Monday 16 July 2012

Does a bone marrow biopsy really hurt that much?

In case you are wondering, the bone marrow biopsy just takes place on a hospital bed, i.e. you don't need to go into theatre or anything, and all you have to do as the patient is lay on your side (flashing a bit of bum!) whilst a doctor first numbs the area at the back of your hip with a local anaesthetic and then inserts a large needle into your hip bone to extract a sample of: bone marrow (the flexible tissue in the centre of your bones) and the bone itself.  Once the procedure is completed, the samples are sent off for analysis, which takes a few days, and you are left with a small plaster over the biopsy site, which you can remove in a couple of days.  When the local anaesthetic wears-off, you will probably feel a dull ache at the biopsy site for a day or two, after which you may still feel some discomfort (it can take up to a couple of weeks before you no longer feel anything), but it is all pretty minor really; Initially, you may wish to take some paracetamol if you feel the need - I never bothered myself.

Putting aside the background information, the real question is: Does the procedure itself really hurt that much?  Well, in the last few years, I've actually had three bone marrow biopsies, one when I was initially diagnosed and another after each relapse, and every time the experience has been different, so the honest answer (at least as far as I'm concerned) is: It depends.  I'm not sure why each time was different, but they were all performed by different doctors, and the amount of time taken did vary - It may be a coincidence, but it seemed like the quicker the procedure was done the more it hurt, so perhaps waiting that bit longer for the local anaesthetic to fully kick-in is what made the difference.

My first bone marrow biopsy was nothing really, as all I noticed were three things: the first was the stinging as the local anaesthetic went in; the second was a weird kind of shooting sensation go down my leg as the doctor extracted the sample of bone marrow; and the third was some pressure as the doctor extracted the sample of bone itself.  To be honest, I was pretty relieved, as prior to having the procedure, the doctor (and a nurse) explained that the pain can be pretty bad, especially in younger patients due to their bones being harder, so I should feel free to swear or scream!  I was actually even offered "gas and air" (Entonox) to help take the edge off, but as it happened I needed to pick my parents up from the airport a few hours later, and I had driven myself to the hospital, so it wasn't really an option - You are not supposed to drive for about twenty-four hours after having it.

It was actually during my first bone marrow biopsy that I was introduced to the head haematology consultant, which is a bit of a bizarre story (one that never fails to amuse me), as I was pretty much just facing a wall at the time, so I couldn't see him, and I also can't help but think that the focus point for his view was probably my bum!  It was a while before I learnt what he looked like, and I'm not sure how long it was before he stopped recognising me by my bum, but it certainly made for one of the more unusual introductions I'm ever likely to have.

My second bone marrow biopsy was not too different from the first, as I mostly just felt the same things; The only exception was that early on in the procedure I also felt a sharp shooting pain go all of the way down my leg, which definitely hurt, but was over pretty quickly.  It was after this bone marrow biopsy though that I saw what the samples looked like; There was nothing really all that noteworthy about the bone marrow sample, but I was quite surprised at the sample of the bone itself, as it was much bigger than I was expecting: It was cylindrical in shape, a couple of millimetres in diameter and a few centimetres in length!

My third bone marrow biopsy was without a doubt the worst of the three, as I felt the sharp shooting pains a few times early on in the procedure, i.e. leading up to the sample of bone marrow being taken, and even the extracting of the bone marrow sample seemed to result in more of a pain than an odd sensation, but fortunately the latter part of the procedure was fine really - That didn't seem to match the expectation though, so I can only assume that typically patients find extracting the bone sample to be the worst bit.

A student nurse was present during my third bone marrow biopsy, as she wanted to see what happens during the procedure, but about halfway through a nurse asked her whether she was feeling alright, as it was clear the colour was draining from her face; The student nurse left shortly afterwards, as she said she was feeling sick - She was fine once she'd had a glass of water, but would have probably fainted if she had stayed!  I'm told seeing the size of the needle and it being pushed in does tend to have that effect on people.  After my first bone marrow biopsy, I remember a nurse telling me that they had to stop family and friends from being present during the procedure, as they had more problems with them fainting than with the patient having the bone marrow biopsy!


  1. I had it done yesterday. It's not exactly very nice but it's not that bad either. Definately manageable. I had the gas and air but didn't use huge amounts although when I stopped at Boots later for paracetamol, instead of giving them my Boots card for points I was trying to use my library card. Guesse it must have been pretty good stuff after all.
    What I would say to anyone facing this is don't be afraid, the reality is that it's not that bad at all. You can do it.