Last Friday I underwent my 7th bone marrow exam since being diagnosed with leukemia in 2007.
A bone marrow exam is the technical term for what most people refer to as a bone marrow biopsy. In reality, what people often call a bone marrow biopsy is a 2-step procedure that includes (1) a bone marrow aspiration to draw samples of the liquid bone marrow from inside the bones and (2) a bone marrow biopsy to obtain samples of soft bone marrow that is in the hollow of the bones.
It is all taken from a tiny area on the pelvis/hip bone and let me tell you something. It hurts.
If the doctors want to do the full bone marrow exam, they typically do the aspiration first, which is to say that they draw the fluid first, that is the most painful part; they quickly follow with the biopsy.
In my experience, my 4th and 6th exams went wrong. My 6th went horrifically wrong. While the doctors would say that it was successful because they got the samples they needed (and in that regard I agree, they got the tissue samples they needed) I don’t think it was as successful as it could or should have been. It was traumatizing. You can read all about it here.
When I woke up the day after that 6th bone marrow exam, tears were on my cheeks and I had pictures playing through my mind of the events that had occurred the day before; my hip was throbbing and I looked out the window with such a heavy heart thinking that if I get well, I will have to go through many more bone marrow exams in my life and at that point, the thought of going through it again was almost too much to bare.
Last week I refused to allow myself to think of the procedure until the date was so close that I really could not ignore the facts any longer.
Thoughts of the exam started drifting into my mind pretty frequently on Thursday and I did all that I knew to do: prayed for courage, envisioned a better experience and then forced my mind to move to another thought.
When my husband woke me up Friday morning, I looked into his eyes and said that no, I did not want to go, that I felt afraid. He did what he does best; he pulled me up with a big hug and said “you can do it sweetie pie, it’s going to be a great day, your sister is going to be with you. you are going to be great today and tonight we will rest and watch a movie”.
Have I mentioned that he has been a saint throughout this trial?
Sistah picked me up and spent the day at the hospital with me. It sounds really weird to say that my bone marrow exam was a wonderful experience, but it was. They did everything right.
When we got to the clinic, the nurses took my vitals and discovered that my blood pressure was 88/55 (yes, that is low). They drew labs and then took us back to one of the bone marrow exam rooms. When the NP (I think that she is a Nurse Practitioner) came in, we talked about my last experience and what we could do to make it different this time.
She said the most magnificent sentence, it was something along the lines of: with leukemia, bone marrow biopsies are a necessary evil so we need to make it as comfortable as possible; we don’t need to make you hate them so much that you are too scared….
My heart smiled, she understood. And she took such good care of me.
Since my blood pressure was so low they could not give me anything to ease my nerves so she told us that we would not rush it, she decided to give me a liter of IV fluids to get my blood pressure up so that she could give me a light sedative.
Once a significant amount of fluids had been given, they checked my blood pressure and it was a little higher (still only 90 something over 60 something). It was high enough that they could give me just a tiny bit of sedative to help take the edge off. They also put a nasal canula of oxygen on me, so that might have helped with pain–I know it helped with breathing.
The things that they did that really made it amazing:
- The NP did not rush. When she injected the lidocaine into my hip, she went extremely slowly and massaged the area as she advanced the needle. So, the lidocaine really got into my bone tissue. Last time it did not get very deep which is why I felt everything.
- They had a woman massaging my legs throughout the procedure (when the marrow is drawn, you feel it down the back of your leg so that massage helped tremendously.
- Sistah stayed with me which helped decrease fear.
Granted, sistah almost fainted. Prior to the exam, they warned her that they would not be able to stop and pick her up if she passed out. She has a strong stomach and did not think twice about it (plus she was sitting down, so the risk of fainting was even lower).
They told her that if she started to feel faint to look at the wooden door and count lines on the panels.
Sistah confirmed to me that the bone marrow exam tool actually does look similar to a wine bottle opener. The NP rotates the device down into my hip and when she pulls it back up, test tubes fill with samples.
Sistah said she kept wondering if the NP lifts weights because she was twisting so hard to get the tool into my bone. Ouch.
A few minutes into it, sistah was counting the lines on the wooden door.
There were a few moments of “breathe deep” and “think about the beach” but there was no screaming, no trauma like the last time.
And I slept sweetly that night.
The next morning when I woke up, a song was playing in my mind. It is a song released by Celine Dion in 2002 “A New Day Has Come”
In every way my 7th bone marrow exam was the polar opposite experience of my 6th. God granted me mercy and I am so grateful.