painful bone marrow biopsy procedure

[bill4872]

My 80 year old (RAEB-2, 2004) Mom’s MDS looks like it may be progressing to AML, because her WBC counts have jumped to 50,000 over the last two months.

Future diagnoses depend on the current bone marrow results. THe last bone marrow biopsy (taken recently by the local hematologist, with little pain or discomfort) was not readable, too much blood in the sample or something. So today when we went to the AML specialists, they wanted to take another bone marrow bioposy. Now my Mom is very tough, but this time, the biopsy (taken by a Fellow, read young MD) hurt pretty bad and she will not let this guy and take another sample thats for sure.

I was curious what other people’s reactions to bone marrow biopsy’s have been and if there is any advice you can give us to try to keep it not as painful (like going in more slowly?)

Thanks,

Bill

[Neil]

Hi Bill,
BMB techniques may be different from doc to doc.
I have had 5 of them with very little pain, although the last one took a bit longer to heal. They were done by 3 different docs. I had a bit of Lidocane at the incesion site with each.
They can sedate her to relieve the pain/anxiety during the process and provide pain meds for the pain afterward.
This can be a pretty tough procedure on an 80 year old. I guess the question is, do you want to sedate an 80 yr old? Hope the samples were adequate for a good look at her marrow.
Some people react differently to the pain. Some docs are a bit clumsy. Other patients go through them with no difficulty.

[Suzanne]

I have had a lot of these-more then15 I know. They use the local numbing injsection fot the site. some people are better at getting it numb then others Now they also give me 10 mil each of “float” right through-can’t drive myself of course and I take a long nap afterwards but my nurse practitioner says the two work together very well and being relaxed makes a bit difference. They can also a stronger drug that pretty much puts you out.

[Suzanne]

whoops! Don’t know what happened to what I typed! It is 10 mil each of Ativan and Oxycodone

[Cherbear]

I have had 6 BMB’s and 4 very bad experiences. I agree that being relaxed is a BIG help. I also received 10 of Ativan and 2 Percosets the last time and “floated” right through the procedure. Everyone is different, as are the doctors who do the biopsies.

Happily, I don’t have to have another biopsy for a while – YAY!

Take care,
Cheryl

[covergirl]

I’m gettign ready to schedule my 4th BMB. Ironically, my bones are too hard to have the biopsy done in the dr.’s office. I am hospitalized, given something to numb and make me loopy(can’t drive, but know its not oxy or ativan) and they go for it.

I too noticed the last one was longer to heal and sore longer. With each one my nerves are on edge but the results are worth the wait – no change in MDS, still holding.

Take one day at a time,
–cheryl

[Jimbob]

I have had at least 15 BMB. The most painful was from a Fellow who later became my lead doctor and subsequently also able to preform at least 6 more that I barely felt. Local pain killer plus ativan made part of the difference.
Jim

[Jack_dup1]

I have had 6 BMB and they have all been painful, some worse than others. The worst was the first, done by the local Hematologist, felt like she was using a Jack Hammer. I found it goes better for me if they numb a larger area. I am having one in two weeks, always a thrill.
Jack

[Jerry]

Y’all …

For those of you who can get it, try Versed … it works wonders … that is what they use at the Fred Hutchinson Center in Seattle … I have had ntohing, had Ativan, and had Versed and I will never allow them to do one again without Versed.
Just a thought …

Jerry

[Jack_dup1]

Jerry,
Versed is used by military as truth serium, hope you don’t have secrets.I have to go alone next time and it is a 2.5 hours drive each way, so drugs are out. I would confess to anything if it would kill the pain, Versed is also used as a date rape drug, no memory of event.
Jack

[Carl]

I’m with Jerry. I have had three BMB-Aspirations without anything but a local anesthetic and they were really painful. I’m told my bones are extremely hard and therefore it is hard for the doc to ease into the bone/marrow.

Anyway, I am now having them done on what they call partial sedation. I get Demerol and Versed by IV and I don’t feel or remember anything. The Versed acts like a memory blocker and you may be awake, but don’t know what is going on. It is done in the hospital by a Pathologist (MD)on an outpatient basis.

It’s the ONLY way I will have any more BMB/Aspirations done.

[Jerry]

Jack …

OMG about the truth serum …LOL!! And if someone wants to date rape me, well … just kidding … it is a shame you cannot get anyone to take you … Carl and I know what a pleasant procedure a BMB can be with the right drugs. For me, for example, 10mg of Ativan does NOTHING but irritate me that it is not doing more … good luck …

Jerry

[Jim]

I’ve had three, all with the local, Ativan and morphine. The second was the only one to give me trouble. The nurse had a problem getting the IV in and I had a major anxiety attack.

JW

[Jimbob]

Most of the bone marrow biopsies I had were NOT really that painful. It was mostly pressure. What really hurt was the aspirations – after the intial core is removed – when they then suck out some bone marrow. There is no way to numb that and unless you are out, you really feel it. Ativan, or I suppose versed, does seem to make one forget about how much it hurt. My next set (BMB and BMA) is scheduled for mid November. I ask about versed at that time.
Jim

[Jack_dup1]

Jerry,
I am not against sedatives, I would take all I could get, the hospital where I am doing my trial does not use them. They tricked me the last time, the nurse said I would be given a sedative and when I got into the torture chamber they said “we don’t use sedatives”, I was not a very happy guy.
Jack

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