying in case it helps to know you are not the only one! But I have no answers, and no understanding of what has happened.
Thank you helvella, it’s reassuring to hear of others’ experiences, albeit not much fun for them. Today is the day after and I’m just exhausted, I know when I wake what the day will be like as my morning cortisol is low, this morning I really struggle to wake from a very deep sleep, I’ve been struggling all day and gave up at 2pm and headed to the sofa, deep sleep again until now. I’m struggling with a new NDT prescription anyway, but I’m pretty sure this is cortisol as HC alleviates it. All I can do is monitor it and continue with the NDT but it’s a relief that I’m not the only one.
Do you know if having a skin biopsy to detect small fibre neuropathy would cause similar issues? I don't really know what's involved but I'd like to have one done.
There is little deeper than my ignorance on these matters!
However, my biopsy was quite large (in terms of biopsy) whereas, if I have understood things properly, I get the impression a small fibre biopsy is smaller.
Over the past few years, skin punch biopsy testing has emerged as a diagnostic standard for SFN. This diagnostic procedure is recommended in practice guidelines for the diagnosis of SFN by both American and European task forces [10, 15]. The European Federation of Neurological Societies has provided a level A recommendation for the use of skin biopsy to measure the density of small fiber epidermal innervation [15]. Additionally, an American Polyneuropathy Task Force also recommended the use of skin biopsy in the evaluation of polyneuropathies, which include SFN [10]. The joint task force guideline report, published in 2010, updated their guidelines to include skin punch biopsies in the diagnosis of SFN, noting that, based on the vast experience of skin punch biopsies in 10 established laboratories worldwide, the 3-mm skin punch biopsy technique is a safe and minimally invasive procedure [15]. Major side effects have not been reported with the skin punch biopsy. Only 2 side effects were reported, the first being mild infections, often resulting from improper wound management which resolved easily with topical antibiotic therapy. Excessive bleeding from the punch biopsy was the only other side effect reported, which resolved without the need of a suture [15].
Yes especially if you have not specified adrenalaline free anaesthetic - I am having same done in 5th August and have been told to double my steroid for 2 days !
Thank you, that might explain why I felt so good immediately after.
Hi forgot - even at dentist you MUST say adrenaline free injections ! I have adrenal insufficiency and even hot and cold weather affects my adrenals and I have to up my steroids to compensate !
Interesting you say this. I am struggling a lot with hot or even just slightly warm water these days.
If you are a thyroid patient you don't need so much thyroxine in my opinion (and others) in the hot weather- especially if you are overheating which is a sign you might have too much - then in the Winter I can if symptoms are showing - increase my thyroid hormone to accommodate my thyroid needing to work harder to keep me warm etc. I find it easier because I am on liquid thyroid hormone due to lactose intolerance but might be more difficult with tablets.
I've thankfully not had many problems with my teeth but the last time I had a local at the dentist I was flying for hours afterwards, I didn't know why at the time as it was a number of years ago and before this 'journey'. I've not been diagnosed with an adrenal problem but tests show I run low all day.
Are you on thyroid hormone may I ask?
Yes, I'm currently using 1.5 armour and struggling with that too.
You shouldn't be crashing as you are - I had that and it was awful - so I know where you are coming from - if you can't wake in the morning readily then it sounds like low cortisol - it is worth remembering or at least it works with me - if I have an increase in my thyroid hormone then I have to up my steroid to compensate for the uptake in energy from the metabolic. Perhaps have a word with your medical team. Hope you feel better soon.
Thank you, I agree, I have an update mid august so I'll hopefully get some answers then.
After my kidney was removed, they took the adrenal gland too without permission. Apparently it "was easier". Anyway my remaining adrenal gland used to fire up all the time, and I learned there were two ways to shut it up, so to speak. One was to walk and walk and walk and the other was told to me by an old nurse. I cannot recommend the second way but it may be worth a try - a nip of brandy. It did work. She said that is why people in shock used to be given a nip as they knew it worked.
Even now, years later, if I get a shock, I get exhaused for ages. Just passing on what worked for me.
Hi wow so interesting - what symptoms did you get when it ‘fired’ up ?
The feeling of impending doom, jittery and cross for no reason. I had been given a "not breeding any more" labrador who was very fat at the time. That lab was slim and fit within weeks with all the walking we did. Shame my legs dont work like that now!
Yes that is an adrenal issue especially the impending doom - I have had Sepsis twice and when I got the impending doom I think I am going to die I knew how serious it was. Not a lot is understood about these amazing glands and everyone thinks that the heart is the emotional part of the body when it is actually the adrenal glands - if you think about it - every emotion we feel will affects the adrenals - whether that be a happy event or stressful. I always know when I have a adrenal/kidney issue too when I get extra cross and jittery ! Thank you for posting this.
must admit , a homeopathic amount of brandy is my 'go to' for ... all sorts of things . eg . if i get travel sickness, it works a treat (as a passenger obviously ... rather harder to sanction this if driving , but then who get's travel sick whilst driving ? )
ah ha! Rescue remedy is in brandy isn’t it 👏 it’s all making sense
Thank you, I've noticed that a nip of malt whisky does the same thing, but ye know, how many nips is ok and first thing in the morning doesn't really look good.... I'm also exhausted for ages after a shock and do walk a lot (don't have a car) but if I walk too much, I crash next day.
"first thing in the morning doesn't really look good".
lol ..... put it an a Bach's Rescue Remedy bottle...... that looks very healthy .
i crash badly after arguments / shocks / fear ... and also after some medical procedures , but not others , haven't worked out 'which ones are which' yet ....felt blooomin marvelous after a General Anaesthetic which i gather is not normal.
i'm due to have some biopsy 'orribleness of my own in 3 wks time (with a local) . i am expecting i might crash afterwards /next day ... so am making arrangements for one of my 'staff' (child)to drive me home. ....... seriously considering having 'rather more than a homeopathic amount' of brandy BEFORE i go in, biopsy is only tiny , but it involves having a scalpel about 2 mm away from my eyeball ,.... somewhat terrified.
Good thinking on the Bach's - I can see you've been here before! Yes, I avoid arguments/shocks etc as much as I can now, just can't deal with it. I hope it all goes well for your biopsy, I'm away to get some brandy..
You saying that just reminded me I used to live next door to a really horrible man who always had an axe to grind, he waited until my husband went to work ( what a big man) and then came round and had a go about anything and everything. I was on my own with two small children.
After he'd left I used to feel like my legs were jelly, I was shaking and I felt utterly exhausted. I've got much better at being assertive but direct confrontation or sudden shocks still make me feel physically weak and drained. Its very odd.
Ditto.
I felt absolutely fantastic after general anaesthetic as well. Had so much energy I was practically bouncing and felt so much better than I had for a decade (ME/CFS dx). Even the nurse who brought me back to the ward looked at me weird as I went from the recovery trolly to the bed - on hands and knees lol. I thought it might have been the oxygen, but not sure.
You were given an adrenaline based anaesthetic which kicked your adrenals which shows they are low !
Interesting, I’ve never really thought about me being low. I need to check it out and see if I have symptoms of it. Thks
yes they do look at you like you funny don't they ... when i insisted i was fine to stand up and go to the loo myself if they would just take the drip out of my arm first ... the surgeon looked equally befuddled when i saw him a couple of hours later ... by which time i was dressed and itching to be let out ......anyone would think i had two heads they way they were looking at me. Shame we can't repeat the feeling more often , but having an op every week would be a bit drastic. lol
lol, def a bit drastic, although I’m curious if the same would happen again. I also went to the loo walking as well and yes ‘the two heads’ thing was def real for me too. I was the last surgery of the day for my surgeon so I didn’t see him before I left later that night.
Many years ago a good friend of mine with dogs told me that when dogs have any kind of procedure, they just find a comfortable spot and lay there, sometimes for many days. They get up for food and go back to lie down again. They know exactly how to respond and work their way back to health. We don’t seem to understand that.
Also I was fascinated watching birds in the garden earlier in the week and how industrious they were for long periods just searching around for food.
That’s something else many of us humans don’t think is our job. I very much would prefer getting my food served up to me, rather than planning/shopping/preparing etc etc.
All the above is much worse when hypo because so much depends on it.
Thank you, I think you're absolutely right, and often think back to the old convalescent hospitals where patients were often placed for weeks after surgery. We're now expected to leave just days after. I'm slowly learning to repair and recover although it's a hard lesson for someone who's used to keeping all the plates spinning.
Thank you for telling us about your experience and I hope you feel better soon. I’m having a biopsy done on Wednesday (on my leg) and am feeling apprehensive about it. I’ve been told by my dentist as I’m levo he has to allow more time for the local anaesthetic to take effect 🤷♀️. I’ve had root canal work done under local anaesthetic without any problems and I had my wisdom teeth out under a general anaesthetic and didn’t have any complications either.
Thank you, I hope it goes smoothly for you, the procedure really was a breeze, so please be reassured on that, but I now know that anaesthesia definitely affects me in a way it didn’t used to.
For me, my biopsy was on my left hip area - so pretty much leg! - and the procedure itself was fine.
I did have very slight remnant feeling at one end - but he checked before he did anything and injected a bit more anaesthetic. From then on, nothing.
It took longer to heal than I had expected. Six weeks until the remaining scab fell off. And it had been uncomfortable (but not painful). I ended up using a silicone scar treatment which might have helped - possibly should have started that sooner!
I also took photographs throughout as it enabled me to check progress. (I'll not be posting them. 
) Despite the angle being very awkward.
That’s what I’m apprehensive about, not enough anaesthetic 😳. My site is the back of my calf. Like you I will use a silicone scar treatment. My daughter trialed a patch when silicone was in its infancy back in the early 90’s after a knee op. We were living in Spain at the time and her surgeon said it was worth a shot.
He was very careful not to start without having checked, thoroughly, that it was fully anaesthetised. It was obvious that he didn't want me to react to what he was doing as much as I didn't want to feel it!
I wish I had known about the silicone scar stuff. I simply had not realised that it would take as long as it did, and cause discomfort as it healed.
Thank you for sharing your experience. Part of me doesn’t want it done but it needs to be done as there’s a chance it’s a skin cancer. 🤞🏻
I had a biopsy in Aug 2022 then another in Dec 2022 and finally removal of grade 1 melanoma and skin graft. I do have a 8cm crater on my outer left calf. I used palmers stretch mark body lotion on wound when it was healed. Haven't heard of silicone. It takes a long time for the fascia to heal. It can feel sore and tight at times. Pilates stretching really helped me. Also re anxiety I am on 1.5 grain armour twice daily. Sleeping with my arms above my head really helps anxiety as this deactivates the vagus nerve I am told which goes all the way to the gut.
Thank you for sharing your experience and for the information.
Hello Helvella - do you have a silicone treatment you’d recommend?
No - I just found one and used it. Have no idea how it compares with other products - silicone or anything else. 
Kelo-Cote is what I used.
It is even difficult to be sure it helped! - After all, it was healing anyway. I think it might have eased the pulling and drawing a bit. And it felt better after applying some.
But if anyone has experience of such things, do dive in and add your comments.
Many thanks, my tiny scar seems to be healing well and I’ve kept it covered until today when stitches were removed and nurse said I didn’t need to cover it. I’m not particularly comfortable leaving it open right now and wondered if the silicone treatment provides a barrier?
Yes - it does.
The nurse said the same about mine. It had a solid scab over it so I wasn't that concerned. But surprised quite how long it took to heal - must be my age! It was very much trying to stop the scab getting water-logged or otherwise damaged that made me decide to try it. If I had known, and used it from the start, it just might have helped.
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