I had my BMB yesterday and it all went well 👍🏻

[Pachena]

I thought I’d share that the whole procedure went well. I had a twilight sedation. I felt no pain.

They explained to me that I would feel the anesthetic needle sting and pain for about 30 seconds. I only felt the first insertion prick and nothing more.

Also they said that the bone cannot be numbed so I would likely feel like a sciatic pain going down my leg and to try and keep my knees up close and still to my chest regardless.

I didn’t feel anything. I did feel the vibration of the doc ‘digging’ for the marrow which had no pain. So I feel very grateful.

The nurse asked me afterward how I fared. When I told her as the above, she said that I would have felt it tho I just don’t recall. That could be likely.

I didn’t have any pain last night or now the following day.

The operating pathology haematologist asked if I had any questions or comments and I said I had dis-ease about using a chemo pill and he said it really wasn’t a bad drug and not like regular chemotherapy drugs. He said we feel at ease giving it to babies so you really don’t need to worry.

I see my haematologist at the end of the month for the results 😃

[Joetcalr]

I had a similar experience, and had been v nervous about having it.

[Pachena in reply to Joetcalr]

The man before me didn’t have any sedation and I could hear them suggesting he did. Maybe he had no one to drive him home and stay with him. The nurse said some people are in that situation. She said if she needed one, she would def have the sedation. It’s not a general, just a light twilight dose. I’m a fan of it now 😄

[GarciaB]

I’ve had ten biopsies in the past 18 months. Just using local numbing. I won’t say it gets easier, but I’ve never experienced intolerable pain. The anxiety is always worse than the actual procedure . I’m glad you got through it easily

[Pachena in reply to GarciaB]

wow, Garcia 😧 I didn’t realise there may more biopsies. Thank you for enlightening me. Mine is confirm the ET diagnosis, I am JAK2 positive 😶

[PhysAssist in reply to GarciaB]

Hi GarciaB,

May I ask what kind of biopsies you had, and what sites they were of?

I had a bone biopsy of my femoral chondrosarcoma with spinal anesthesia and light sedation, and woke to a pounding sensation in my pelvis [I was numb, below that, but the sensation was transmitted upwards by the bones] as he was using a hammer and chisel to excise some of the harder bone around the tumor. I don't remember what he said exactly, but it was to the anesthesiologist and I went out immediately afterwards.

I also had my knee replacement explanted [because of a joint infection] on my 55th birthday with a spinal and femoral nerve block under light sedation [because I was too septic for general], and I made a smart comment when I heard them drop an instrument- something like "I hope you were done using that, but no matter what, don't pick it up and use it again.

PA

[GarciaB in reply to PhysAssist]

mine we’re in my illium, for aml monitoring

[PhysAssist in reply to GarciaB]

Hi,

Wow, I'm sorry you're having to deal with that- I was assuming [ass-[not-you] me] that they were multiple sites like skin or whatever.

I will keep you in my prayers!

Best,

PA

[GarciaB in reply to PhysAssist]

thank you. Im in remission. Trying to stay that way

[Pachena in reply to PhysAssist]

😟

[LT55]

So glad you had a good experience! My recent BMB in March (with twilight sedation) wasn't bad either. The anesthetic needle hurt quite a bit, but was over quickly. My issue was that I was quite ill the remainder of the day and into the next day. Attributed to a reaction to the sedation. I am not 100% sure what I will do for my next BMB (i.e., sedation or not).

[Pachena in reply to LT55]

oh my sorry to hear you didn’t have a good day and after.

I’m a bit naive so I didn’t realise that it to possible that I may have more 😯

I guess if you need to have them often then you will try without sedation and compare the experience. I’m sorry to hear you suffered afterwards 🌸

[PhysAssist in reply to LT55]

Hi LT55,

If they think it was truly a reaction to the sedation medication [which would be more likely related to the Fentanyl/opioid component], they can pre-treat you with Zofran or one of it's cousins, or even Dexamethasone, which is a long-acting steroid the gas-passers use for intra- and post-op nausea and vomiting. most often with very good effect.

Best,

PA

[LT55 in reply to PhysAssist]

Thank you! Super helpful! Of course hoping it is a long time before I need another BMB!

[WRLM]

Wow! I wasn’t offered any kind of sedation when I had mine, and it was awful. It took almost 2hrs and a 2nd Dr had to be brought in. I really hope I don’t have to go thru that again, but if I do I’m definitely asking for drugs!

I’m so glad your experience was so easy.

[Pachena in reply to WRLM]

oh my WRLM 😵 My haematologist said she would give me sedation. I said thank you, I’m happy to hear that and she said no, I wouldn’t put you through it any other way. I’m thankful. My SIL said she was sore for months afterwards 😔

Gosh if there is a next time, ask for the twilight sedation 🌸

[PhysAssist in reply to WRLM]

Hi WRLM,

I don't know where you live, but my heme/oncology MD referred me to the interventional radiology department, where a PA [physician assistant] performed the procedure with fluoroscopic [moving picture X-rays] guidance, which was very slick, quick, and nearly painless.

If/when I need a repeat, I'm going back there- where they do multiples daily and so have it down to a science. I used to work in [a different health system's] IR dept and between lumbar punctures and CT-guided biopsies, I had more than a few every day- which greatly increased both my proficiency and speed. Patients truly appreciated both.

Best,

PA

[WRLM]

I will definitely ask for the good stuff, if there’s a next time.

Funny enough it wasn’t all that sore after, despite all the poking and prodding and shaking. It felt bruised if I rolled onto that side in bed for about 2 nights, but other than that it didn’t really bother me once the procedure was over. I have read about some people being very sore for weeks, so at least I had that going for me!

[Pachena in reply to WRLM]

A relief that the bruising was short lived 🤩

My SIL said she was sore for months 😔

[Sagiegirl]

Glad you had a pain free BMB.

I've had 7 in the last 10 years, and each 1 is different for me.

During my last one, we realised that I have so much more scaring in one hip than the other. That they had a go at both hips to get the sample they needed!

Unfortunately, I'm one of those people that is in pain for a week after the procedure... so I now make sure that I give myself a few extra days to rest.

I've done both twilight and not..... definitely take the twilight... so much better.

[Pachena in reply to Sagiegirl]

Gee SaggyGirl, I’m sorry to hear you have had so many BMB’s. I’ll have to read up why they do them more than once. The nurse did say to me some pathologists will take from both hips tho it was only one for me.

My sister in law who has ET said that hers bothered her for months afterwards so I was very lucky.

Thank you for sharing. I’m learning more all the time 🌸

[Mardigras]

Lucky you I’m so pleased it went well. I had mine done in the Canaries without any sedation. No picnic.

I really hope that your bmb results are good,

Kind regards

Marci

[Pachena in reply to Mardigras]

Thank you warmly 🌸

I now understand how fortunate I’ve been. ☺️

Best wishes to you, Mardigras, I’ll share the results when I find out 👍🏻🌼

[PhysAssist]

Hi Pachena,

I'm glad you had a relatively "painless" experience! The usual medications used in conscious sedation are Fentanyl and Versed, which have a lovely effect called retrograde amnesia- which is likely what the nurse was likely referring to.

You go through the experience, but since the combination [especially the Versed] interferes with processing your short-term memory into long-term memory, you quickly forget it.

It's kind of analogous to when you wake up knowing that you have dreamed of something, but you can't quite remember what it was. Most often, it's because something else [another stimulus like your alarm clock going off] occurs and interrupts you from processing the dream into your long-term memory storage.

Don't forget to ask about whether they performed "Next-Generation Sequencing" to look for non-driver mutations that can have an effect on you r response to therapy.

Thanks for sharing, my experience was similar to yours, but I was prone, and did [fuzzily] remember the core needle causing a "grabbing" sensation in my pelvis deep to the insertion site.

Best,

PA

[Pachena in reply to PhysAssist]

thank you for explaining that, PA 🤩

Very interesting esp when relating to a dream type experience.

If I have a similar experience again, I’ll ask the nurse if I had any physical or vocal responses to the procedure that I didn’t remember.

Thank you also for the tip on asking about the “Next-a generation Sequencing” when I see the haematologist soon 🤩👌🏻