Anyone here who had bone morrow test?Will it help a lot?Is it painful?

Good day everyone. Im Gracee and I've been diagnosed with ITP 3 years ago, every year it just keeps dropping down. This year was my worst year since my platelet dropped from 48 to 12. My doctor let me take steriods for 7 days  to help increase my platelet, but I don't usually follow my doctor. If he tells me to take it 3x a day, I would usually take it 2x a day and try my best to eat healthy. After a week a went back to my doctor and my body responded well with the steriods, my platelet increased to 53, I was so relieved when my doctor told me not to take steriods anymore since he doesn't want my body to get used to it cos eventually it will have a bad effect. I was told to go back after a month, however when I went back my platelet just dropped to 9.  The reddish spots on my skin just keeps appearing. I know when i see bruises and red spots my platelet is low. I have a new doctor and he had been monitoring my platelet count for almost 6 months now. He suggested that I should go for a bone marrow test. He advised me to take steriods again for a week. I really don't want to take any meds, but i don't have a choice. I don't want to go for a bone marrow test either. Anyone here who had bone marrow test? Do you think it will help? I've seen the pictures in google and I'm really scared to go for it. My doctor told me I might have an aplastic anemia. But, he really cannot diagnose it unless I would go for bone marrow test. Do you think it will be good for me to do it? I dont really feel very sick. I just get dizzy but other than that im all good. Im doing my best to eat heathy. It just that knowing that I only have 9 counts and drinking steriods are really making me depressed. I tried to be positive about it but it really gets into me especially now. Could you please tell me what I should do? Thank you.

15 Replies

  • A FULL diagnostic workup is obviously required and this should be done at a specialist center.  You need to find a proper heamatologist who is fully familiar with the various types of blood diseases.  The research into blood disease is changing VERY fast and only the truly up to date specialists know what medicines to use.

    A bone marrow test is common and if done by a nurse who does them frequently is hardly painful at all.  Sadly sometimes they are done by a nurse who does perhaps two a year and the patient suffers.

    It is common to ask for either a full local anesthetic or a full whole body temporary anesthetic which is what I had.   I had a very slightly painful mark which lasted only a few hours and then I could feel nothing after that.

    My advice is to find a true expert in blood diseases.  Blood cancer heamatologists are the experts in all this type of thing.

    Best of luck

  • Hi Gracee,

    I had mine done by the hematologist, 2x already but several years apart. the doc inserted the needle at the bottom of my spine & in between the pelvic bones. I didn't feel the pain while the needle is being inserted or taken out (just the pressure when doc push the needle in the bone & you might hear some cracking sound since bone are not soft) but I did feel the pain when doc took the sample even an anesthesia was applied. It felt like an electric current ran through the back of my spine. After the procedure, a band aid is all I got then some pain when the anesthesia wears off but it went away after a few hours or a day.  It's quick and necessary. The prep takes longer than the actual procedure. They need to know if my bone marrow produces the platelets or not as well as eliminate any other possible causes of low platelets before they can diagnose that it's itp. It's bad if your bone marrow has a problem producing so I am glad that portion is still in working order. Without the bone marrow test, your low platelets may not be itp, it can be other diseases that causes your platelets to be low. Many doctors misdiagnosed itp. In my case, it's really itp. No rare disorder or cancer. It's outpatient, you will need someone to drive you the day of the test. Although there is no problem producing platelets, my immune system destroys my platelets faster than I can produce. At one of my blood test, the med tech is unable to produce the # of platelets & I was told that this happens when the bone marrow tries to replenish the platelets in our body too early. The platelets has not matured yet in the bone marrow but must replenish what was destroyed. 

    Hope you understand that it is necessary to avoid misdiagnoses & really get to the bottom if there are other diseases that causes your low platelets. It's better to have an early intervention than finding out in the future that you have other things going on when you are at your worst. 

  • Make sure to ask your doctor to request testin on other possible diseases from hematologist so you only get the bone marrow test once in a blue moon. I had two bone marrow test because the first one ... I was out of the country & it was my sister-in-law who happen to be a hematologist saw my unusual bruises & immediately did the testing but she asked me to have it done in the u.s. too when I go back so they can follow-up with treatment. 

  • I had 2 bone marrow biopsy's when I had ITP - the first one was to confirm the initial ITP diagnosis and the second was when I was undergoing NPlate (Romiplostim) treatment and there had not been any increase in platelets after the first 5 injections. Thankfully the 2nd biopsy showed the presence of many megakaryocytes which a week later resulted in a dramatic increase in platelets.

    Both biopsy's were taken from my hip (separate sides) under a local anesthetic and were pain free with the only sensation being one of pressure and a 'click' when they took the sample.

  • I did bone marrow test recently (one month ago).  Its painful but if you have a strong will you will find it much comfortable

  • I had a bone marrow test to diagnose the Itp 12 years ago, it was done in my chest which felt really weird, especially when the fluid was drawn out.  Afterwards I felt sore for about 3 weeks there, especially when driving so perhaps having it done in your back is better.  The pain is worth it for the oeace of mind of a correct diagnosis.

  • Bone Marrow Aspiration (BMA) - (though the term suggests being scary) is not painful at all.  I had it during my hospital stay in mid-Jan 2016 (when my platelet dropped into 5K only.    Per my hematologist, I had undergone local anesthesia  but still, after sometime, it is not painful at all.    The purpose of this BMA is to check from the bone marrow itself if it produces its own platelet and/or destroying the platelet it being produced.  Medically, ask your hematologist about it.  But for BMA per se, rest assured, it is not painful. 

    Hoping for your earliest recovery -- God bless.

    John MC

  • A Bone Marrow Biopsy is normally given when patients are over 60. Diagnosis of ITP is a process of exclusion. One of the reasons a Bone Marrow Biopsy is given is to exclude myelodysplastic syndrome or leukemia which can worsen with some of the treatments given for ITP. They are also looking for megakaryocytes which are the pre cursors for platelets that your Bone Marrow produces.

    Heavy reading but worth the effort:

    Seems odd that you respond well to steroids and now they want to give you a Bone Marrow Biopsy.

    Correctly done the Bone Marrow Biopsy does not hurt but the area can be sore for a while afterwards.

    There are many degrees of severity of ITP - some respond well to just low doses of Steroids - some don't respond to anything! - some bleed and bruise badly with low levels - some have no bleeding even with low levels.

    To give you an idea I have had and failed every available treatment for ITP and I am currently having 50mg of IVIG intravenously weekly at my local hospital. Each visit we start with a full blood count and my count does not get into double figures! However with this treatment I don't bleed or bruise easily.

    The best thing with ITP is to read all you can on the Internet so as to be able to discuss your treatment path with your hematologist.

    I have a great relationship with my hematologist - we are pretty much making it up as we go along at the moment because of the chronic refractory nature of my ITP.

  • Hi Gracee,

     I have not been diagnosed a year yet. I had a bone marrow test done with in the first few weeks, it is uncomfortable and i did feel alot of pain but that was more to do with the fact anesthetic wears off very quickly with me, ( have the same issue at the dentist and when i had my children.) with me i had bad bruising but me count was below 10 when i had it done.

  • It is very common to get one and should be done. I had a surgeon do my most recent as out patient hospital and was given the local, plus pain meds in my IV with a conscious sedation so I felt no pain. I HIGHLY recommend you ask for that!! I have had it done with only a local as a child in office and the pain was horrific. Good luck to you! 

  • Actually ITP is usually diagnosed by looking at the blood smear through a microscope. Only if something odd is found that doesn't look like ITP will a biopsy be necessary. The only exception is for those who are over 60 and those who are considering a splenectomy. Find a doctor who is experienced in treating ITP as your treatment so far has been unusual. Have a read of the latest guidelines too..

  • I did have the bone marrow test. It is one way to rule out it being a cause. It was quick and painless. Done on outpatient basis. Mine was negative.

  • I had a bone marrow biopsy done just last month and it was ok. It does not last long and is a fast proceedure. I ran into a problem for when the doctor said it would hurt for you can not freeze bone I felt nothing so he asked if I had many fractures. I told him I broke my back when I was 17 so he had to go into another area but when he hit my bone it hurt but not much now that might be because of lack of bone mass but It still went smoothly. I am glad I did it for No cancer found, pathologist said probably ITP.

  • Thanks much for all your replies. It was very much appreciated and helpful.

  • Bone marrow test is one of the diagnostic test to know the etiology of low platelet count. And knowing etiology will help your doctor for further management plan. Blood cell are produced from the bone marrow. So it is one of the important test to know whether there is less production of the platelets and if there is another blood related condition is associated or your body is producing enough number of platelets but it is your autoimmunity that breakdowns your cell. Plan of management is different for both the condition. I had undergone my bone marrow testing at the time of ITP diagnosis only. So if your doctor is advising for it please go for it.

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