A Pain in the…

I’ve never had a good one, mind you, only “less bad” ones. The very first biopsy I had back in 2007 was by far the worst. Before the recent bladder infection, this bone marrow biopsy was the most painful thing I had ever experienced.  Oddly enough it was the only one performed by a doctor; all the rest have been administered by a physician’s assistant or advanced practice nurse. The first one was also when young, virile Jeff Cole refused the general anesthesia, a mistake that ranks among the worst in my life. Fifteen minutes into it both the doctor and I were drenched in sweat and praying, at least I was, for a merciful end to the agony. I’ve only had one other bone marrow biopsy without medication, which is usually morphine, Xanax, or Versed, and that was only because I didn’t have an escort that day. It was still bad but not like the first one.

I felt somewhat like a condemned man walking to the gallows as I was called back for the procedure yesterday, or at least like I think one would feel. The nurse started with administering the pre-medication so it will take effect before the procedure starts. I’ve had the same nurse several times before. She’s nice, dimming the light and turning on soft music so that I relax before the tortu…er, biopsy, starts. After a few minutes the provider comes in and gets down to business.

The pain comes in three waves. The first is from the lidocaine. It’s not really that bad. “A pinch and a burn” is the standard warning before the needle is injected, numbing the area down to the bone. Afterward comes the inserting of the biopsy needle, a large gauge instrument of torture outlawed in most civilized countries (or at least it should be). This usually brings only pressure, not pain, thanks to lidocaine. 

Once the needle penetrates the bone and begins the withdrawal of the liquid marrow, though, all bets are off. The marrow extraction, or aspiration, brings with it a sharp pain that often shoots down my upper thigh toward my knee. It hurts less when they go slower, but then it takes longer. There is no way to numb the inside of the bone, so it becomes a matter of breathing and hoping the meds help. Usually, they do, but only marginally. I once nearly shot out of the bed like a bottle rocket despite being groggy from morphine. It was probably funny for a bystander.

The final step is breaking off and removing a piece of the bone. This usually doesn’t take too long, but feels as bad as the aspiration. And then it’s over except the clean up. I’ll wear a thick bandage for a couple days and avoid a shower or anything else to cause infection.  We should get the results of yesterday’s biopsy within a week or so.

Lord willing, I’ll have only two or three more to check the progress of my transplant. Doctors can tell from the marrow if there is any cancer remaining in my marrow, as well as other indicators about the success of the transplant. As long as the results continue to be good, then at some point in the next couple of years I’ll no longer need to have biopsies. That will be a day to celebrate. 

For now, I have a reprieve for a couple months before the next scheduled biopsy, although I continue to fight GVHD. It has gotten somewhat better in my eyes, but I still have blurry vision and light sensitivity, although to a lesser degree. I will actually be wearing contact lenses again to keep the moisture in my eyes; it’s been eleven years since I wore them or glasses since having LASIK.

So, that’s the latest installment of what it’s like be a former leukemia and current stem cell transplant patient. If all goes well, we’ll be heading back to Kentucky in another three weeks or less. In the meantime, we continue to trust the Lord for healing and mercy, and certainly appreciate your prayers.