Thursday, March 28, 2013

My Cancer Story: Bone Marrow Biopsies and Lumbar Punctures

I know I said on my earlier post that the next one would be about chemotherapy, but that is going to be my next one. This one I am going to discuss a bone marrow biopsy and a spinal tap so that when those stories come up in the future you will know more about the process.

Neither one of these procedures are fun and even thinking about them makes me cringe a little bit, but they are important to know about since it is all part of my story.

Before they start the chemo the doctors not only had to do a bone marrow biopsy, which they needed for finding out more information on the type of cancer and how many blast cells were in my system, but they also had to do a spinal tap to make sure that the leukemia was not in my spinal fluid.

What are blast cells? Blasts are the cancer cells and they do not carry any oxygen, which is why I had that severe pain in my leg, because blast cells were gathering in that area making it difficult for the good blood cells to get by and provide oxygen to the area.

One of the worst procedures I had to endure several times throughout the years was a bone marrow biopsy. Imagine a corkscrew being twisted into your hip bone. Did you just wince a little bit at the thought? It is OK, I did too. However, that is basically what a bone marrow biopsy is

A bone marrow biopsy (BMB) is exactly what it sounds like. Usually the bone marrow is collected in the hip bone, but can also be taken from other areas as well. This is not a pleasant procdure, and neither is the spinal tap for that matter. However, if I had to choose one over the other I would totally go for the spinal tap. Soon you will understand a little bit more about why. In order for the doctors to get a biopsy of the bone marrow I had to lay flat on my stomach (because they obtained my biopsy through my hip bone) and the doctor would numb my skin first, as well as the path the needle would pass through. After numbing that area they would tap the hip bone with the same needle to numb it as much as possible in an effort to reduce the pain. When the skin was numb they took another needle that was hallow, which I referred to as the "corkscrew"because this would take a sample of the bone marrow by the doctor putting a lot of pressure down on my hip bone and twisting the needle into the bone in a similar fashion as twisting a corkscrew into the cork of a wine bottle. The doctors are then able to use the sample of the bone within the hallow needle and allows for the next step. Now the hallow needle allows for the doctors to aspirate some of the bone marrow, which is really really painful since there is no way to numb that process. The sharp pain would shoot straight through my body, but fortunately the pain generally subsided after they were finished sucking out some of the liquid. Thank goodness the doctors administered a small dose of medication that helped relax me before beginning this lovely process.

Now onto another delightful procedure, a lumbar puncture, otherwise known as a spinal tap. A spinal tap, in my opinion, is not as painful as a bone marrow biopsy. There are a couple different ways of positioning oneself for this procedure and it usually depends on which position the doctor is more comfortable performing the tap. I tried all of them and there really is not a difference for the patient. For all of them you are basically positioning yourself in the fetus position. Then the skin is numbed and the path that the needle will travel, and the spinal needle (a very long ass needle) is inserted between the lumbar vertebrae and is pushed in until the doctor feels two pops. After the second pop the stylet from the needle is removed, which allows spinal fluid (cerebrospinal fluid - CPS) to drop and be collected into a vial. After this procedure is finished I had to lay on my back for a minimum of 30 minutes so the fluid could build back up and reduce the chance of a spinal headache or migraine occurring, which is one of the side effects. The spinal fluid is checked for leukemia cells, which would require chemo to be administered directly into the spin. Fortunately for me there were no signs of leukemia cells in my spinal fluid.

I also consider myself really lucky that I was out of it for these two procedures the first time. However, I did not know at that time just how many of each I would still have to do in the future. I had a total of 8 bone marrow biopsies and 6 spinal taps done throughout the years. Some of them were better than others, but I had a really really bad experience with both the spinal tap and bone marrow biopsy, which you will of course learn more about in future posts.

Both of these procedures contribute to the next phase. They help the doctors determine what types of drugs they should use for the chemotherapy cocktail and they help stage the cancer and the specific type. All very exciting stuff. :)

Lotza love!


4 comments:

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  2. You're amazing! Thanks for sharing!

    Amanda* http://modernhippiemomma.blogspot.com/

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  3. I'm absolutely petrified of either procedure. I'm wondering if they can totally sedate someone for it. I have high anxiety with needles in those areas.
    With blast cells and leg pain, did you have pain in both legs and butt/hips with progressive worsening? I read it's harder to treat when the blast phase is diagnosed.

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