Re: Bone Marrow Biopsy

From: Larry (Larry_at_nospam.net)
Date: 06/23/04 

Date: Wed, 23 Jun 2004 09:42:13 -0400

Gauge wrote:
> Larry <Larry@nospam.net> wrote in message news:<cbaieh$pne$1@news.btv.ibm.com>...
>
>>I am not a doctor, but a patient that has had 5 (sorry I can't compete
>>with your 8, but close enough :-)).
>>
>>I'm afraid that I really do have to disagree with you on this
>>(respectfully, of course). I have had many discussions with other
>>patients on this topic, and have also read many discussions on the topic
>>at the Multiple Myeloma Listserver. Please understand that I didn't
>>record the level of pain that each person experienced and I don't have a
>>tally ... I am basing my conclusions on my memory of these discussions
>>over the years ... and, of course, upon my own experience.
>
>
> Did you have medication before this or did the doc simply walk into
> the room and start drilling? What makes you think that when you're
> comparing yourself to everyone else that you're holding all other
> variables constant. E.g. a dab of EMLA cream on the area before adding
> lidocaine and demerol before the procedure starts can drop the pain
> from a 10 to a 5.
>
>
No meds at all. Just Lidocaine, and lot's of it.

>
>>It really
>>does have a lot to do with the practictioner's technique and upon the
>>individual's threshold for pain tolerance.
>
>
> The term "pain threshold" is pretty much meaningless until it is
> actually define and a procedure is devised to actually measure it.
> Perhaps there are a few people who have a low density of nerves in the
> place where the drilling is done. Perhaps anestesia helps some and not
> others. Anticipation anxiety plays a large role in how much pain the
> patient experiences too.
>
>
>>You are welcome to your opinion, but it certainly isn't accurate (IMHO)
>>to say "Bone marrow biopsies are famous for being extremly painful."
>
>
> I;m not basing this on opinion. I'm basing this on numerical fact. Go
> the the Leukemia and Lymphoma Societies discussion board and look
> around. You'll notice that everyone there who had a BMB has
> experienced large levels of pain.
>
>
>>Take a look at http://www.cancernetwork.com/journals/oncnews/n0004p.htm
>>

Well then I'm basing my statements on numerical fact also. Take a look
at http://listserv.acor.org/archives/myeloma.html , search on "BMB"
"Bone Marrow Biopsy", and "Bone Marrow" and I think you will find almost
as many people who feel the pain is tolerable as those that feel it
isn't. And I don't think you'll find very many who describe it as
excruciating ... some will say "very painful" or something like that.

>>This is a study of an analgesic where patients were surveyed on their
>>experience during BMBs before and after using it. Note the average
>>"pain" score of 3.97 (scale 1 to 5) across 26 patients with no meds.
>
>
> It says
>
> " 3.97 for previous procedures. The previous procedures were sometimes
> conducted with ------->analgesics,<---------- sometimes without."
>
> By the way, 3.97 is nothing to sneeze at since that is a 7.1 on a
> scale from 1 to 10. Not to mention that people can't accurately gauge
> pain with numbers in a non-subjective fashion. And that's a 7 out of
> 10 with pain meds. Pain meds don't work the same on everyone.
>
Never said it was pain-free or that it was something to sneeze at. But
3.97 is an average across 26 patients. Seems reasonable to me.

>
>>Just curious ... have you
>>had all 8 done by the same person?
>>
>
>
> The first was done by a an oncologist from my home town. He just gave
> me a shot of lidocaine and started drilling. It was a nightmare. I can
> tolerate pain pretty well but that was overwhelming. It was the first
> time I ever screamed from pain in the last 25 years. I had to have
> anotherone the next day at Dana Farber. I begged them to give me as
> much drugs as theyu could. They gave me demerol. That was a different
> doc. The next six were done by the same person with differing levels
> of pain, ranging from 7 to 9. I did some research during this time to
> learn how to lesson the pain. I learned that anxiety increases the
> pain. I also learned that EMLA cream can kill a lot of the pain. The
> last one was a piece of cake. The third one was kind of funny since
> the doctor said "Uh oh!" It was his first one and he thought he didn't
> hit the bone. He actually did but he didn't know it right off, hence
> the "Uh oh!" And, of course, I remind him of that occasionaly. :-)
>
> Pmb
I have had nothing more than lidocaine every time I've had one. Like I
said, it's not something I'd volunteer to do or go out of my way to do,
but I find it tolerable. I've never had to scream or yell ... the most
I've done is wince. I have more pain when the lidocaine wears off and I
roll over on it that night while sleeping. As I said, this has a lot to
do with the practitioner's technique and I think someone else said it
has a lot to do with the amount of lidocaine used. It's a very
interesting procedure as it results in a wide variety of experiences.

Larry

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