Bone Marrow Biopsy and pain management

[GhostOfHarrow]

Can we talk about BMB and what we where given to manage the pain of it. I'm about to have my first and they have said I get a local in the injection site and the green whistle (penthrox) while they do the rest. I'm hearing mixed reports of how bad this thing is. Should I request to be put under? What is everyones experience. TIA

[noeagaman]

I prefer to just be stuck with one needle so did not have a sedative. It really wasn't that painful although the girls that was in training bent the tool on the first try so my oncologist took over and used a bigger tool. He said that I have tough bones. I had another after treatment and that one went fine with no sedative. I think that it really depends on who performs the biopsy.

Chris

[The-Man-with-a-Plan in reply to noeagaman]

Key phrase here: "I think that it really depends on who performs the biopsy." That's 100% accurate.

[CycleWonder]

I understand your concern because the BMB was a psychological hurdle I had to get past to sign up for a drug trial.

I told my doctor that I had already been through enough physical pain in my life and would like to avoid any unnecessary pain.

He gave me 50% more pairs medication injected into my hip area. I have come to the conclusion that the inside of bones don’t have very many nerve endings. It was like having a tooth pulled with sufficient pain management: I could hear the doctor and assistant talking, there was some pressure but never any sharp pain. There was an odd sensation when they extracted the bone marrow but it wasn’t painful.

If I need to do it again, I will ask for the higher dose of pain meds again just for my peace of mind.

[HopeME]

Hello:

I’ve had three of these with just a local shot of anesthesia and have had no issues. There is a small minority of folks that have a painful experiences. Unfortunately, there is no way to know in advance how things will turn out.

The first BMB I had was done by a NP in training at a regional cancer center. I’m not sure how many she had done prior to mine but she did a good job and I felt no pain. The next two were done by an extremely experienced NP at Dana Farber. No pain with these either. If you can get your BMB done at a research hospital you will most likely have an experienced practitioner who does these all the time so the probability of a mistake leading to a painful experience is lessened. Despite my positive experience at the regional cancer center, I would avoid another BMB done in this type of setting simply because NPs in regional centers don’t do enough BMBs to be experts in the procedure.

Don’t let the fear of a BMB overwhelm you. It isn’t as bad as it sounds. Please let us know how you make out.

Best,

Mark

[lankisterguy Volunteer]

Hi GhostOfHarrow,

-

I've had 5 BMBs - all with local anesthetic. 3 of them were painless and I only noticed the push to get the tool to "bite" into my hard bones- per the experienced NP that does many of them each week.

The other 2 had a sharp sensation like an electric shock that lasted less than one second, done by the same NP.

I would guess that the difference was hitting a nerve fiber on the way to the bone surface.

-

BTW- my CLL Expert doctor advised me to have the NP do the BMB- he admitted that he is "rusty" at the procedure, and the NPs have the current experience and "muscle memory" to use the tool assertively and effectively.

-

Len

[Cheshire2016]

we’ll I was so anxious about it, I passed out in the hospital corridor! Resulting in a bruised cheek.

My husband who was actually having the BMB found it to be painless. He had a local anaesthetic and oral tablets. ( diazepam I think)

He’s had 2 now, and both similar experiences.

[Lady_Lymington in reply to Cheshire2016]

🤣🤣

[CycleWonder in reply to Cheshire2016]

Your post made me chuckle out loud! I am glad you suffered only a bruised cheek

[Cheshire2016 in reply to CycleWonder]

What’s worse was we hadn’t told many people about his condition or impending treatment, and my bruised cheek caused a few acquaintances to have concerns that I was experiencing domestic abuse !

[very]

My husband only felt the pressure of the needle being pushed in ,no pain.He was uncomfortable for a couple of days after.

Jenny uk.

[Mariacat01]

I had one done a few years ago .they numbed the area and I honestly never felt any pain. You feel a bit of pushing but that's all I felt

[Paulhonda]

I had the Green Whistle and did not feel a thing. A lot better than going to the dentist😀.

[stevesmith1964]

I have had 2 , no issues less pain than a visit to a dentist, I think the fact my consultant is a big lad helped as it was quick.

[Sepsur]

the skill of the practitioner was key for me -

[bettyba]

Hello I asked my consultant for diazepan and I had gas and air - they had to stop the procedure for a little while as I was laughing so much. I was scare - as I didn't know what to expect but I went with an open mind and talked it over with my consultant. Explained on the day that I was very nervous and they looked after me well. I took deep breaths of the gas and air when ever I felt an twinge. I have had 2 bmb and will have a 3rd before the end of the year - but I know what to do now. So have a chat with your consultant - you do not have to suffer any pain. All the best.

[Dahlia7]

I have had 10 BMB. I learned the names of those that were proficient and requested them by name. The discomfort all depends on the skill and experience level of the technician. All mine were done with local anesthesia. Don’t hesitate to ask who’s the best and you may have to do some digging to get a recommendation. I prefer the electric drill but have had painless biopsies with and without. The drill is quicker usually. Good luck. Tony

[Big_Dee]

Hello GhostOfHarrow

I chose the local shot rather than have anesthesia which would have required a 4-6 week wait for an operating room opening. BMB was a breeze and is not near as bad as it sounds. My doctor told me before BMB, that bone marrow does not have nerves. Best solution is to have well qualified person perform BMB. My doctor had done over 100 BMBs.

[Gradyboy]

I had my first one last October. I felt two very quick pains that made me gasp. They only lasted like one second each. After I had zero pain not even a bruise. In saying that I have another coming up in November and am as nervous as I was the first time. I think the results are what scare me the most. Best of luck to you. Another thing it is very fast only took a few minutes.

[Skyshark]

I just had a local. There was a sensation of pressure as the needle went though bone. Bit uncomfortable for few days after. Didn't use any painkillers.

The local somehow rendered all muscles at the hip useless. I couldn't stand and fell. I could move the knee and foot but not the thigh. They got a wheelchair and moved me to a staff break room. Then fed me crisps, biscuits and cups of hot chocolate for 3 hours until I recovered the use of my leg.

[Toast-up]

I am sorry to break the run of good stories of BMBs but I have had 4 and all have resulted in a fair amount of pain.

The first two were 17/18 years ago without any pain relieve and are best forgotten. The other two, 18 months and 1 month ago, involved an injection into the hip pre-biopsy with no offer of additional pain relief.

The trick I found is to remember that the pain is only temporary or at least that is what I told myself and is true. The last BMB need to go deeper than the doctor expected and seemed to go pass the area of numbed tissue so did result in some very choice words.

Unfortunately the slides the doctor produced weren't good enough when reviewed by the lab and I will need to have another BMB shortly. Fortunately I have two hips.

[SERVrider]

I've had one. It was done by my CNS and a colleague. I little uncomfortable as the needle aspiration was done then then the "drill" into the bone with a hand-tap which was uncomfortable; I said a few robust words as she did it, I apologised and Sarah said "Oh don't worry, we've heard far worse" I drove home, no after-effects.

[xpetes]

I had it done once, with just a local numbing agent. The pain was super intense, but very short lived; by the time I had cringed it was over. Afterward I was a little sore, but nothing too bad. The bummer was my sample was shipped to one of the top labs here in the USA for the study by FedEx overnight priorty one and it got mishandled and arrived two days later, so the results were somewhat inconclusive. I declined doing it again, as we had enough info at that point from other tests.

You can't make this stuff up...

[tonyfrench]

I'm sorry, but I told CTCA to "Knock my Ass OUT", I've had too many procedures for Kidney Stones, lower back, and I didn't want to know Nothing, they gave me Propofol(I can see why Michael Jackson was hooked on it) I was out for 30 minutes, but it felt like I had 24 to 36 hours of Solid Sleep(which is something that I'm not had in over 25 years.

I was diagnosed with CLL January 15th 2018, but had symptoms for 9 months before I was diagnosed(They found Enlarged Lymph Nodes during a CT Scan for Kidney Stones) A Lymph Node Biopsy later, and my CLL Train hit the track

[sdowney8600]

I had my first one in October 2017. After that I swore I’d never do that without anesthesia again. I have a lot of autoimmune joint, bone & tissue pain, BUT I’m also used to pain from procedures. I get spinal epidurals for pain without anesthesia that feel similar to the BMB but it’s much quicker. I was just told that I have to have a second BMB on 8/14. I told my doc I’m not doing it without anesthesia! He kept trying to convince me that the NP doing the BMBs now is GREAT! And patients said they didn’t feel a thing! My response was, “I don’t care if she’s a goddess, I’m not doing it again without anesthesia!’” Anesthesia is no fun either, but for me, this one time, it’s worth it.

Bottom line: I think it comes down to your natural pain tolerance, tolerance for anesthesia, and trust in the person doing the biopsy. It’s not a one size fits all approach. It’s doable without anesthesia, but it’s certainly not fun. If you tolerate anesthesia well, I’d go for it. No need to suffer if you don’t have to.

[BeckyLUSA]

Also sorry to have a negative story, but….I have had three. The first one was with local only. My husband said I almost broke his hand I was squeezing it so hard. I was told I could get something to lessen the pain ahead of time, but they neglected to tell me I had to ask ahead of time so that a prescription could be written and the drug acquired as I was not in a hospital setting. I thought they would give me something automatically! I am sorry to say, it did hurt. I have a pretty high tolerance for pain; had 2 babies, naturally, the second one 10 lbs, 15 ounces. Had severe back pain for 10 yrs before finally having surgery (successful thank goodness). I have bad veins and nurses have had to stick me up to 4 times per IVIG infusion before I got my port and that didn’t make me flinch.

My second time, I got my prescription and took a pill 1 hour before the procedure….it didn’t take effect until on the way home. It hurt again. Not as much as the first, but still bad. The third time I told my doc my issues, and he said ok we’ll let the hospital do it. Third time, it was done at the hospital and was given a drug cocktail. Did not knock me out. I knew what was going on, could talk,etc. It was not as painful, but was very uncomfortable. I don’t know why they can’t use the stuff they give you when they put you under for colonoscopies.

So, many more positives than negatives…the averages are in your side. Good luck!

[Nanno77]

My first BMB was so painful that i had to have assistance walking out of the area. I asked around and sure enough, someone was new and practicing on me. I had difficulty walking for about 24 hours. When it was time for my second BMB I requested to be sedated and it was a breeze.

Since I'm part of a study, I will have to get another one eventually. Good luck and let us know how it goes.

[francc]

There ate only two things at play here: your own pain tolerance and the skill of the technician. … and maybe the drugs. 🙃

[doc1947g]

I just got 2 local injections only

[DriedSeaweed]

Just speak up if you are uncomfortable. They can try to accommodate the pain or try another location to go in.

It isn’t fun… but once it is over it is over. Hopefully you don’t have a bad experience. It shouldn’t take very long to do.