Saturday, 10 May 2014

The Bone Marrow Biopsy

Considering the amount of biopsies I've had done and that I still have to have done, (every 3 months for the next 3 years.) I haven't really mentioned them before now.. my first experience of a bone marrow biopsy was pretty soon after I was admitted... I cried the whole way through it, pretty hysterically, whilst holding tightly onto the nurse's hand by the bed and covering the white pillow case with my black mascara tears.

I listened to the doctor explaining to me how the biopsy procedure would go, how it would be performed, that they were hoping to get a specific diagnosis out of it, the possible risks.. essentially everything I needed to know. I signed the consent form after everything had been explained, but if I'm honest, I was such a mess that I hadn't really taken on board any of the information I'd just been told. I understood, but I didn't want to. I never really wanted to know how bad my cancer was, or that it was indeed cancer. I just wanted to curl up and for everything to be done and dusted. Just like that. Life back to normal... but it doesn't work like that.
To date, I've probably had around 9 or 10 biopsies... I had one when I was admitted, one after my first cycle of treatment, one after my second cycle of treatment, one after my third cycle of treatment and one after my fourth cycle of treatment and I've had several more biopsies since then. Initially I was having my biopsies under a local anaesthetic, which is the standard procedure... you have a couple of shots in the skin/tissue of your back and then a couple more deeper down.. the needle goes in, (around those nobbly bobbly bits you can feel on your lower back) right into the bone and then your marrow gets sucked out, with a bit of pushing and pulling. With the pushing and pulling and having the needle in your back in general, I experienced a lot of discomfort. The pain shot from my back, straight down my leg and it was a very weird, uncomfortable and persistent sensation, with sharp shots of pain popping up every now and then to add to the pain that was already there. It's really hard for me to accurately describe the pain I experience... but I wouldn't wish it on anybody. Sometimes it wasn't as bad, but other times it was just unbearable and I'd kick out without intending to and have to have my legs held down until the needle was out. The more times I had the biopsy, the more I anticipated the pain and the tenser I got beforehand which didn't help at all. The first couple of times, I felt so rough that I don't think I was fully aware of the pain. It does also depend on who's doing the procedure, as some doctors put more anaesthetic in than others... there is also the option of having gas and air, but that didn't really work for me. For the majority of my biopsies I was crying so much that I was a big mess of tears, snot and dribble, I couldn't really grasp the whole 'breathe in breathe out' technique, as well as squeezing my Mum's hand and trying not to concentrate on the pain... I wasn't very good at multitasking. It might be because of my lack of multitasking, or because my pain tolerance got progressively worse with each biopsy, that the last two I've actually had done under a general anaesthetic. I'm slightly torn by this, as it does mean I spend the majority of my morning in hospital, (arrive at 7am, then I get home by about 12/1ish) although I am fast asleep and pain free with no clue what's going on during the procedure.. however a part of me thinks it might be easier to grit my teeth and just cry my heart out for 20/30 minutes, then I can run off home straight afterwards.

Obviously, everyone's pain threshold is different.. you might be reading this about to go for your bone marrow biospy, go in, have it done and then come out thinking that I must be one of those people who cry when they tread on a lego brick. I've sat on the day unit waiting to go in and have seen people three times my age go in and out of the room for their biopsy like it was nothing. It totally depends on the person and mine have definitely gotten worse the more I've had done, but that is probably down to me working myself up over it days before I know it's going to happen. For the type of cancer I had (Acute Promyelocytic Leukaemia) now that I'm in remission, having a bone marrow biopsy done every three months is the easiest and most effective way of monitoring the cancer if it comes back, which is why I have the biopsy and bloods done and not just blood tests.

It may not be as bad as you think it will be, my first handful of biopsies, pain wise, were bearable.. they just got worse with time. As with all procedures, if you're worried about scarring, it isn't too noticeable... like a faded dot to dot along your lower back!

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