Pre-Transplant: Bone-Marrow Biopsy

Since this test and the traditional bone-marrow transplant itself are probably the things that create the most fear and anxiety in patients, I’m going to spend a little more time on it than on most of the other tests.  Here’s the process:

1. Find the right spot on your hip bones to take a sample.  The nurse or physician doing this will press hard on the back and/or front of your hips to identify the best spot to use.
2. Numb the area with Lidocaine.
3. Insert a hollow needle to the bone.
4. Push a second needle through the hollow one, down through the bone.
5. Withdraw a bone marrow sample.
6. Go to another nearby spot and take a bone-fragment sample.

Each of these steps has a component of discomfort associated with it.  Your health care provider may or may not provide sedation during this procedure.  Mine did not, but they allowed me to take an oral sedative I already had (from my own prescription), and gave me a new prescription for an anxiety relaxant for the additional bone marrow biopsies that were scheduled to take place after the transplant.  As with many things where pain is an issue, staying relaxed can make a big difference.  Take deep breaths and try not to tense up your muscles.



The biopsy itself, once begun, takes 15-20 minutes, but during that time you may experience pain or discomfort for only 2 minutes or less (I came up with 1 min. and 41 sec.).  Most of the discomfort is relatively minor (less than a 4 rating).  The sensation of drawing the bone marrow sample is perhaps the most memorable but also of the shortest duration.  They told me ahead of time to expect a sharp, shooting pain down my legs when they extracted the sample, but in my opinion I would have been better prepared if they’d described it like a low-level electrical shock instead.  Still, the sensation lasted for just a second and then was gone entirely.



For me, pressing hard on my hip-bones to find the right sample spot was perhaps the most painful part of the test, and took about 30 seconds to complete.  My overall opinion on the procedure is that the idea of it is far worse than the reality.  This is probably a great example of how knowing what to expect can vastly improve your experience.  That being said, taking a pain or anti-anxiety pill prior to the biopsy will really help keep your muscles relaxed, and I recommend that where able.

Bone Marrow Biopsy – Teri	Type	Rating	Duration
Locating Test Site	Pressure	5-6	30 sec.
Numbing Test Site	Stick/Sting	1-2	10 sec.
Inserting Collection Needle	Stick/Sting	2-3	20 sec.
Needle through bone	Grinding Pressure	2-3	10 sec.
Bone Marrow Sample Collection	Electrical Shock (down legs)	4-5	1 sec.
Bone Collection	Grinding Pressure	2-3	30 sec.

Bone Marrow Biopsy –	Type	Rating	Duration
Locating Test Site
Numbing Test Site
Inserting Needle
Needle through bone
BM Sample Collection
Bone Collection