34 replies to this topic

[cam_kris]

Hi, when I had my first bone marrow I was put to sleep, never felt a thing, since I was in the hospital at the time, I don't  know what dr gave it to me or if it was an onc

Upon my checkup on Monday my onc told me I was going to have  another one in October.  Ok, I thought,  well when he left my nurse came in to wrap up my visit and she was

going

Over my next appt.  I told her I want to b put asleep like I was the first time because I have heard nothing but horror stories.   Today she calls me and says my onc says absolutely no way that I will put to sleep!  He said he will do it and it will not b painful.   I am scared to death!!!

Is this normal that ur onc performs the bone marrow biopsy ??  Is it ok not to b put to sleep??

I so need tour input on this

It's three months away and I am already a nervous reck!!

I just don't understand why he is so bound and determined to do it with me awake?

Please tell me how you had your done and who did it.

Thank you!!

[0vercast]

My first and only BMB was done by my Onc upon initial Dx.  I was awake and was given a light dose of morphine thru an IV.  It hurt like hell for about 3 minutes and then it was over.  There was no bleeding and very little lingering discomfort.  Surprisingly little actually. 

I have another one next Monday.  Not looking forward to it, but I'm telling myself I'd better get used to a BMB once in a while.  It won't be my last one.  I'm not a big fan of anesthesia and like these opiate painkillers even less.

[Antilogical]

I was given only a local anesthetic (lidocane) for my BMB.  I was told that they rarely did it any other way.  A technician performed the test - not my doctor.

It took 15 minutes total, and the only real pain occurred during the aspiration part - it felt like 30 seconds of really intense sciatica.  The biopsy was more like 5 minutes of uncomfortable pressure.

[GerryL]

Ask the nurse are they using a local or drip similar to overcast, with both you are awake. I've had both and the initial injection for the local was more painful than the BMB itself. I did say ouch a few times though. A lot of the issues come from bone density and if your original onc didn't have any issues than you should be okay.

[mariebow]

I had it done last January, and my onc did it.  I knew that when he told me that I had to have one, I immediately said that it would be a painful experience,  because I remember growing up hearing that bone marrow procedures was painful.  I told him that I was concerned that when I did have it, was I going to be put to sleep, he said no, that he will give me local anesthetic, I told him that it needs to be enough, because I have a very low threshold for pain.  He reassured me he would give me enough.  Well with my RN daughter, the nurse, my onc in the room, he used three or four large needles and shot me with the pain med,  then he proceeded to do my biopsy.  I hurted so bad, and it took about 15 to 20 min, with a few minutes break in between.   I told him the next time, he would have to put me to sleep the next time or I was not coming back,  it is time for another one, but he has not scheduled one. I go back to him, the last of August.  You mean you was put to sleep the first time. Wow you were blessed.  I am tellng you my experience.   You asked and I am telling you.  But you may have an easy time of it. everybody is different.  It would have helped if I was given a sedated, like some people. And he told me that I had thick bones.  It took me a week to recover from it.

[TeddyB]

cam_kris:

Hey, i was dx`d in april and had my first BMB wich was not a nice experience, however, when i did it the next time, the doctor gave me Vival(Some kind of valium i think) one hour before the BMB, then a local Anesthetic in the chest where he was going to do the BMB. I was talking the whole time, probably because of the Vival, and the procedure didnt hurt one bit, except for when he gave me the local Anesthetic, and this pain only lasted a few seconds while he gave it to me. The BMB itself lasted for about 2-3 minutes, as my Onc was very good at what he did. So if he wont put you to sleep, i would ask for a something to calm the nerves as it helped alot for me. I am not going to have any issues with my next BMB, but i am going to ask for a Vival again, as that did the trick for me.

Here in Norway we do BMB at 3, 6 and 12 months, then every 6 months until complete cytogenic respons, and every year until MMR, so i just have to get used to them.

[Sneezy12]

The Mayo Clinic exclusively does BMB's using Propofol and Fentanyl. There is no pain and no "hangover". It requires an Aneshesiologist, and hence the average office-based Oncologist does no want to bother. You should INSIST! You have every right to do so. Frank

[Stevea]

My Doctor has done all mine.  He only numbed the area a little bit, it was more uncomfortable and had consistent pressure then actually hurt (the tattoo's on my feet hurt more!).

Mine was done on my lower back every time (I would say about 4 or 5 times), I think someone said Chest before.  Where has everyone else had it done?  I couldn't imagine the chest.

I was diagnosed in April of 2002 and probably had all my BMB's withing the first 3 years and never had one again.  I see the doctor every 6 months and he has told me there is no need for them anymore with me and that he can see everything he needs to in the blood work.

So hang in there you should not have to do BMB's forever!

[WoofWoof]

I've had two, both done with just a local. Painful? No just uncomfortable and took about 30-40 minutes. Both times I drove myself there and back home. If you insist on being fully put out make sure it's done by an anesthesiologist. Let me rephrase that: Make sure it's done by an anesthesiologist.

Just in case you missed that let me repeat:

Make sure it's done by an anesthesiologist

Make sure it's done by an anesthesiologist

Never ever ever let anyone but an anesthesioloist put you under. Remember that your life depends on them

[Marnie]

Everyone is different.  I've had 2 BMBs and both were done with just lidocaine.  They were a little uncomfortable but not particularly painful. . .or at least not painful for very long.  I prefer having mine done that way so that I can drive myself to and from, and don't have to deal with the long wait to come out of the anesthesia. 

Marnie

[CallMeLucky]

I've had two biopsies.  Both I was awake for with just a local shot of lidocaine.  It was not comfortable but it was not horrible.  Everyone is different in how they tolerate the pain.  It is not about being tough, it just comes down to some people feel more discomfort than others.  The first time the doctor did it, the second time a tech did it.  I generally prefer to have techs when possible because it is what they do all day and are usually better at it.  There is a downside to anesthesia and there is a risk anytime they knock you out.  For this procedure I prefer to be awake, but again it depends on how you feel about it.  They can't force you to do it if you are not comfortable so if you want to be knocked out, then insist.  They won't like it, but they will do it.  On the other hand you could try it and see if you can get through it.  You wil be done faster and you will know for next time.  Although unless you are not responding well, BMB should not be an ongoing procedure.

Best of luck

[Susan61]

Hi:  It looks like your getting a BMB every 3 months.  They gave me one  every 3 months up until I got to a Ccyr.

My Oncologists always did the BMB.  The worst time for me was when I was in the clinical trial for the Gleevec, and I had to travel to NY.  The doctor doing the trial was very old and short.  He could not even reach the examining table to get high enough to be able to get the right position to do the procedure.  He probably should have had a little stepladder to reach me.  He would only give me Lidocaine, and he never even gave it a chance to work before he started doingthe BMB.  He had trouble doing it.  He should have been retired or dead already, and he was still doing these trials.  He retired right after the trial was over.  Maybe he knew he could not do it anymore.

He would knock my back out everytime he did one on me.  I was at his mercy if I wanted to do the trial.  It was done through NY Presbyterian Hospital which is a excellent hospital, but they would not let me get it done there in a better environment because I was not paying for it. So they were done in this doctors office.

     My regular Oncologist knew ofthis doctor, as he must have been good in his day.  He asked me how old this guy was, and I told him I figured him to be around 110.  My doctor laughed.

    Once I was able to let my regular Oncologist do my BMB, then it was done in the outpatient at the local hospital.

I got LIdocaine, Versed to make me a little sleepy, and he would put some Dermerol into the IV Drip.  Then I had no problem doing it

     If you are at a cytogentic response, then I would ask him how long he wants to do a BMB on you.  If You have had a complete cytogenetic response than he should be able to just starting doing a regular PCR blood test to find out what he needs to know.

     Ask questions, and be forceful to get what you want.

Susan

[Happycat]

I had one and only one at dx. My onc doesn't believe they are that necessary anymore with all the molecular testing available. I'm sure if I lose response, I'll probably have to get one, but so far so good.

Mine was done by one of the residents on the floor. He was pretty good. They gave me something, to take the edge off a bit, can't remember now if it was before or after the procedure!  I know I got something like lidocaine as a local anesthetic.

I believe the important thing is the skill of the person doing the procedure. Some are really good at, and others aren't. The nurse assured me the resident was really good, so he would always do BMBs for my onc. He was good, I only felt a slight pressure when he punched through the bone, then an uncomfortable sensation as he aspirated the fluid. But it wasn't that bad.

If you can find out at all how good your doctor is at the BMBs, it might give you some confidence in his skill. Nurses know the most, just depends on if you know one and can get one to spill the beans.

Traci

[OhRose]

I also only had one BMB done by my onc at dx. He was very efficient. I had local only and some support hand holding by his nurse. It was very tolerable tho a bit uncomfortable. It did not take long and was over quickly. I had some bruising on my hip/lower back, but no real pain there. The aspiration was the greater discomfort but it was so quickly done...a weird feeling for sure. Once I was numb, I'm not sure the whole thing took 5 minutes. It must truly depend on how skilled the "operator" is. I did not find this to be a horrible experience,  just uncomfortable.

I would suggest you allay your fears soon by checking with your dr and making your plan now so you can relax. Ask about taking something before you come to the office which will relax you by the time of your test, i.e. zanax, vallium etc. Once you have a plan you can more easily await the test. I send my best positive thoughts to you.

[Rissa]

I've had two.  The first one hurt but I think my biggest problem was that I got myself so stressed out before the procedure that I could not relax.  For my second, my onc prescribed an anti-anxiety drug, I don't remember what the name of it was, and it helped a lot.  In fact, it didn't hurt at all, it was just uncomfortable.  See if your onc will prescribe something to take the edge off.

[Cliffee]

I have had three since dx. One at dx, 6 months, and just had my one year.

The first was at Chandler Regional Hospital here in Arizona. I was put to sleep. When I unbandaged the area the next day I had a hole the size of a .38 bullet with a black and blue circle around the hole that extended about 2 inches. It oozed blood for days and hurt like hell.

The second time was at Mayo Clinic here in Scottsdale. I was told that I would be awake and I flipped. I couldn't imagine being awake and going through that. To top it off, we have a friend who is a nerse and was told the BMB was horible. I then called my Oncs head nurse and tried to get her to change it to being knocked out. She asked if I ever had one at Mayo before. I said no. She told me that all their patients do it awake and it not bad. She promised.

When I checked in, day of and finally get into the bed where the bmb would be done the nurse came over and started setting up here instruments. I quickly notice she has a DRILL!!! She tells me that I wont feel a thing and when she'd done I will only have a tiny papercut like mark on the area.

After being given Propofol and Fentanyl I can honestly say, the worst part of the whole thing was the sting from the initial shot to numb the area before she began. I felt nothing!

The next day when I removed the dessings, there was a few drops of blood on the bandag. No bruising and the cut was just as she promised. I could barely see anything. All I needed was a bandaid for the next two days and it was all over. I felt some soarness in the area when sitting down for about two weeks after.

I just had my one year doen at Mayo and it was just as pain free as the last.

If I have to do it again, I wouldnt be the slightest bit scared at this point.

Don't listen to what everyone says. I think they have come a long way in doing these. At least Mayo has.

Good luck!

[CallMeLucky]

A point that should be noted is there are two procedures done.  One is called the bone marrow biopsy and the other is called a bone marrow aspiration.  At diagnosis, they do both.  The aspiration is where they extract the bone marrow fluid via a syringe that is inserted into the hip bone.  The biopsy is where they go back and remove a small chip of bone from the hip that has bone marrow on it.  Typically the biopsy should not be repeated each time unless they are looking for something specific.  As would be expected the biopsy is a bit more intrusive and likely to cause more discomfort during the procedure and in the days following.

[mariebow]

Cliffee you and others person on here had propopol and Fentanyl, I imagine having this would make it easier to have.   I did not have these medications and it was an awful experience, yes, sometimes people do have horrible experiences, as I have heard others experiences in older posts.  Others mild discomfort and soreness.  It is what it is.

[TeddyB]

marie:

Indeed, my first time was one of my worst experiences ever, this was when i was not drugged.

The second time, was a good, or at least a much better experience, and this time i was drugged on Vival

(Another factor might have been that i knew exactly what was happening the second time, the first time i was abit shocked)

So my recommendation for a BMA if you cant be put to sleep, is at least to GET DRUGGED

[msdrezer]

So true -- if you can't be put to sleep, ask for drugs.  Lots of people do not know that they can take oral pain pills at home an hour before the procedure.  I had 4 BMBs -- the first one was in one hospital for diagnosis confirmation, and they had you in IR (interventional radiology) where you're put to sleep with the anethesiolosit and all.  Perfect.  The next two were in the hospital I was actually going to have treatment in, and they wouldn't let me go to IR for it.  I had a nurse practitioner both of those times, but I was on an IV anyway since I was a patient there by that time, and they pushed morphine into the IV, so that was really no problem, too.  The last one I had at Day 100 at my doctor's office by a nurse practitioner.  They wouldn't have given me ANYTHING if a nurse sometime hadn't told me I could ask for a script ahead of time to get pre-medicated at home.  So I had Ativan and Morphine pills which I took before we left for the doctor's.   She said some people get so medicated up ahead of time, that everything finally  catches up  to them when they're LEAVING the office, after it's over, that they have to be carried out of there!  It was funny.  I was sleepy, but I didn't take too much ahead of time because I'm afraid of that crap and didn't want to take too much!  But it definitely matters WHO does the procedure.  As people said, trust the doctor when he/she says so-and-so does millions of them and people actually request her for their biopsy!  I would much rather have someone like that than the doctor who doesn't do them often enough to be great at it.  It should be quick -- 10 - 15 min. in and out.  And I don't have to have another one unless my blood results start to look funky and they need to see what's going on.  You can do it!  The thought of it is MUCH scarier than reality.  I think I would still be scared if I had to have another one, even though I've never even had a bad experience!  It's just natural.