For some reason the department responsible for my first bone marrow biopsy (BMB) did not take the FISH test, or they made some kind of mistake and lost the result. It was made in June, and I wrote about it in this posting on September 16th.
Therefore I had to go to have another one made yesterday.
I am being treated at the hematological department where the myeloma experts are. The new BMB was made at the hematological department where the myeloma experts are in charge, and when I asked about what to expect, they told me that they were extremely good at doing BMB's.
The first BMB I got at another department was moderately painful and a little scary -- not so much because of the pain as because the feeling of having your interior attacked in such an intrusive way.
Anesthesia
After the first BMB I knew I could endure it with only local anesthesia applied to the tissue. They also told me that they would make people unconscious if they suffered from hysteria, due to the risk you always have when using not needed medication.
They explained that they would apply the injection to the soft tissue and to the periosteum, the membrane covering the bone on the outside. The periosteum should be very sensitive with many nerves.
No nerves in the bone itself, but they told me that there is also a membrane on the inside of the bone where I would probably feel the penetration.
Who does it
At the other department, the BMB was done by a physician assisted by a nurse. But here at the hematological deptartment I was told that they had a team of medical students attached who did nothing but BMB's. The student would be assisted by a nurse from the department. A little bit scary, a student!
They told me that they trained the teams to be experts at doing this and that they never had any failed tests, and that they are much better than those doctors doing it every now and then.
The BMB
A very young female student (OK, she was probably 22, +/- 2) explained what she would do. The nurse filled in and knew everything. They put me in a completely different position compared to the first BMB, like a fetal position with my knees drawn up to the chest. What a sight -- I am 193 cm and not lightweight.
They told me that this position give superior access to the hip bone.
The nurse had everything ready for the "BMB expert student" and they both worked together. The student applied the local anesthesia and told me what feelings to expect. Then she waited for it to work and started testing how sensible I was. When she went in to the outer membrane, she tested and tested to make sure that there was no feeling left.
Then she started penetrating the bone, and while the last time I could sense it as very unpleasant, I could nearly not perceive it this time. I do not know how she did it, but it was not like a plummer going through the bone. Maybe a soft pressure while she worked hard.
She told me that my bone was thick and very solid. Good for a multiple myeloma patient, I assume. A few times I felt a kind of reaction, not real pain, but an unpleasant feeling telling me that I should probably stop this thing from going through my bone. More a psychological sense than a physical feeling. Nonetheless, I did not like it.
I felt a distinct stitch when she penetrated the inner membrane. And then she started taking the probes.
It probably took 2-5 minutes to take the test samples. Time is such a subjective thing when you are in a situation like this. She told me when she was going to do something what I would feel and how much she expected me to feel, probably thereby making sure that my imagination did not make me feel more pain / irritation than needed.
Then they told me to wait while they compared and evaluated the samples. And that was it.
At this department they then told me to lay on my back on the bed for 20 minutes, since it was their experience that this would lessen the pain afterwards. And also because some of the patients here may be low on thrombocytes and therefore maybe need to be taken care of.
Conclusion
Lucky?
Or is it better to have the procedure done by a young experienced student who does a lot of BMB's every week?
No or little pain going in and through the bone. But still unpleasant, although difficult to explain.
A stitch, not pain, going through the inner membrane.
Some distinct pinch-like feelings as she took the probes. Each time she told me "now you will feel a pinch".
That was it.
Category of pain
If I had been asked on a questionnaire to categorize the pain I felt, then it would have been 1 for the anesthesia and for going through the bone and through the inner membrane, and 2 for taking out the samples.
But the psyche is different. Here I would probably have given it a 2-4, but this was mainly because I was afraid from the previous time. Next time, and with the same very sweet student or one of her team mates, I will relax.
Forums
-
Lev - Name: Lev
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: June 2014
- Age at diagnosis: 57
Re: Pain-free bone marrow biopsy (BMB)
Sorry, I actually created this in the thread under one of the bone marrow biopsy weekly surveys. But I changed the subject, and thereby ended up creating a new thread. This was not so important, and obviously carries no questions.
I just wanted to add my not-very-scaring-bmb experience to the long list from other contributors.
I just wanted to add my not-very-scaring-bmb experience to the long list from other contributors.
-
Lev - Name: Lev
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: June 2014
- Age at diagnosis: 57
Re: Pain-free bone marrow biopsy (BMB)
I've had 3 bone marrow biopsies in a year. First hurt a little but last 2 not at all. My bones (neuroradiologist said mine were a 4 out of 10) are soft, so I unfortunately have an advantage. I just do what they tell me to do, focus on pleasant things, and wait for the Tylenol (acetaminophen, paracetamol) afterwards.
Kully
Kully
-
kullybunnny1 - Name: Kully
- Who do you know with myeloma?: me
- When were you/they diagnosed?: August 2013
- Age at diagnosis: 48
Re: Pain-free bone marrow biopsy (BMB)
It sounds like the technique used can make a significant difference in the pain experienced during a BMB. My thinking is that, for things like this, experience and lots of practice count a lot more than how much education one has from medical school. If a student, a nurse, or nurse practitioner has done a lot of BMBs and has got it down pretty good, I would not worry much about if they are an actual doctor or not.
I had a lymphoma removed from my chest this year by a nurse practitioner who did it in half time it took my GP doctor to do a skin biopsy. Minor surgery was all the nurse practitioner did, though 5 days a week all day long, and he said he did nearly a thousand procedures a year. My GP did a good job too, but I know he was not doing these kind of procedures by the thousands, so he had to go slower.
In the years since my myeloma diagnosis going through the medical system, I have had quite a few students take part in my treatment. This has increased in my area in the last year as the area I live in has a doctor shortage and there has been push to get more medical students in local universities and into local hospitals as interns etc. I am all for it and do not mind at all being treated by student under supervision. Everybody has to learn sometime.
I had a lymphoma removed from my chest this year by a nurse practitioner who did it in half time it took my GP doctor to do a skin biopsy. Minor surgery was all the nurse practitioner did, though 5 days a week all day long, and he said he did nearly a thousand procedures a year. My GP did a good job too, but I know he was not doing these kind of procedures by the thousands, so he had to go slower.
In the years since my myeloma diagnosis going through the medical system, I have had quite a few students take part in my treatment. This has increased in my area in the last year as the area I live in has a doctor shortage and there has been push to get more medical students in local universities and into local hospitals as interns etc. I am all for it and do not mind at all being treated by student under supervision. Everybody has to learn sometime.
-
Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Pain-free bone marrow biopsy (BMB)
It has been my experience that knowledge and expertise almost always triumph over age.
Charlie (grouchy German)
Charlie (grouchy German)
-
Grizlump - Name: Charlie
- Who do you know with myeloma?: me
- When were you/they diagnosed?: June 2014
- Age at diagnosis: 67
Re: Pain-free bone marrow biopsy (BMB)
Eric:
Are you using voice recognition software?
I think you meant to say "lipoma" (a benign fatty tumor, often appearing on the trunk), not "lymphoma" ( A "B" cell dyscrasia) ?
Lipoma's often re-grow -- and in a year.
Are you using voice recognition software?
I think you meant to say "lipoma" (a benign fatty tumor, often appearing on the trunk), not "lymphoma" ( A "B" cell dyscrasia) ?
Lipoma's often re-grow -- and in a year.
-
Rneb
Re: Pain-free bone marrow biopsy (BMB)
Can any of you tell me if a bone marrow extraction / biopsy is something that would be advisable for a woman who is almost 95 years old and has complained about pain from just having blood drawn?
My mother is scheduled for one later this month. My brothers and I are debating whether going through with it would be in her best interests, with the possibility of a stem cell transplant if the results so indicated.
At 95 years of age?
My mother is scheduled for one later this month. My brothers and I are debating whether going through with it would be in her best interests, with the possibility of a stem cell transplant if the results so indicated.
At 95 years of age?
-
JimB
Re: Pain-free bone marrow biopsy (BMB)
I heartily agree. I have had only one BMB, conducted at a large teaching hospital with a large team of cancer specialists and particularly myeloma specialists. The woman who does the BMB does hundreds a year. The team was phenomenal. Even though I had conscious sedation anesthesia, I could see doing this with only a local. I had absolutely no pain.
JimB - While medical treatment is an individual decision, my personal completely uninformed thoughts on treatment / diagnosis particularly for your mother who is so advanced in age is: why? My dear mother is 87 and has dementia. We have already decided we will keep her comfortable but we would not do anything that would cause her pain. At some point you have to ask yourself if the testing and treatment are worth the potential quality of life issues.
Like I said, I am no doctor or expert, but being in a similar situation, I have spoken with her physician and he has been most kind and reassuring in his approach to treatment. He has helped me to overcome some of the feelings of guilt I have had about my mother and her care (I am the POA for her health care).
I wish you all the best as you an your siblings discern what to do.
JimB - While medical treatment is an individual decision, my personal completely uninformed thoughts on treatment / diagnosis particularly for your mother who is so advanced in age is: why? My dear mother is 87 and has dementia. We have already decided we will keep her comfortable but we would not do anything that would cause her pain. At some point you have to ask yourself if the testing and treatment are worth the potential quality of life issues.
Like I said, I am no doctor or expert, but being in a similar situation, I have spoken with her physician and he has been most kind and reassuring in his approach to treatment. He has helped me to overcome some of the feelings of guilt I have had about my mother and her care (I am the POA for her health care).
I wish you all the best as you an your siblings discern what to do.
-
Toni - Name: Toni
- Who do you know with myeloma?: self - MGUS
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 51
Re: Pain-free bone marrow biopsy (BMB)
Toni -- Thank you for your comments and sharing your considerations for your Mom.
Since last night, I've done more searching -- online and soul. My youngest brother and I have come to the same conclusion as you have with your Mom. Now just have to convince the brother who has the POA.
Since last night, I've done more searching -- online and soul. My youngest brother and I have come to the same conclusion as you have with your Mom. Now just have to convince the brother who has the POA.
-
JimB
Re: Pain-free bone marrow biopsy (BMB)
My husband had his BMB and said he experienced some pain for approximately four seconds. He said it was not that painful.
Jim B, my heart aches for you and I am in no way suggesting to you what to do with your 95 year old mother, but I know that if it was my mother, I would never subject her to this, as you asked why?? Let her enjoy the time she has left and my question also is, what doctor would do a BMB on a 95 year old patient? Best of luck Jim.
Jim B, my heart aches for you and I am in no way suggesting to you what to do with your 95 year old mother, but I know that if it was my mother, I would never subject her to this, as you asked why?? Let her enjoy the time she has left and my question also is, what doctor would do a BMB on a 95 year old patient? Best of luck Jim.
12 posts
• Page 1 of 2 • 1, 2