My consultant at the RD&E hospital has decided to carry out a bone marrow biopsy in March and an abdominal scan. The biopsy is so that he can get a base line for disease progression.
I'm just after some general advice about what to expect during the biopsy and also for the few days after. I'm assuming that I will need to be driven home afterwards?
Many thanks
Ian
Hey,
I know when I had mine the thought was much worse than it actually was.
They applied some local anaesthetic to my hip and lay me on my side, it was uncomfortable but not particularly painful.
I don’t know if you have to be driven home, I was in hospital anyway when I had mine but afterwards I don't recall feeling anything other than a little sore so you may be ok to drive, it should say in your paperwork.
paul
Hi Paul
Thanks for your reply. I'm sure you're right that the thought is much worse than the actual procedure!
I haven't received any paperwork yet, the procedure is in March so I'm assuming I'll receive something in the next couple of weeks.
Thanks again
Ian
I had one earlier this year. Local anesthetic only, experienced person doing the BMB. No pain really just the odd feeling of pushing and pulling during the procedure. Recovery was not an issue, a bit sore the next day then was back to normal.
My wife drove and I would suggest you have someone drive you to and from as well. The anesthetic gave me some light vertigo for a couple hours afterwards and I would not have wanted to drive in that condition. The hospital required that someone drive me so that made it an easy decision.
Best of luck and don’t let your imagination get the best of you.
Hiya, I have had several bmb, they used to give me twilight sedition, a quick shot of lorazepam, and then you were waking up and it was over, obviously if they do that , you need to be accompanied and driven. But more recently they did it as described above , with a local, but apparently this doesn't actual numb the bone, but it's pretty quick and you mostly feel pushing and pulling. Take some painkillers before local wears off. The worst problem have had is that it for a few days after the site feels like a bad bruise on back of hip, which made sleeping a bit tricky, since rolling over on it would wake me up, and I am not good when sleep deprived. But yes, it's not as bad as you would think, although please laugh at any Dr that tells you it's just a bit of discomfort. Good luck
I had mine done in December and like you thought it wise to get a friend to drop me off and pick me up. Procedure was a little uncomfortable as Dr drew out the marrow but over in seconds . I had no after effects other than a little tenderness over the site but not enough to need painkillers . Would have been able to drive but nice to have someone to chat too after the procedure. Took several weeks to get results and confirm type of MPN. Hope all goes well in March
Hi Ian, , in my view much can depend on the skill of the bod performing the procedure as to ones level of discomfort. I've experienced both skilled and trainee. For your first one I would expect it to be carried out by someone well practised and you'll be fine.
It should normally take 20 - 30 mins with local anaesthetic. There are 2 parts , one being the bone marrow aspiration (spongy bit) and the other to take a sliver of the solid portion. Together called a Bone marrow exam.
The level of discomfort varies from person to person so depends who you ask but most folk tolerate them quite well. As it goes apart from my first one I didn't, but for a couple of mine that was partly due to the inexperience of the person doing it. At least one was a trainee under instruction but they need to learn it by doing.
It helps if you can take your mind to a good place like holiday memories or round the golf course etc while it's done.
As for driving home I did on one occasion but was using patient transport for the others because of the distance to the hospital. Your lower back will likely be bruised for a few days and a tad tender at worst.
Anyway good luck with it and as Paul says the thought and build up is often much worse than the reality.
Chris
I am sure you are right Chris it depends on the person doing it, I mean even having my bloods taken can vary. Mostly it's fine but very occasionally it feels like it's being done by a drunk with a screwdriver.
The worst pain I've ever had was having a cannula fitted, had them fitted quite a few times In recent years with no issue but when I was 23 I was rushed to hospital with a serious asthma attack and they had to fit one, the guy who did it for some reason just couldn't do it, that and the fact I could hardly breathe I was in so much pain and discomfort, the following day my arm was black.
He is lucky because had I not been unable to move because of my asthma attack I think I would have fitted the cannula on him, right where the sun doesn't shine
😆
Tried to reply a couple of times Paul but lost them as site or tablet playing up. Briefly I can empathise because i had similar issue with cannula , nurse trying to force it in back of hand, I said I felt a bit woozy after a few minutes of her waggling it around. She announces to the ward "we got a fainter" I said you'd feel queasy if I did this to you. A senior nurse came took needle out which was bent by now said I had a gait in my vein and simply inserted a replacement higher up in my arm.
A bad experience like that early on can stay with you put you off having blood taken etc.
One of the best things about having a Stem Cell Transplant is having a Hickman or Tessio Line inserted. Giving blood via your line is a doddle, open the wee tap and out it flows. I do miss mine.
Chris
Thanks Chris, RD&E have been really good to me so far, so fingers crossed I'll get someone very experienced doing it!Ian
I have had three. The first, 20 years ago was under sedation and absolutely fine. The more recent ones, with local anaesthetic, were uncomfortable rather than painful but I ached for a couple of weeks afterwards. I don't think driving home would be a problem but if possible, it's nice to be a bit pampered afterwards.
Thanks for your reply, I think I will try for the pampered option!Ian
I travelled home afterwards on the bus having refused a friend's offer of a lift. How I regretted that decision! At that time I had no idea what a BMB involved and hadn't taken any painkillers beforehand. I wouldn't make that mistake again if I have to have another one.
Trueblue8, as others have mentioned about skill levels do ask before you go how many bmb the person scheduled to perform the procedure has done. My wife suffered for months because of inexperience. The next bmb was going to be done by an MD who had done twelve and she told that doctor no and requested someone who had done more. That individual was a nurse practitioner who over the course of seven years had done hundreds. It made all the difference especially when the anaesthetic wears off. The three hour ride home was uneventful and she healed quickly. The same nurse practitioner will be doing the next bmb at the end of this month.
I would definitely suggest some sort of sedation other than a local. Evidently I'm one of the few who had problems with it. My hematologist did it in the clinic, using a local. For me it was extremely painful but over quickly. But then the fun began. The nurses kept me lying down and put pressure on the place before dressing it. Fine so far.....but it's a good thing I had to sit in the waiting room of the clinic to get the results of my blood test because when I stood up to go to the bathroom I discovered that I was all wet....with blood!!! The tiny wound had opened and there was blood everywhere, even down to the floor.
The nurses grabbed me and pulled me into one of the treatment rooms where the doctor gave me two pills to stop the bleeding. By that time my clothes were soaked, so they gave me hospital pajamas to go home. My buddies, the nurses, joked that I was showing off the latest fashion.
The entire are where the BMB was done turned almost black and was was extremely sore
for quite awhile. This wasn't due to inexperience of the hematologist or the nurses. They had done many BMBs prior to mine. And one of the nurses who's worked there for 20 years said that was only the second time she had ever seen anything like that.
There's an upside though. When I went back after a couple of weeks to talk to the hematologist about my results he said he was sort of happy the whole thing happened. It showed him that I'm more of a bleeder than a clotter.
Anyway, if I ever need a BMB again 😱 I'll ask for sedation and those anti-bleeding pills.
Sorry to hear that you had such a bad experience with your BMB, thankfully it sounds as though it's fairly rare! I must admit though, if I get offered sedation I'll take it! However, the general consensus is that the thought is worse than the procedure!Ian
Defo get someone to drive you home, when I had mine they take one for the liquid and one for the bone, I had what they call a dry tap couldn’t get any liquid so had to try to go in again without success, needless to say bit uncomfortable to go home, not saying to frighten because all over in mins but need to be prepared.
Hello Ian,Long time no speak. I hope you are keeping well.
I had a BMB 8 years ago at RD&E as a base line before starting Hydroxy. Mine went very well, my daughter came in with me and drove me home after. I had gas and air, I might well have gone for sedation if offered but they said it wasn’t possible as an operating room would need to be booked and have it at a later date. I just wanted to get it over with. I certainly puffed on that gas and air, although much quicker than having a baby! 😂.
I went back to work the next day. (Sat in an office)
Good luck, I’m sure you’ll be fine, they are all so lovely there.
Judy xx
Hello Trueblue8I had my second BMB three days ago, a skilled Dr is not hesitant, completion is quick. I can say it has an uncomfortable moment, a little sharp pinch and firm pushing, all over before you know it, not something any of us would choose but bearable. I went home on the train afterwards, a three hour journey, made sure I got up every twenty minutes to stretch my legs.
The wound site was a little sore especially as I kept forgetting and sat down too quickly.
Good luck with your BMB , hope it is quick, smooth and untroubled for you.
Take care
Nellin
My BMB was quite uncomfortable and I did get the impression it was not done very well! However, with just a local anaesthetic which continued working for some time after, I walked home following the procedure. All the best with yours!
I've had both in recent ti,es. A bit of discomfort after the BMB burt was able to drive home after both.
HiOddly I posted the same a couple of months ago.
Just to re assure you - the BMB procedure was fine. My wife drove me home although I think I probably could have driven. A little tender for 24 hrs after the local anaesthetic wears off but nothing too bad.
Thanks for your reply
I’ve a two, both in the office. Felt some pressure and was over in like 2-3 minutes. I was fine following bmb, just a little sore at injection site, but not bad at all.
Hi Ian The bone marrow biopsy is a little painful & may last around 15 mins. The scans are non invasive so you should be ok to drive afterwards. I was fine & just a bit sore for a couple of days.. Good luck..
My first BMB was in 2008 in the doctor’s office at age 52. He first injected a numbing agent and then did the biopsy. It was a simple, quick procedure. I drove myself there and back. I was diagnosed with Et jak 2.
The second one was in 2019 prescribed by a new hematologist, but she wanted it done in a hospital. Even though I had light sedation, the procedure was painful and uncomfortable, and I was sore all weekend. I was diagnosed with post Et Mf.
My third one was in 2021 to determine whether I was a candidate for an SCT. It was similar to the second one. So my conclusion is maybe the BMB experience depends on what stage you are in your disease, since the first one was so mild.
I wish you well.
Cindy
I forgot to mention that the second two biopsies, since I was on light sedation, I did have someone drive me and take me home.
I’ve had two BMB and would describe them (the second one in particular) as more a tussle than acute pain. They are quite physical.
I’d definitely vote for the being driven home option. The first one I made the mistake of a brisk 30 minute walk back to the car (getting slower and limping somewhat the further I walked and the more the anaesthetic wore off). I then sat down with an exhausted thump on the edge of the bucket shaped car seat bang on the injection site. And nearly passed out. The next time the car was parked in a nearby multi story and I edged in gently. Recovery was much quicker second time around! Good luck!
Hi, like others here have stated I think it all depends on the skill level of the person doing the procedure. When I had mine it was done by a hematologist with 40 years experience and local only and I had no pain whatsoever. Maybe a little pressure and strange feeling when he aspirated the marrow out but no pain. My wife was with me to drive me home but I feel sure I could have if I had wanted, back to normal the next day. Best to you on your BMB.
I have sent you a private message regarding your postJan
Had a BMB done to confirm diagnosis and establish a base line. Mine was done by my MPN specialist who has completed many. It was done with just local applied at the site. I unfortunately am one of the few that experienced a painful procedure. It was much more physical than I had expected (the doctor kept saying "strong bones" and was actually sweating by the end). Luckily a lot of the pain was somewhat mitigated by the local and I filled a prescription for hospital grade Tylenol immediately.Had my wife drive me home which was definitely the right move. I was sore for about 10 days with the first day being very difficult to move. I don't think my experience was routine/normal ( have talked to many people who only experienced the pulling/tugging sensations and were a little sore for a couple of days - so I think in general that is the much more common experience - thankfully). Given all that, still very happy I did it as I always crave data and the BMB helped provide some important information and probably most importantly set a baseline. I am sure yours will be OK!
I’ve had three, first two a bit uncomfortable since feeling of marrow being sucked out. Last one painless, the hem extracted the core very slowly and I didn’t notice!
So say to hem please extract slowly and you will be fine.
I drove home all three times, no problem
So please don’t worry
Thank you for your reply and the advice
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Bone marrow biopsy first time 
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Bone Marrow Biopsy 
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