Bone Marrow Exam from This Side of The Needle

doctor of freinkenstein

Famous Physician

Tomorrow is the big day.

Bone marrow biopsy.  Technically I am having a “Bone Marrow Exam”. Bone marrow biopsy just sounds so much cooler and people sort of understand what it means, which is why I use the term. For those of you who do not know much about bone marrow procedures, briefly (and without too much graphic detail) bone marrow provides really great information about what is happening at the cellular level.  During a bone marrow biopsy the doctor takes a solid/bone sample of tissue and during a bone marrow aspiration the physician takes a fluid sample. Usually both are taken during an all encompassing procedure known formally as a Bone Marrow Exam.

I had 5 of them in 2007-2008.

So tomorrow is not really that big of a deal. But it kind of is because I will see the oncologist, have the procedure, start a new chemotherapy, hope that my body can handle the new chemo, hope that the new chemo works, and wait for the results of the bone marrow exam to confirm what the doctor suspects (that my body has become resistant to the current chemo).

This is the deal with bone marrow biopsies, or bone marrow exams. Most people are given twilight sedation to get through it. Twilight sedation is strong enough that you don’t really feel much but is light enough that it does not require an inpatient anesthesiologist (so the procedure can be done at the cancer clinic, outpatient).

There are people out there who don’t get sedation with bone marrow exams, and if I understand correctly some hospitals do not offer it. I am not one of those people. I go with the sedation option and even sedated, there is a moment where I always wake up.

 The same oncologist who performed my bone marrow exams in 2007-2008 will perform tomorrow’s exam. He trained at America’s top cancer center. He is a good oncologist and knows what he is doing (it just still hurts, no matter who does it).

~So This is How it Goes~

I get to the cancer clinic.

They send me to the lab to draw a bunch of blood and I go through that awful internal conflict of emotion, it happens every time: I feel sort of sorry for myself that I go through this stuff but at the same time, I feel guilty because I can guarantee that just an hour ago a really fabulous person was in this same chair close to dying, so I have no right to feel any sense of self pity. The way I deal with it: I ask the people who are drawing my blood to tell me about their families, or I notice that their scrubs are cute (I used to think that scrubs with designs were not cute, now I find them to be a wonderful distraction, amazing how your opinions change according to your vantage point).

 Then they send me to a room and put me in a hospital gown, and from then on, I am freezing cold.

 I waiver between states of complete silence and then being super chatty (because that is what I do when I am nervous, I giggle and talk too much). Fortunately my sister who has the gift of cool sarcasm will be with me, so she can give me something to laugh at while I shiver with nerves in the gown, in the cold room, on the cold table.

Then the nursing staff start coming in and they are really nice. I continue to be chatty and just stupid silly because I am nervous. They always know how to deal with nervous people talking in nonsensical circles about absolutely nothing (I have provided them with plenty of practice). After many questions, chart updates and vitals, they start the IV drips and I try really hard to stay awake because nobody wants to be that person who never fell asleep before the procedure started.

In real time, before you know it, you are actually totally asleep and the procedure has been going on for a while. That is when the oncologist announces something along the lines of “ok Jessica, I am going to (puncture your tail bone with a wine bottle opener)”. I cannot remember exactly what he says but he does alert me that he will be doing something that might hurt.

And each time, I must open my eyes because I always see this thing that looks similar to a wine bottle opener and I always hear myself make a small yelping sound and then the next thing you know, I am surrounded by people who love me saying my name while I try so hard to wake up in a recovery room. And I know I look so ugly because I am sleeping so hard, but there is nothing I can do to fix it (because I really was drugged).

So, that is how it goes.

Except for that one time

…the 4th out of the 5 exams in 2007-2008….

There are only a few places which harvest enough bone marrow that the doctors can rely on as a good source. The most common place is a tiny area near the hip. Tiny area. That year, my doctor had to go to that area for samples 5 times. The 4th time he hit a spot where he had already taken samples. Holy Smokes. I came off the table. Actually I didn’t because I was sedated but I remember crawling up the procedure table and in real life it was probably a pretty funny scene (watching me try to escape, slow motion).

When I woke up my doctor explained what had happened and that he was going to send me inpatient for the 5th exam where they could do the procedure under fluoroscopy (it’s like a moving x-ray) while putting me under stronger sedation. Too many samples had been taken that year so it was very hard to not hit a spot that had already been hit (especially without the fluoroscopy).

It’s been right at 7 years and I am hoping that the bone marrow hip area is all healed up, that it won’t hurt the way it did that 4th of 5 times.

 If you are praying for us these days, please pray that I get through tomorrow smoothly. And please pray that this crohn’s flare stops. It hurts horribly. Truth be told the chron’s pain is my biggest problem these days. It is awful. As I will be starting new medications tomorrow, I must be able to get food on my stomach to help with nausea. Please pray that God will be merciful.

Thank you again for your support.

Wrapping it up in gratitude, today I am grateful for:

1. Strong support from family and friends

2.  A warm house and bed

3. My husband’s patience and unconditional love for me

4. Scrambled eggs (which I wrote about just the other day)

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