I have just had my fourth bone marrow biopsy today. The first three were done with local anaesthetic (lidocaine). I think I have a pretty high pain threshold – having soldiered through broken bones, dislocations, dental work, etc – and while the punching into the hip and the after-effects were fine, the 10 seconds during aspiration was the most pain I have ever experienced.
This time round I opted for conscious sedation. In Australia we have methoxyflurane (Penthrox) available which I used. This is an inhaled substance (they call it a green whistle) which is used by ambulances for acute trauma (broken legs, etc). I don't think it is available in the US. It was brilliant - pain during aspiration was very mild. I'd highly recommend it.
Forums
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PeterSydney - Name: Peter Mansfield
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: 2011
- Age at diagnosis: 45
Re: Bone marrow biopsy with conscious sedation - options?
Just wanted to properly finish the thread with a follow up. I had my BMB today. I was a wreck, I was shaking and even shed a few tears in fear. 
My doctor was so wonderful. Took lots of time to talk with me, explain everything, and gave me half an Ativan. Hubby held my hand. Well, the most uncomfortable part was the fist lidocaine injection. I felt a shooting pain down my leg, but it wasn't awful. The second lidocaine felt odd, but he put it all over the bone and then paused to let it sink in.
Then the procedure began. The doctor explained all step by step, and I would say it was not painful at all! Lots of pressure, but really no sharp pains. I even donated some extra marrow to the research dept.
So just wanted to finish the thread. Now I have to wait two weeks for results. The doc said we had to do the BMB to confirm MGUS diagnosis and rule out smoldering -- that the results will determine the type of monitoring I need.
Either way, he said I am nowhere in the treatment realm yet. He also said I wound not need another BMB unless my numbers were showing some kind of progression. Also, if all is well, I won't have to go back for another year. I pray that is the case. I thank God for answering my prayers today and giving me a wonderful husband and doctor to help me get through it.
Truly the anxiety I've had for the last two weeks was unwarranted and much, much worse than the procedure itself.
Also thank you to all who generously gave me advice and support on this thread. Now praying for good results!
Nikki
My doctor was so wonderful. Took lots of time to talk with me, explain everything, and gave me half an Ativan. Hubby held my hand. Well, the most uncomfortable part was the fist lidocaine injection. I felt a shooting pain down my leg, but it wasn't awful. The second lidocaine felt odd, but he put it all over the bone and then paused to let it sink in.
Then the procedure began. The doctor explained all step by step, and I would say it was not painful at all! Lots of pressure, but really no sharp pains. I even donated some extra marrow to the research dept.
So just wanted to finish the thread. Now I have to wait two weeks for results. The doc said we had to do the BMB to confirm MGUS diagnosis and rule out smoldering -- that the results will determine the type of monitoring I need.
Either way, he said I am nowhere in the treatment realm yet. He also said I wound not need another BMB unless my numbers were showing some kind of progression. Also, if all is well, I won't have to go back for another year. I pray that is the case. I thank God for answering my prayers today and giving me a wonderful husband and doctor to help me get through it.
Truly the anxiety I've had for the last two weeks was unwarranted and much, much worse than the procedure itself.
Also thank you to all who generously gave me advice and support on this thread. Now praying for good results!
Nikki
Re: Bone marrow biopsy with conscious sedation - options?
It's great that the bone marrow biopsy today went so smoothly, Nikki. Thanks so much for getting back to us to let us know that you had it and how it went. Your update will make the discussion in this thread even more helpful to people who come across it in the future.
Here's hoping the biopsy comes back with good results!
Here's hoping the biopsy comes back with good results!
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Boris Simkovich - Name: Boris Simkovich
Founder
The Myeloma Beacon
Re: Bone marrow biopsy with conscious sedation - options?
Nikki,
I just want to second what Boris said. Your BMB experience was similar to mine (I've had 7 so far). The anxiety beforehand is worse than the procedure itself. Please let us know about your results. Good luck!
I just want to second what Boris said. Your BMB experience was similar to mine (I've had 7 so far). The anxiety beforehand is worse than the procedure itself. Please let us know about your results. Good luck!
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: Bone marrow biopsy with conscious sedation - options?
Yikes, that's a lot of BMB's! So glad they were not painful! Hopefully whenever the next one comes for me, I pray it will continue to be a fairly painless experience.
And thanks Mike, I will update. Now the really scary part comes. Praying for a encouraging result. Will let you know.
Nikki
And thanks Mike, I will update. Now the really scary part comes. Praying for a encouraging result. Will let you know.
Nikki
Re: Bone marrow biopsy with conscious sedation - options?
Nikki, just to close the loop for you. I had my most recent BMB in July and got back awesome results - no myeloma cells found, so I am now in sCR and MRD negative. It was definitely worth the hassle of the BMB to get that news!
Hoping you get good news too!
Hoping you get good news too!
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: Bone marrow biopsy with conscious sedation - options?
Congrats on the wonderful news Mike! Very happy to hear your result, which definitely makes the BMB worthwhile. 
I'm trying not to think too much about the results, but easier said than done. I still have to wait another 12 days! Hope to follow in your footsteps.
I'm trying not to think too much about the results, but easier said than done. I still have to wait another 12 days! Hope to follow in your footsteps.
Re: Bone marrow biopsy with conscious sedation - options?
Mike - that is indeed wonderful news 
Nikki - I had my BMB over 2 weeks ago! I don't remember why, but I scheduled my follow up appointment for 3 weeks after the BMB. So I'll finally get my results this Friday. I've found myself on the forums nonstop .... ugh! Let's hope for the best possible outcomes!
Nikki - I had my BMB over 2 weeks ago! I don't remember why, but I scheduled my follow up appointment for 3 weeks after the BMB. So I'll finally get my results this Friday. I've found myself on the forums nonstop .... ugh! Let's hope for the best possible outcomes!
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Toni - Name: Toni
- Who do you know with myeloma?: self - MGUS
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 51
Re: Bone marrow biopsy with conscious sedation - options?
Just thought I'd write a follow up for this thread in case it could possibly help anyone in any way.
I was sore for a least a week where the biopsy was taken, but really only noticed this discomfort at night while lying in bed.
I don't have the actual report, but this is my simple understanding of what my specialist told me today.
I have MGUS.
There was 4% of the cells in my aspirate and 10% in the core. All genetic testing normal, FLC ratio normal, all immunoglobulins normal except slightly elevated IgG. Iron and platelets good. All other blood test pretty much normal.
Doctor said the core may have been in a spot where more cells were clustered. Further, he said the aspirate takes cells from a wider area, so in his view he averages the two and so I am at 6% of the cells that cause the problem.
I go for the next follow up in 6 months unless some symptoms develop. Since my elevated IgG was found during fertility treatment testing, he said that it is interesting to note that women who have such issues often suffer from some chronic inflammation, and the elevated IgG may very we'll be a response to that. In which case the likelihood of progression multiple myeloma could be even lower.
I left the office feeling better than when I arrived, but the 10% in the core scares me a little. He gave me the impression that the aspirate is a more comprehensive view of what's happening.
Anyway, I will gladly take any good news I can get. So this is the end of the story for now. I will request an official copy of the report, so I may be back soon with more info. Nikki
I was sore for a least a week where the biopsy was taken, but really only noticed this discomfort at night while lying in bed.
I don't have the actual report, but this is my simple understanding of what my specialist told me today.
I have MGUS.
There was 4% of the cells in my aspirate and 10% in the core. All genetic testing normal, FLC ratio normal, all immunoglobulins normal except slightly elevated IgG. Iron and platelets good. All other blood test pretty much normal.
Doctor said the core may have been in a spot where more cells were clustered. Further, he said the aspirate takes cells from a wider area, so in his view he averages the two and so I am at 6% of the cells that cause the problem.
I go for the next follow up in 6 months unless some symptoms develop. Since my elevated IgG was found during fertility treatment testing, he said that it is interesting to note that women who have such issues often suffer from some chronic inflammation, and the elevated IgG may very we'll be a response to that. In which case the likelihood of progression multiple myeloma could be even lower.
I left the office feeling better than when I arrived, but the 10% in the core scares me a little. He gave me the impression that the aspirate is a more comprehensive view of what's happening.
Anyway, I will gladly take any good news I can get. So this is the end of the story for now. I will request an official copy of the report, so I may be back soon with more info. Nikki
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