I have had 2 BMB's - 1 in at a local facility summer 2013 the 2nd at one of a regional cancer center (one of the largest / most well known in the country) this May. Definitely the 2nd was much quicker and less painful though I for some reason can feel very well unfortunately when they "tap the bone" (after they complete the local and choose a site to puncture the bone).
Thankfully the performer of the 2nd BMB at least "poked" around at several areas (bone) and asked which could i feel the least - where most people do not feel the initial poking of the bone at all (my wife cannot - she's lucky) apparently I'm more sensitive and the PA that performed my 2nd BMB at the specialty center went with as much lidocaine as is possible - 20cc (normally they use 5cc and about all that can "fit" is 20cc but still each time she barely poked at the bone to select a final location i could still feel it - my wife on the other hand could not feel anything at that point - of course my wife just like me can feel when they take the aspirate and bone marrow samples - the strange sensation that to me is felt deep within your stomach - i can't really describe it, just a strange feeling that luckily is more weird than painful).
I can say that at the regional cancer center the process was much faster - i guess as they perform supposedly up to 75 per day total (not sure if that's just for the Myeloma / Lymphoma clinic or includes Leukemia - my wife has leukemia and her BMB's are in the same unit but diff area that only works with leukemia while mine are now done in the myeloma specific area within the BMC clinic).
My 1st BMB at a local facility, the HemeOnc doctor performed the BMB and while it felt about the same as at the regional facility it seemed to take forever - especially when removing the needle - it seemed to take forever as he "unscrewed" the needle and he seemed to tug and push with much more pressure as if fighting for the sample - not sure if it was the different side that was rougher than the side used this year at the larger facility but i think it's just the experience at the larger facility that they crank out several per MD / PA and it just makes for a more efficient process.
Also my wife had virtually no pain at the 3 BMB's done at the same larger facility over the past 18mo and her lone BMB done locally (not by the doctor near home that performed my 1st BMB but another local oncologist performed her initial BMB when she was 1st diagnosed with leukemia and it was a HORRIBLE experience for my wife - first of all this doctor only performed BMB's while patients were fully sedated which when we knew nothing of the procedure sounded much better but I think the reason she required sedation is that the doctor wasn't very experienced - my poor wife - after that 1st BMB done locally the doctor came out to talk to me after the procedure to tell me that she was hardly able to obtain a sample, that my wife's anatomy was "off" and the needle "nearly broke" and the sample may not be of any use and they would need to perform a repeat BMB and only by using a laser guided CT needle! Well the sample was usable and we switched to the regional cancer center at that time. My local HemeOnc thankfully was much better than my wife's initial local specialist.
Bonus Info related to my wife Jan 2013 and myself summer 2013 both undergoing and dealing with BMB's:
I have to admit i would nearly faint just having blood drawn and almost felt like i could have fainted when that 1st doctor came out to the waiting room after my wife's 1st BMB and told me how the needle almost broke - at the time i was so shocked that my wife in Jan of last year had been diagnosed with leukemia and also thought the BMB was so rough and no way could i ever take that as i can't take giving blood - then a few months later last summer I myself was having a BMB as I followed up on my own MGUS case from 2010 which the local facility only saw me ONCE when my para protein was 1st discovered by means of an SPEP following botched knee surgery in which the ortho's said i was fine but my knee was horribly swollen for months even though they never did anything during surgery as no issues were found once they scoped my knee!
A rheumatologist informed me that my issue was structual and that I should return to Ortho but Ortho sent me to the "medicine" side o the house and while bounced around a super slight M spike of .010 g/dL was found, i was referred to HemeOnc and told (ironically by the same specialist that had issues performing my wife's initial BMB 3 yrs later!) that "i may have a greater chance to dev lymphoma or other blood cancers due to the M spike" but that it was "probably a false reading and merely extreme inflammation causing the para protein with monoclonal banding reading" - she never followed up - while reading up on my wife's Leukemia I came across MGUS / Myeloma and had to order my own followup oncology appointment which the same institution would not see me (oncology) without a referral when of course THEY had already seen me in 2010 after the .010 M spike appeared in the SPEP ran by the arthritis specialist! I had to see my Primary Care Provider and ask him to look at my 2010 M spike / oncology visit (same hospital system) and he ordered in May 20113 last year an SPEP , UPEP (24 hr urine) which the .010 g/dL M spike had increased to .375 g/dL - needless to say just like my wife i did NOT see the oncologist that we both initially saw and thankfully were able to travel and have insurance approve changing to the regional cancer center.
So there i was a few months after my wife's 1st BMB and cancer diagnosis having my own BMB and FF to this year and I my 5% plasma cell count from 2013 increased 10mo later in May this year to 10% and though no clonal cells were found in the 2013 sample this year 91% of my plasma cells were aberrant (also "small mature morphology" was noted in additional to several abnormal antigen staining's turning out the "wrong way"). I'm also anemic and they cannot determine the cause of anemia after seeing benign hematology and other specialists though it turns out finally we may have a reason for the lack of RBC creation - a hormonal issue - i should soon be treated with hormonal injections and possible my H&H may raise and we can stop worrying about Smoldering Myeloma as the cause of my anemia which would be awesome so we can concentrate on my wife's leukemia (she will find out in Dec if she will undergo a stem cell transplant anytime soon).
Life's been interesting over the past 1.5 yrs - time flies by, $$$$$ is short as it seems nearly all spare $$$ goes to medical costs with both of us having to travel to the regional cancer center (at least usually we can go together - combo appointments) - my wife cannot work , i was able to move her to my insurance but the premium is much higher than when she worked (she was an RN) and the loss of her full salary / income / benefits and new medical costs (her meds are quite expensive - TKI chemo even with insurance costly) combined with new medical costs , it's overall a very tough hit as far as $$$$$$ then the stress of both of us always undergoing labs, workups - always a doctor's visit - so many for me trying to find the anemia cause , it's just a bit crazy but with both of us just barely into our 40's now this is how it's going to be for many years - the rest of our lives , we have to deal with it - - perhaps a cure will be found for my wife's leukemia (rarely a transplant can provide a cure at this time) and treatment for my SMM may arrive one day and prevent me from ever experiencing active multiple myeloma. Until then I guess we are dealing with it - but obviously as i'm writing all of this (was not planning to do so) it can get into my mind as it is right now at 4a in the morning on a weekend, haha .
Thanks to all for sharing their BMB stories maybe mine and my wife's BMB experiences here will give others insight - try to have your BMB performed by someone that's very experienced, i know that sounds like a given but definitely try to do so if possible and good luck!
Forums
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pinball - Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2010 MGUS, 2014 Smoldering
- Age at diagnosis: 39
Re: Weekly Poll – Bone Marrow Biopsies And Pain - 2012
I wrote about my first BMB here. And about my second which was almost pain free and nearly a pleasant experience here: https://myelomabeacon.org/forum/pain-free-bone-marrow-biopsy-bmb-t4085.html
In the discussion following this the general conclusion was that what matters is that the person doing it has a lot of routine. In my case it was a young student who did it. She was in a team of students connected to the department, doing nothing but bmb's
In the discussion following this the general conclusion was that what matters is that the person doing it has a lot of routine. In my case it was a young student who did it. She was in a team of students connected to the department, doing nothing but bmb's
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Lev - Name: Lev
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: June 2014
- Age at diagnosis: 57
Re: Weekly Poll – Bone Marrow Biopsies And Pain - 2012
Hi pinball,
Thanks for your post. It's bad enough when one member of the husband/wife team has some form of cancer. So I can only imagine what you and your wife are going through.
While I was in the hospital after my SCT (a month-long stay because of some complications), my wife went through a series of increasingly worrisome tests for breast cancer before she was given good news that everything was ok. But for a week or so, we really didn't know how we would manage if she got bad news.
Best of luck to both you and your wife.
Thanks for your post. It's bad enough when one member of the husband/wife team has some form of cancer. So I can only imagine what you and your wife are going through.
While I was in the hospital after my SCT (a month-long stay because of some complications), my wife went through a series of increasingly worrisome tests for breast cancer before she was given good news that everything was ok. But for a week or so, we really didn't know how we would manage if she got bad news.
Best of luck to both you and your wife.
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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: Weekly Poll – Bone Marrow Biopsies And Pain - 2012
I have had one biopsy. The local anesthetic worked well, and I felt noticeable but tolerable pain while the needle was going in. Otherwise, I would rather describe the feeling as "weird and invasive" than "painful". Like my renal biopsy, I knew that the needle was really only going a short distance, but it felt long and huge.
I was able to drive home, and took the next day off for rest. I experienced some minor aches for about 3 days, like when you've fallen on your hip. I probably should also mention that I'd already had a skeletal x-ray survey that showed no bone lesions. The experience may be different in cases where bones have already been weakened.
I was able to drive home, and took the next day off for rest. I experienced some minor aches for about 3 days, like when you've fallen on your hip. I probably should also mention that I'd already had a skeletal x-ray survey that showed no bone lesions. The experience may be different in cases where bones have already been weakened.
Re: Weekly Poll – Bone Marrow Biopsies And Pain - 2012
I had a bone marrow biopsy in January under a local anaesethic and it was excruciatingly painful. The pain in my leg and pelvis throughout the procedure was unbearable and it left me shaking and traumatised.
Needless to say, when I was informed that another biopsy needed to be taken, I dug my heels in and refused to have it done without 100% pain block. I had the biopsy done today under a general anaesethic and it was so much better.
Bone marrow biopsies are notorious for being a really painful experience for many patients. It seems to depend upon whether the nerves inside the pelvis are drilled into during the process. There is no reason why patients should be expected to put up with unnecessary pain in this day and age, so my advice to anyone facing one is to insist on 100% pain block.
Needless to say, when I was informed that another biopsy needed to be taken, I dug my heels in and refused to have it done without 100% pain block. I had the biopsy done today under a general anaesethic and it was so much better.
Bone marrow biopsies are notorious for being a really painful experience for many patients. It seems to depend upon whether the nerves inside the pelvis are drilled into during the process. There is no reason why patients should be expected to put up with unnecessary pain in this day and age, so my advice to anyone facing one is to insist on 100% pain block.
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robes15
Re: Weekly Poll – Bone Marrow Biopsies And Pain - 2012
I have to say that my last bone marrow biopsy wasn't bad at all. It makes a lot of difference who does them. My last one was done by a physician assistant and there was only mild discomfort. The only medication they gave me was a pill that was taken an hour before the procedure. My previous one was done by a doctor with IV pain killers, and there was much more pain involved.
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