34 replies to this topic

[Antilogical]

Another observation:

Some people like to know the gory details and some don't.  I crave information - it helps me get thru procedures - so I asked the tech to keep talking to me during my BMB.  And she did - she told me exactly what she was about to do and how long it would take each step of the way.  If she said something would take 2 minutes, I'd start counting (mentally, of course - you don't want to annoy the person holding the knife!).  So if you're like me, ask the knife-wielding person behind you to let you know what they're doing.

As an aside, I am awaiting permission from my onc to finally get the knee replacement surgery I need.  Nowadays, they keep the patient awake for the 2-hour surgery, with just a spinal and some other nice drugs to really relax you. I wonder if I'll care what they're doing to me?

[Susan61]

Hi: Antilogical:  Not to get off the subject, but my husband put off his knee replacement for too long.  Once he had it done, he said why did I wait?  He is doing very well since the surgery.  He just had his 2 year check-up.  You mentioned Sciatica, and I am in terrible pain with that now.  I have to say I can live with the Sciatica more than a BMB without heavy sedation.  Some people can take pain in higher degrees than others can.

Susan

[LivingWellWithCML]

I have had one BMB and I received some mild sedation with it ... mainly because of anxiety at the time of diagnosis, and not from the BMB itself.   Anyway, the sedation was pretty awesome ... I was awake and just chilling out & chatting with a nurse and barely felt a thing while another person did the actual procedure.  Better than being completely put to sleep, and I was also asking questions during the procedure, etc.  They even showed me the sample after they were done, which was pretty interesting.  And I had a mildly sore back, but I ran 3 miles the very next morning with no issues.

If you are really nervous going into it, then I would recommend mild sedation just to calm you down.  It definitely worked for me!

[felursus]

I've had 7 BMBs - each one was a different experience.  The first was done by Dr. Siddhartha Mukherjee - the author of the Pulizer Prize-winning book "The Emperor of all Maladies: an autobiorgraphy of cancer."  I had NO sedation or anti-anxierty drug.  He talked me through it, and my husband held my hand.  The lidocaine was ALMOST the worst part - except for when he withdrew the aspirate, but that pain stopped immediately when he stopped and was very quick.  This was was done with me in prone.  They asked me to lie flat for 1/2 hour afterwards, but after that I had no pain - only some discomfort when sitting in certain positions for about a week or so afterward.

The second was done when I went into Columbia Presbyterian for my first induction (I have AML), and they had me in side-lying.  What I didn't know at first, was that my MD let his Fellow start the procedure, (I was lying on my side holding my husband's hand with my eyes screwed shut), and I was in AGONY.  I told him he had to stop - and at that point my MD took over and it was bearable.

For the THIRD one (after induction) I asked for a good whallop of pain meds, and they gave me morphine (I was in-patient still), and I had forbidden the Fellow (who was a nice guy) to be in the room.  I had a couple of seconds of pain, but that was it.  The morphine kept me quite happy.

The FOURTH one was done out-patient and will a drill (it sounds horrible - like they are drilling to screw something into a wall), but it's faster.  That time I had an oral morphine tablet and a Valium in advance.  There was one moment when I had a horrible burning sensation in my groin (shouldn't have happened, the nerve responsibe is supposed to run anterior (in front of) the iliac crest - which is where they are digging for "gold".  As soon as I said "stop", the MD did and the sensation went away never to return;

The FIFTH was similar to number 4.

The SIXTH was done at Memorial Sloan Kettering by a final year Fellow.  I did take a hydrocodone and a valium in advance, but I swear I never felt anything after the lidocaine shots.  (BTW, I've come to the conclusion that is't less painful when they do with with the patient prone.)  I never had any pain or discomfort afterwards either.

The SEVENTH happened yesterday by the next "final year Fellow".  This time I only took a Valim, because I'm feeling nuts enough on the antifungal, antiviral and antibiotic cocktail they have me on.  Again, only the lidocain hurt.  I do have some discomfort now if I sit in certain positions (which put pressure on the site).  I was told to keep the bandage dry for 48 hours.  (I have Aquaguard patches for my PICC in any case.)

I generally chat with the staff while they do the procedure.  It helps my nerves.  Good luck.

Karen

[TeddyB]

Hmmm, sometimes it actually sounds better to have it done on the Sternum.

The only thing i couldnt do after my BMB, were push ups, no problem sitting or walking

Of course the Dr is kind of "In your face", but the last time i actually felt no pain at all, except for the local anesthetic, and some slight discomfort when he took the "needle" out of my chest.

[cam_kris]

Thank you all so much for your experiences!!   I guess I am just a big chicken, I just think we are all scared enough with this disease and if there is no need to have pain

that is what I want.  No Pain.  I have a couple of months to respond to his demand.  I will see if I get my nerve up or not to go through with it w/o putting to sleep. It was just so

nice last time, woke up layed on my back for about an hour and went home. didnt feel a thing.  Again, thank you and I will let you know how it goes!!

[0vercast]

I just had my second BMB a couple hours ago.  It hurt a lot less than the first one, maybe in part to the fact that I knew exactly what to expect.  The worst part was when the doc pulled the plunger back on the needle during the bone marrow aspiration.  That was a sharp pain for a few seconds, but all in all, it wasn't so bad.  I'll be a lot less concerned about the next BMB than I was about this one.

[TeddyB]

Were you asked to hold your breath when he pulled out the marrow Overcast?

I was, and when i did, it did not hurt at all. (At least not like the first BMB i had.)

Who knows, maybe that works better when BMB is performed on the sternum, but it would be worth a try

[Tavian_A]

My first BMB was july 20 it was at the hematologist office and he told me it would not be painful just a few minutes and that would be all. The local anesthetic they gave really didn't work that well but I worked through it. The aspiration was not that bad for me just a two min pain and thats it. The biopsy however was not so pleasant just the pressure going through the pelvic bone was intense for me I felt like an eternity of him chipping away. The worst part was he had to go in a second time cause the first sample was not good enough. He said since I'm young the bone is a lot more tough to penetrate. He actully fibbed and told me he needed just to get some fluid out and it would not hurt, next thing I know he says this part is going to hurt. I turned around and before I could say what there he goes chipping away and me feeling the intense pressure. Finally he finished and all I could do is laugh and say your a damn liar. Once it was done I got up normally and was admitted to the hospital and diagnosed with AML. I have another BMB Wednesday Aug 8 this time I'm going to be drugged so I will not feel a thing (I hope). 

[BY196]

I agree that knowing what to expect helps, because anxiety often heightens pain. (At least that's what they told me in my nearly-useless childbirth classes.) My onc said the first BMB is always by far the worst because the marrow is so full with leukemic cells. He assured me that subsequent BMBs would be much less painful and they were. (It also helped that he didn't have to do the chipping part--I guess that's the biopsy as opposed to the aspiration--after the first time.)

Beth

[0vercast]

I wasn't asked to do that.  I'll try to remember that for next time, but it'll be a while.

[Lizzybee]

I've only had one bone marrow biopsy, done by my onc in his office. I was wide awake, had only a local anesthetic, and it was really no big deal at all.  Getting the lidocaine shot was worse than the biopsy.  I drove home afterward with only very minor discomfort.  I took motrin before bedtime for about 3 nights afterward, but I didn't need anything during the day.  Everyone is different, but there's a good chance that anticipation of the biopsy will be worse than the actual experience.

[Brenda]

Just a couple of things I haven't seen mentioned (and thank you everybody for all your answers, which I am going to need also)  --

You don't have to get the anti-anxiety and anti-pain medications from the onc.  You can get them from your regular doctor.  That's what I did.  Your own doctor is sometimes a lot more helpful.

I notice here that Cliffee mentions Propofol and Fentanyl as not being considered an anesthetic.  I've heard nothing but rave reviews for that combination.  I may go for it myself next time since it is very difficult, if not impossible, to get consious sedation (e.g. Versed) or a general anesthetic for a BMB here in NY.  It seems to be an insurance thing.

[idahobeavers]

ok i have had 3 of these buggers. all were byopsy,s by the way. the first i was knocked out cold. 2nd i was given a good drug cocktail yeah! baby.3rd i had nothing. never will that ever happen to me again. they will either knock me out or drug me. the last one was so bad that i was crying,yelling and demanding he stop. but of course he wouldnt and to top it all off he never even got a good sample wth !!!!!!!!!!but as everyone has said depends on your pain tolerance level. dont be scared if u have a good dr. it should not hurt. but every time i bruised,bled and was sore for a week. but to each their own