I had mine last month and am just now getting around to sharing my experience. As they prepare you for the procedure, I highly recommend looking at the caregiver with a somewhat crazed expression and using a very slightly elevated voice say “Give me drugs!” And when the person who actually is to perform the procedure shows up, begin with some idle chit chat about the weather or something mundane and then casually ask “BTW, how long have you been doing this and how often per week?” Unlike our lymphocyte count, here we actually want BIG numbers!
In any event, I got a calming sedative in my IV and a localized anesthetic. I really experienced pain only during the withdrawal of fluid and marrow, which they did twice, and because it was so brief each time, there really was nothing to it. And then they take an actual bone sample and I did not feel any pain at all from that (surprisingly). And there was no post procedural pain even in the absence of any subsequent pain medication. Now if I would apply any inadvertent pressure to the site, I would definitely feel pain while doing so but after a week, even that was not an issue. I am a fitness nut and I went running two days after the procedure and had no difficulties. I would end by saying that the drugs worked well enough and the person who performed my biopsy does it as a full time job, 3-4 times per day, and has been doing so for 20 years. I have to believe such experience played a major role in how smoothly things went! Bottom line: If the person performing the procedure is very experienced and you get some medication as described, it is NOT a big deal!
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Luap001
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Great advice Luap001! In my 23+ years with CLL, non of them in W&W, I've had several BMBs. Here is my experience, extracted from an earlier post.
In my experience the pain associated with BMB depends on the skill of the person administering it, as Luap001 has said, as well as the gauge of the needle used.
When my own oncologist administers a BMB with only a local it is totally painless. When new residents try to preform the procedure with the same gauge needle, it it is excruciating. In the US, newly minted MDs show up for their residency in July. I can tell you from experience, that is not a good time to schedule a BMB.
I also have had a CT-guided biopsy where I requested only a local because I wanted to remember what I could see on the monitor during the procedure, only to change my mind during the procedure. Fortunately an IV was already hooked up so it was easy to administer the additional medication. My oncologist prefers the CT-guided biopsy because of the more representative sample that can be collected with a 8 gauge needle that is used in that protocol instead of the smaller 14 or 16 gauge needle that he uses in his office.
i had my first in the hospital-got on my stomach and a local. then 2 times at my doctor's office. she did them herself with a tech there. i 'm used to them with just local. there is some pressure and sting but not a lot.
I too think it's about the skill of whoever is doing it. I have had some that went smoothly, and the one done by summer (hence brand new) residents who missed my appointment window & took me after the premeds wore off was excruciating. It took them several attempts and that hip was sore for a good 6 months. One of my 3 last year had me nauseous and sweating because the anesthetic hadn't yet taken hold & my sample kept crumbling; she had to repeat a few times to get a good sample, but that hip wasn't sore afterwards. So a local will be fine, as long as there is enough time for it to be effective. After the first nauseous/sweating one for the trial I was in, we waited longer for the local anesthetic to take effect for the next two. No problems with the others. But anyone with a low pain tolerance may want/need the IV sedation. I had to drive after the appointment, so IV sedation wasn't an option for me.
My GP did my BMB, he was old hand at it and only one qualified to do BMB at my local hospital. I was given choice of local or general anesthesia. Decision was based on "local" was done in out-patient office and available same day. General anesthesia route required minimum 4-6 weeks to schedule operation room. I had 8 gauge needle and GP told me before BMB that only muscle tissue and bone have nerves, the morrow itself does not have nerves. I had local because I was more worried about my CLL than BMB. BMB was easy-pleasy, felt little pressure for about a minute. I told my doctor if that was the worse thing to happen to me that day, I had it made.
Hi..your experience sounds better than mine ..I have had 3 now and find the whole experience dreadful , uncomfortable and a little painful. In fact I cried with the 2and one. Dont think I got offered sedation but i did get some sort of local anaestic.
Very much depends on who does it. I had my first biopsy some weeks ago and the proceedure with just a local anaesthetic was less painfull than my Covid jab. Some minor discomfort the next day but will not worry when and if I need another oneThe really good news is following the results I have been told I am in remission and now only need consultations every three months
I've had 3 so far, all under local. In my opinion it is the care they take with each step that is important. The first was ok (done by a Senior Registrar. The second was by far the best. This was taken by a trainee doctor who had only done 2 before. They didn't pressurise me to have her practice on me. She took so much care and took each step slowly (she had worked as a care assistant before her training), telling me what she was doing at each stage. The third was by far the worst. This was taken by a young, cocky junior doctor who rushed everything and pushed so hard at one point that I nearly fell off the bed. It was rather humiliating as he was meant to be demonstrating to someone (I was never introduced). I was in so much pain that I insisted someone else finish the procedure. So, in my opinion as long as they take it slow, stop when asked and explain as they go along it will be fine.
Agree. Very short period of pain (seconds only). Inexperienced petite caregiver simply not strong enough, but not an issue when they got someone bigger.
Hello - well done you for making sure you were administered pain relief and your experience was a good one.
I had gas and air and I sucked on it so hard I started to belly laugh and people filled to room to see what was going on lol as they could not understand the uncontrollablelaughter. I laughed so much they had to wait a while and start again. They tried to take the gas and air off me but I was having non of it. The procedure commenced and I continued to use the gas and air and they finished in time for my second performance of uncontrollable belly laughing again. The healthcare professionals were also laughing at this point and they all hugged me when I finally left the unit the staff said they had enjoyed meeting me. Well I wonder if they remember me when I for my next one. Xx
I have had 4 done over the last 4 years only ever been given a local injection into the bone area to give some numbing. A little discomfort but nothing to stress about. I guess I’ve been lucky really
I have had 3. First one nothing except local. It still hurt. I go to a cancer center, not a hospital and you have to have a sedative drug prescribed before the procedure. No one told me that until I asked for a sedative before they started and they had no prescription! Second time they prescribed me a Valium type drug which I took an hour before but it didn’t kick in until the ride home. Third time it was done in a hospital and they gave me some kind of drug cocktail that took the edge off. I was awake , still felt some pain, but it was not as bad as the first 2 times. If I have to have another one I want the stuff they give you during a colonoscopy. I do not want to know what is going on!
I actually think it’s more than luck - you likely had people that were good at performing the procedure. Some people thankfully are talented in certain ways...
I had my one and only bone marrow to date in February 2020, and I had been on Watch and Wait since April 2018. Having a bone marrow biopsy that early in the game is unusual; since, they normally wait for the first one until they are seriously questioning the start of treatment. I was very early in the game, but I had just had a 50% spike of WBC in two months. It scared my local oncologist, so I sought out one of the top in the country. She wanted to make sure where things really were; thus, the biopsy. Fortunately she felt alright with continuing a six month Watch and Wait which still goes on today.
It scared the hell out of me when I was told on that visit that we would do a bone marrow biopsy. Like Luap I asked the tech doing the procedure how many she did and over how long a period of time. Being at a major center, and since she had been there for ten years, I at least felt calm with her likely abilities. I only had a local anesthetic and I didn't get the impression it is normal to do an IV anesthesia. After the local took effect she began to step by step go deeper, and asked me constantly how I was doing and warned me a couple of times when it might be a bit more uncomfortable. I just took deep breaths on those warnings. Finally she got to the part where she would need to go into the bone and draw out the inside material. She warned me again and I just took deep breaths and within a reasonably short period of time from that point it was over.
I too had very little discomfort after I got up and walked out, and next to nothing that I recall on the next day.
Overall I have to admit it wasn't as horrible as I anticipated, and I got through it fine. I can't say I am looking forward to my next one, but at least I won't freak out when told i need one.
I have had 3 bone marrow biopsies at MD Anderson...all under locals. After hearing from a friend how horribly painful her BMB had been, I admit I was apprehensive leading up to my first, but actually none of them have been bad.
I do agree that the level of experience of the tech makes a huge difference, and during my last BMB, the tech talked and calmly explained what she was doing throughout the procedure. I left that room hardly knowing anything had happened!
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