Hope the following might help anyone faced with a Bone Marrow Exam for the first time.
Just had my first one recently as part of the baseline tests for the CLL10 "FLAIR" trial, I've signed up to.
Like some of you I've heard descriptions in the past of Bone Marrow Biopsies BMB that were difficult experiences for the patient.
So decided beforehand that I wouldn't do too much reading & research, but hope for a better experience.
Anyhow the following describes my own experience and understanding, and all turned out much simpler and relaxing than I'd expected, from the patients viewpoint.
Please correct me here on any horrible errors.
First thing I didn't understand was that there are two kinds of bone marrow sample; liquid and solid.
- The liquid is a "Bone Marrow Aspiration"
- The solid a "Bone Marrow Biopsy"
The two tests together form an "Exam".
Different medical conditions require one or the other sample, or both the tests. CLL requires both.
Now which bone is used ? I wasn't sure of all the options there before the test, but turns out the Pelvis is now the bone of choice, with samples taken from just below your waist from the back.
Feel around the back of your waist and you can feel the edge of the Pelvis on each side.
So you simply lie on your side with knees part raised to the chest, and don't get to see the needles (unless you really wanted).
I did ask for a pillow between the knees for extra comfort (wondering of the old CLL leg cramps might cause me a problem at a bad moment).
You are wondering how painful it is then ?
Don't think of the word pain, its more a gentle warming/tickling sensation for short periods of time.
Now obviously you don't want to move around during the test. I've heard in the past of people being braced against a wall.
So I was surprised to have a very kind nurse apply some gentle pressure to my knees, also at the same time hold my hand when I asked, just to help me keep still (no great force involved on the knees, just gentle pressure).
We are all used to the call of "Sharp Scratch" before the blood test needles, so what do they say before the bone marrow ?
Well - its not like that. They very cleverly distract you with genuinely interesting conversation, so no time nor need to think about the needles.
In my case several attempts at the liquid Aspirate drew a blank. That is referred to as a "Dry Tap".
Understand that can happen in CLL, and I'm sure it wasn't to do with the excellent team performing the test.
The Bone Marrow Biopsy for the solid sample yielded a good result, about 1.5 inches long, 3mm wide and pink and white in colour (The only bit you get to see if you want to).
Tea and biscuits followed the test - what more could you ask for ?
The "After results" were just two small red dots, covered with a small stick on bandage to be left on for 24 hours (great excuse for a lunch time soak in the bath the next day)
So what about the pain afterwards. Again "pain" is not the right word. I can only describe it as a mild "Bone ache" that wears off over about 5 days in my case, and didn't prevent me, or put me off from doing anything.
I did remove my belt on the way home to make the drive more comfortable (about an hour with the traffic at the moment).
If anyone cares to share your experiences of Bone Marrow Exams that would be interesting.
I'm concious of SLL patients who need more of them of course because in that case the CLL hides in the bone marrow and isn't detectable in the blood stream with normal basic blood tests.
Other tests for the "FLAIR" trial have included echo cardiogram, CT scan, and numerous blood samples (all taken together in one go).
So all complete now, good to go, and waiting to be randomised by the central computer in Leeds into one of the two arms of the FLAIR trial, FCR or IR. Glad I'm not choosing in my case.
Kind regards and thank-you for all your excellent posts.