I am just curious what medications others have been given when undergoing a bone marrow biopsy? When my husband had his first biopsy, he wasn't told to take anything and it was one of the most excruciating pains he has ever gone through. First, the lidocaine, or whatever it is they use to numb the area, doesn't work very well on my husband and we told the doctor this but I don't think they believed him. The last time he had a cavity filled, the dentist gave him 6 shots of novocaine and he could still feel what was going on. Anyway, he tore their pillow apart when they were doing the BMB because it hurt so bad. The doctor said some people don't even feel it - I don't know who these people could possibly be! So they suggested that he might want to consider going into the hospital for the next one, which is on Friday. We decided against the hospital and the doctor gave my husband ativan and percocet to take before the biopsy. My husband is terrified that he made the wrong decision by doing it at the cancer center again and is so afraid of the pain. This is a 6'3'', can-handle-anything kind of guy. So, I was just curious where others have it performed and what drugs were given to ease the pain. Thanks for the input!!!!
Medications given for BMB test?
Posted 05 May 2011 - 05:01 AM
Some of the other members have commented that they have a high level of bone density, which is great when you get older and will help prevent broken bones, but can make the BMB a bit harder on the patient - which is perhaps what is happening with your husband.
I've had a BMB done by both methods and though I had a bit of discomfort when it was done under a local it wasn't the worst pain ever.
I changed doctors and my new doc prefers to do the BMB himself in the private hospital. They use a catheter in your hand to deliver the drugs, you're only in there for about an hour - half of which I spent lying around waiting for the doctor to turn up. Though I was wide awake for the procedure, there is certainly less pain, in fact it didn't really kick in till the next night when I rolled on to the spot where the BMB was performed.
If it isn't too late perhaps your hubby can switch?
Hopefully the TKI is working and he can move onto having PCR done through his blood work in future.
Posted 05 May 2011 - 06:20 AM
I have a pretty high pain tolerance but I decided at the very beginning I wasn't doing a BMB without conscious sedation. If they can do that for a colonoscopy they can do it for a BMB. I have mine done at Mayo Clinic - Rochester, MN. They use a combination of Propofol and Fentanyl. It is wonderful! I am out during the procedure but talking on the way back to my little recovery room.
We had a very interesting discussion on this board about this 1-2 years ago but I think it may have been before they switched to this new format and I don't think it is accessible to us any longer. One person had a great quote (I'm sorry I can't remember who it was to credit them and I'm sure I'm paraphrasing but you'll get the drift) "I don't know what is going to happen to me with this CML, but I'll be damned if they are going to torture me while I am alive!"
I don't think I'm a "weenie" because of it either; I had my children at home, I know what pain feels like, I just don't see the need to experience it when there are options. Thankfully Mayo recognizes that.
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
Posted 05 May 2011 - 06:47 AM
Sorry to hear he's had so much pain.
I am one of those anomaly's who has a high threshold for pain. I have only received the local anesthetic for the 2 BMB w/ aspiration I have had done. Minimal pain/discomfort during both procedures and that was right at the end. Best of luck to your husband and i hope they are able to minimize his discomfort.
Posted 05 May 2011 - 08:35 AM
I sympathize with his pain! I had a similar experience. The doc at the time must have been a role model for sadism! If I'd had a gun, he'd probably been in worse shape that he left me in! I couldn't sit or lay on my back for weeks! Har! Seriously, superficial pain relief is a joke! I'd go the spinal block or conscience sedation route. And get a prescription for pain relievers for afterwards too! I had only one BMB/BMA done at DX and that was enough! Once you're husband starts to respond to the TKIs and the FISH becomes negative, then its really only PCRs that need to be done and those can be standard blood draws. I'd be curious why they would need to do anymore BMB/BMAs after he reaches CCR? And definitely it would be fishy after MMR. You might want to ask what the plan is? Sometimes I think all these "procedures" are just a good way for the medical establishment to make more money? Seems like the business of medicine is now business more than medicine. Heck, just look at the cost of these meds were taking. My 2 cents worth!
Tracy in Colorado
Gleevec 800 mg/d 6 years
Sprycel 75 mg/d 2 years
Posted 05 May 2011 - 10:03 AM
I just had a local anesthetic ( lidocaine) with no problems. I would be lying if I said there was no pain or discomfort but even that was minimal. I guess just look at the past responses, each individual has a certain tolerance or intolerance to pain for whatever reasons.
Posted 05 May 2011 - 01:05 PM
Yep, just a local anesthetic here. It was painful, but mainly in a way that I've never had before and it wasn't too bad. They had to drill me 3 times to get in there. It felt like I had a low-voltage live wire going through the top of my skull down to my right toes, just on that side (where they drilled), and whenever he hit the back inside of the bone.
Posted 05 May 2011 - 01:10 PM
First BMB I just had lidocaine, second one I had Ativan and was given a prescription for Morphine for afterwards. I did not need the morphine, but the Ativan was a godsend. I think since I relaxed alot more I did not get nearly as much muscle stiffness with first one. IT was much easier! Only problem is you can not drive afterwards.
Best of Luck!
Posted 05 May 2011 - 01:11 PM
I think it really just depends on where you get it done. Mine was done in a clinic that was not attached to a hospital, so I just had a local. When there's not an anesthesiologist available, they just use a local. You need an anesthesiologist to administer fentanyl and such. Knowing how it feels now though, I would definitely prefer to get it done in the hospital with fentanyl. Definitely.
Posted 05 May 2011 - 01:15 PM
It does effect everyone different, I'm one of the local anesthetics too. It hurts, but only for a few moments, feels like they are trying to pull your gluteus through the syringe. I'm actually more sore afterwards. I can tell you that I found the bone marrow aspiration less painful than the biopsy, but I was more sore afterwards.
My advice is to try and get a technician to do it instead of the doctor. Anytime you get something routine done, I find it is better to get it done by the person who does it all day long instead of the person who does it occasionally. Ever had your blood drawn by an actual MD? Usually not a good things, a phlebotomist is usually a lot faster and less pain. My experience has been the same with the bone marrow.
Posted 05 May 2011 - 02:37 PM
I got my first BMB in late March at Emory Winship in Atlanta, GA. And although I had planned on being Mr. Tough Guy and take it unsedated, my wife promptly reversed that decision when we arrived. I was one of those newly diagnosed CMLers who had a quiet, but panic-striken meltdown while I was waiting. I just couldn't believe where I was and why I was there, especially as I surveyed the landscape of brave cancer fighters in the waiting area that were in various stages of health and hair loss.
Anyway, I don't know what they gave me specifically, but it was gradually administered to me through an IV in my forearm while I was lying on my stomach before the procedure. It was just enough magic potion to calm me down, but not enough to eliminate my awareness or put me to sleep. It seemed to take only a minute or two to kick in, then I was golden. I was fairly comfortable throughout and barely remember any pain at all - and I imagine that the sedation played a role. Afterward, I recovered in a recliner with some apple juice for about 15 minutes and walked out perfectly sober.
If/when I get my next BMB, I will be asking for the same magic potion - that is for sure!
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Posted 05 May 2011 - 02:41 PM
I agree! I forgot to mention that in my post earlier, but my BMB was done by a Physician's Assistant who was a real pro. Before I walked into the "room" to get the deed done, I was sitting in a prep area with some other long-standing leukemia patients. When they heard the name of the PA, they were like, "Oh yeah, Dan - you'll be fine. She's the best!"
Needless to say, I will be asking for this woman by name the next time, along with the mild sedation, LOL
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Posted 05 May 2011 - 07:38 PM
Ditto! My exact M.C. experience. Many Oncs do not wish to expend time having to deal with Anesthesiologists, etc. One should INSIST on Propofol and Versed, or similar meds. Frank
Posted 05 May 2011 - 10:59 PM
Thank you all for taking the time to give your input. The info is much appreciated and it made my husband feel much better to know that he wasn't just being a 'whimp' - that others experience the same type of pain. He is really considering going into the hospital for sedation and with as nervous and anxious as he is, I think it is a good idea. Thanks all! Steph
Posted 05 May 2011 - 11:12 PM
Hey Tracy - My husband and I share the same sentiments! We have pretty good insurance, too, so sometimes I think they are trying to get as much out of the insurance company as possible. But thank GOD for insurance. The doctor said that if his BMB comes back good, then he won't have to have another one for a year. The ABL-BCR test will still be done every 3 months, though, I think. They throw out a lot of info and we are still new at this so I still get confused on the game-plan for treatment. Thanks for the info! Steph
Posted 06 May 2011 - 03:31 PM
Those are the exact drugs they used yesterday. And I don't remember a damn thing! It was fabulous. Husband reported that I did feel pain as they entered the bone, but the nurse must have pressed the plunger on the drugs real hard after that. I woke up in recovery. Don't remember being wheeled there. Again, Fabulous!!!! Even better than the first bmb. First one done at a hospital, not in the cancer center, and with that one, I could feel the pain, but then kinda forgot about the severity of the pain, but I did remember having pain.
I then switched cancer centers to Seattle Cancer Care Alliance, and had yesterday's there.
Sore today and don't want to do much.
So I am not!
Posted 06 May 2011 - 04:13 PM
I had the same discussion with the doc who did my BMB. I told him that the lidocaine won't last very long on me. I seem to metabolize it very quickly, so it always wears off too soon. My dentist knows she has to give me 2-4 lidocaine shots depending on how much time she needs to get a procedure done. I had one procedure done - a crown lengthening - where they had injected so much into me, they couldn't put any more in. It just kept oozing back out, and just dragging out the pain even more. She stood there dripping it onto gauze and holding it against my tooth.
Anyway, I am firmly convinced there are those of us who just don't respond as well to lidocaine. Getting the docs to believe us is the problem - especially if they don't see you all the time and observe it for themselves. My dentist has seen enough of it, she has it written write into my chart. Maybe I need to take my dental chart with me for the BMBs.
Posted 06 May 2011 - 06:46 PM
You are absolutely correct about Lidocaine does nothing. When I was in the clinical trial for Gleevec, my BMB was done right in the doctors office who was running the trial. I asked about the hospital which was right down the block, but I was told it was not part of the trial to be done with sedation. I did my trial through NY Presbyterian Hospital with a Dr. Richard Silver. He is retired now. The pain was the worst thing I have ever experienced, and I dreaded those trips into New York to have it done. My Oncologist used to give me Lidocaine and Versed with Demerol. It was a conscious sedation. That would knock some people out, but I felt nothing and could only vaguely hear what was going on around me. Then I would be in recovery for awhile before I could function to get off the stretcher and get dressed. I always had my husband with me.
I am so glad I am only getting my PCR done now, and no BMB. The clinical trial doctor used to have such a hard time getting into the bone, and he would just tell me I was too high strung. I wanted to say, let me give you a BMB. Lets see how you tolerate it.
You will see everyone has a different experience to share.
Posted 07 May 2011 - 12:28 PM
My Onc will only use the Lidocaine. Its a bit rough and we always end up with a dry tap. I have osteoporosis so I know my bone density can't be that tough, but I make it through. I have noticed one side hurts more than the other so he will only do my good side, that's so nice of him (my sarcasm).
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