GCA biopsy

Have you had the procedure? I am so nervous about it.

No I haven't - which is why I didn't comment on the procedure itself. I do know a lot of people who have - there are probably far more on the HealthUnlocked PMRGCAuk forum than here so why not join that forum and ask?

Most of them had no problems at all but it does depend a lot on the surgeon who does it and like everything it can be uncomfortable, I won't tell porkies there. They usually use ultrasound to find where the artery runs - it varies from patient to patient. It is usually along the hairline and that may have to be shaved a bit. Once the hair grows back the scar doesn't show. It can be a bit sore afterwards - they have cut your skin after all - and it may be a bit numb or sore for a while because nerves in the skin have been cut or stretched. 

Tell the staff you are nervous - they will do all they can to calm you down because an upset patient makes it harder for them.

This is a description of TABs. starting with one from a lady on the other forum who is a nurse so used to hospital procedures:

"I had mine done 13 weeks ago. The procedure took well under an hour. The local anaesthetic done in about four shots in different places, stung for about 10 seconds and then it was numb. I could not feel the doc doing anything in the area except the odd painless tug. I did have aching around the back of my head nowhere near the wound which he said was unusual. It was better than I thought and others have said that too.

Because I'm a bit odd I expect, I had to watch it on YouTube first and made him describe the procedure as if I was a medical student. I think he thought I was mad!

The scar is in my hair and can no longer be found. The shaved area grew back quite quickly, though the rest of my hair largely covered it anyway. The closure was dissolving sutures that drop off (had to pick the last bits off about 6weeks later) and glue. I get twinges and aching there during steroid withdrawal. You can get all sorts of odd feelings like creepy crawlies and pin pricks at odd times for weeks afterwards. This isn't bad but some are worried by it if they aren't expecting it. The ouchy post op pain usually lasts about 48 hours and then it's tender if you poke it.

Although I knew it might give a false negative as many do, especially after steroids have started, I had it done because a positive result is definitely positive. I would then know it was worth the two years plus of steroids and upset. I think this was the main reason the Rheumy wanted it because I am supposedly "too young" at 54 to have it. It was negative and the treatment has been no different to a positive result. Not sure what decision I'd make again, even without hindsight. At the time the clock was ticking with the Prednisolone and I was in shock, so I just went for it.

They take a piece of an artery branch away so it no longer functions, so it isn't like a usual biopsy where a bit of something is taken away, leaving the rest functioning normally. The main artery is untouched. The idea is that there are enough other pipes to make up for the loss of that branch. Talk through the rates of infection, nerve damage etc before, as with any surgical procedure.

Good luck! ...

...A very few people don't respond to local anaesthetic or need a bigger dose than others. The patient needs to make sure they tell the doc if it isn't comfortable and refuse to let them to start until it is numb. That is unless you're like my friend who is one of those, and now doesn't bother with local anaesthetic for anything, even major dentistry! 😮  "

These are other replies from several others who have had it done:

"I was diagnosed with suspected GCA having been admitted to hospital nearly a year ago now. I was told they wanted to do a Temporal Biopsy and was dreading it but it was nothing like as horrid as I thought it might be. They gave me a local anaesthetic and it then took about 20 min, so no pain but just anxiety! It was a bit sore for a couple of days and that was all. The result came back positive which in some respect was good because they then new exactly what treatment was needed, you don't want to be on high steroids unless absolutely necessary.

The only side effect I had was my eyebrow drooped for a few weeks but then went back to normal, apparently this occasionally happens so if it does don't worry."

"I had the procedure in August 2016 and had no problems. It healed well with no pain and the scar (if there is one) is in the hairline. They prescribed 60 mg of Prednisone and it helped...a lot! Good luck." 

"I watched the biopsy on u tube lol so as I lay there for just over an hour I kept asking the surgeon what point he was at !! He even asked me if I wanted music on and I said yes lol he took his time that's why it was so long and only shaved the hair in the spot he wanted.

But don't be afraid they know what their doing, and good luck"

"I was diagnosed with Giant Cell in December 2014, had a temporal artery biopsy on both sides Dec 31/14. My experience was that the procedure was a "non event" I have had more painful and stress full sessions in the dentist chair. The vascular surgeon, myself and my husband being the only ones present as the Ambulatory Care section of the hospital was closed, it being a holiday (New Year's Eve). There were no nurses or assistances available, my husband acted as the assistant. It took an hour and I was awake the entire time having had just a needle for pain on each side of my forehead. The only part that made me a little squeamish was when I could feel him pulling to get enough artery to cut a section for the biopsy. My surgeon predicted that my results would be positive as he said he had done so many that he could tell from the look of the specimen, and the lab confirmed with a positive result. I was given an Rx for pain afterwards but did not have to use it. I hope your experience is as positive as mine.

Then came PMR diagnosis in April 2016. I would have a temporal artery biopsy once a week instead of having to live with this horrible condition and taking prednisone for what now seems forever, best wishes to you, I hope you have a good support system."

"It was no problem I had it done under General Anesthesia no pain and can't see the incision. Very little hair shaved. The Dr was perfect! Excellent bedside manners! Now just a matter of waiting for results and then treatment. I am feeling well. Thank the Lord and a great Dr."

You will always find some people who want to tell you how awful it  was - like the "I had the worst labour ever in the world" people when you are pregnant. Ignore them. And I don't recommend you look on YouTube either because although it is a quite simple op it does look far worse on film than it is! 

Hope this helps.

By the way - does your hospital not have access to the ultrasound diagnostic procedure? It is just as good as the TAB without needing surgery. Is it your GP who is sending you for the TAB? Or the rheumatologist?

Thank you so much Eileen. I really appreciate the encouragement. I am such a worrier. This has helped me a lot!❤️

Hi Pam,

          I was put back on Pred. (15mg). 2 weeks ago as my pmr has flared up. As far as that I feel much better but have had a temporal headache for close to a week. Dr. Started me on 50mg Pred. yesterday for precaution for GCA. My blood work looks good but no improvement on headache. Have to call Dr. tomorrow aft. and he will decide what to do as far as tests. A bit relieved because people say test isn’t so bad but very concerned about this headache which isn’t getting any better.

Thank you Sandy.