Finally a BMB
I finally get a pain in my ass! Been looking forward to this for a week, or more. Well, not really the pain but eager to see how this most recent chemo was treating me. As I described in my last blog post, the blasts were too high to go to transplant so I had a reinduction of Vyxeos in order to hopefully drop the blasts low enough.
Last week my numbers were not high (looking at a combination of white blood cell count and absolute neutrophil count). This week, things had progressed well enough that they proceeded with the bone marrow biopsy.
My appointment to draw labs was at 6:45am. That meant leaving the house at 6:15am. That’s an even earlier wake up than I’m used to. Normally I wake up with the girls around 5:50-6am. The ride into the clinic was thankfully uneventful, although I do find it amusing to watch folks zip in and out of traffic to try to get that one extra car length ahead only to have to wait in line forever like everybody else at starbucks or chick fil a.
Despite having to wake up earlier than usual. I do like the early mornings at the clinic. It’s quiet and the only people there are a few patients but mostly the employees. It’s not have a few extra minutes to bullshit with the ladies at the front desk and catch the nurses to chat when they’re not being bombarded by impatient patients.
Getting there early also means that my lab results are back quicker than any other time of the day. So as I’m waiting to be seen by my doctor, I can get a better picture of what might happen. My platelets and hemoglobin were above the lower threshold so I knew I wouldn’t need any blood products today.
When the triage nurse is able to get me back into a room the nurse is already in there setting up the equipment to do the bone marrow biopsy. They get my numbers a bit before I do on MyChart but even though I thought things were good enough, it was still encouraging to see the nurse setting up and getting immediate confirmation that we were going to get to go through with the bone marrow biopsy.
I think of a bone marrow biopsy in 3 parts. There’s the initial prep work and numbing that they do with injectable lidocaine. First off they pick a spot that feels like it has some nice bone. They’ll lay a covering over my butt and low back. Then comes the numbing. Stick and burn as they describe it. Very similar to a mild bee sting. Nothing crazy. A little bit of discomfort but if you’ve ever gotten a tattoo then you’ve been through worse. They’ve got to get the area numbed up before they start drilling down into the hip. There’s a bit of a waiting period while we wait for the lidocaine to take effect. Usually the nurse and doctor will run out to get a few things done and I’ll either fall asleep or play on my phone. In this instance, I used the opportunity to take a side butt shot.
After the lidocaine has done it’s job and the area is nice and numb, now we really get down to business. I haven’t really been able to watch or video it so I can only describe it based on how it feels. The second of the parts is the actual aspiration of the bone marrow. Usually they’ll test the site with some kind of prickly things because they always ask if I feel any pain. There’s a sense of pressure but never pain. Then the fun starts. There’s a tool that they use to “drill” into the bone. I put the word ‘drill’ in quotes because I have actually had a bone marrow biopsy where they’ve used something similar to an electric drill. In this instance though it’s a hand tool that she actually has to force into the bone. There’s a marker on the tool that they can use to determine how deep they need to go.
It’s weird because at first you just feel a small amount of pressure. You don’t really realize just how much pressure they’re using until they release it and you feel yourself float back off the exam table. What I can feel (and vaguely see out of the corner of my eye) is the doctor pressing down and twisting, rather violently actually, trying to get down deep enough. It’s my ego bragging but I’m hoping that my bones are dense as hell (medical term) and I’m making them work for it. If you want to get a sample of this hot ass you certainly ain’t coming away without working for it. This is the type of ass that bites back if you ain’t careful. *emoji eyeroll*
Anyways, moving on. In BMB in the past, there’s this really weird sensation when they get it deep enough. You know they’re deep when you feel it in the front of your hip and not just from the pressure of the hip digging into the table. The doctor is always good and will ask from time to time how I’m doing. As they’re digging in there and driving this hand drill/needle thing down , there’s this deep-feeling that is the only way I can describe it. I was a bit surprised and pleasantly relieved when I didn’t feel it this time.
*Side note: if you’re feeling extra spunky you can search for bone marrow biopsy on YouTube and get quite a few good hits. Most make me squeamish so you have fun with that if you so desire.*
Aaaannnnddddd, I spoke too soon. Being belly down and just staring at the wall, I can’t see anything but I can hear them quite clearly when they say, “that area just doesn’t seem to be getting it. That sample won’t work.” So, guess what…. you guessed it, we get it to do it all over again. The doctor apologizes about having to do it again but I know that we need a viable sample to get this transplant party started and I’m eager enough. So eager in fact that I let them do a second drilling act in my poor little old hip. This time as they’re pushing and twisting and the pressure is increasing I feel that deep deep feeling in the hip. There’s no pain but it’s just on the border of hurting and you have this weird sensation that you’re expecting that there should be pain that never comes. I know they’ve got it this time.
I’m relieved and extra stoked when the doctor says, “that one will work nicely.” As the doctor cleans up and finally takes her glove off, she lays a gentle hand on my shoulder and asks if I’m okay. I wasn’t bad off before but yeah, I’m really good now that we’re done.
The 3rd and final phase of a BMB is the short recovery time spent on your back. They just got done drilling into your hip. Before they release you, they want to make sure that there is no excessive bleeding or any other issues that might arise. This is just time spent browsing my phone or staring at the ceiling. I’ve never fallen asleep during this phase. I guess the excitement of the process just leaves me too awake to fall asleep even though I’m quite comfortable laying there on my back.
With bone marrow biopsy done, now is just the waiting game. Results should be back by Friday. In the mean time, I’ll double check my bags to make sure I’m packed and ready. Tentative plan is a Thursday admission. So far for next week I have scheduled a pulmonary test, echocardiogram, CT scan of my chest, covid test, lab work, and one more doctor’s visit. It never stops.
I’ll have my hospital bags packed but I’ll also keep a lunch packed incase a short visit turns into a long day of chemo and blood transfusions if things do not go well. Hope for the best (plan and pack) but be prepared for the worst.