Bone Marrow Biopsies Literally Suck...with a bonus Dexter souveneir

Bone marrow has fascinated researchers for decades. It's amazing really, producing hundreds of billions of blood cells every day as well as lymphocytes for your immune system. It is also, unfortunately, notoriously difficult to get to. Luckily for me, doctors manage to do it anyway like in the bone marrow biopsy I had yesterday.

The day's visit began with collecting a vial or two (or 15) of blood to run all sorts of pre-transplant tests. Basically any disease they can test for using blood gets tested. If I currently have some sort of disease or infection that my body is masking or simply carrying, that illness could develop in full force once we deplete my immune system. We run all these blood tests to be sure I'm completely healthy...you know, other than the cancer.

We took so much blood from one vein it collapsed and we had to stick a second one!

Then it was off for the day's main event, my third ever bone marrow biopsy. I'll never forget the first one. It was easily the most concentrated, intense pain I've been in in my entire life (and I've had a baby)! I actually lost the ability to form words and could only scream in awful shrieky noises. (Yes, yes, shout out to Elaine Scarry for those who have read her.) My subsequent marrow biopsies have been much more tolerable, although still not my favorite way to spend a Tuesday.

In order to prepare for the biopsy my doctor ordered me to take four Ativan (.5mg each) before arriving at his office, and two more once I go there if I was still feeling anxious. For those who aren't familiar, Ativan (aka lorazepam) is an anti-anxiety medication that chills you out and makes my memories of traumatic experiences kind of warm and fuzzy around the edges. So six Ativan later I was ready for my procedure.

Transplant coodinator (to me): How are you feeling? ...other than high?
Me (smiling): I don't think I'm feeling anything *other* than high.

You'd want to be high too. That's only part of the needle.

Shortly thereafter I was rolled on my side and the doctor began preparing the site where he was about to dig for marrow. I think they roll you on your side so you can't see the torture instruments they keep back behind you, but they assure me it's just the easiest position for access to the bone. I'm skeptical.

At this point I'm a little fuzzy on how things proceeded. Cut me some slack, I couldn't see what was going on and I was drugged. The version I remember is mainly a series of me thinking up synonymns for "ouch" and "f*ck* but fortunately my friend took some pictures to help tell a more coherent and less foul-mouthed story.

Step one is, of course, numbing the area. I think they numb at various levels, all the way down to the bone. Just local anesthesia though, I get to be wide awake the whole time. The next steps are all a bit of a jumble, but they use a long needle to get down to my bone, then at some point switch the needle for a small drill to drill into my bone, and they use a suctioning device to suck a sample of marrow out of my bone. I kind of think there's a long thin tube (like a tunnel) that goes down to my bone and they can put different implements through it (like a needle or a drill) but that's just my best guess. I'm pretty sure the sucking part hurts the worst, though the slow drilling part wasn't great either. Pain shot all the way down to my knee, which I suspect was my marrow protesting its abduction.

"Ooh ah, just a little bit...ooh ah a little bit more!"

What they gather (the marrow) looks mostly like blood but it does have some little chunks of bone in it as well.

I was hoping for something a little more rewarding, like molten gold.

Finally the marrow is droppered out onto glass slides to be sent off to a variety of places for testing. First and foremost we'll test to be sure no cancer has snuck down into my marrow, since that can happen with Hodgkin's. I'm not entirely certain what other tests will be performed. Some will be to prepare me for transplant, others will further knowledge on blood cancers and transplants. Before the procedure started I mentioned how all the slides laid out on the counter reminded me of the t.v. series Dexter and his collection of blood slide souvenirs.

Most people would be reminded of looking under microscopes, I think of fictional serial killers.

Once everything was said and done, I was ready to be on my way. I insisted I was just fine to walk out on my own, but apparently I kept leaning on things and the doctor said I went out in a wheelchair, no ifs, ands, or buts. I wasn't happy about it, but I cheered up when they have me my going-home present.

My very own Dexter-esque blood slide!