medical tests of my first cancer (conclusion)

The story I was sharing with you in my last entry was running too long to comfortably fit into one entry, so I'll finish it here.

Dr. W. saved the bad test for last.  He always did the bone marrow biopsies himself.  The purpose of the biopsy is to get a sample of the soft center of the bone where your body makes your blood cells.  At least in my case, the biopsies are done on my pelvis, by going in through my lower back.  Dr. W. had me lie in a position halfway between lying on my side and lying on my stomach.

The biopsy began with a number of shallow and deep local anesthetic injections into an area of my lower back to help numb the tissue.  The injections were quite painful in that area, bad enough to make me grit my teeth and hold my breath.  Then Dr. W. penetrated to just above the bone with what felt like an ice pick, or the medical equivalent.  I've never seen a doctor actually doing the biopsy on me since he is standing behind me in a place which is blocked from my view by my own body. 

Don't think that I didn't feel anything of this penetration because of the anesthetic.  I felt plenty of pain and pressure.  Then Dr. W. injected the hard part of the bone with a local anesthetic.  This shot caused pain so intense that I nearly hit the ceiling, while I made a sharp groan of pain.  Dr. W. then took a mallet and a sharp object of some kind and began to chisle through the hard outside of the bone.  I could hear and feel the "chip, chip, chip" of the instrument forcing its way through the bone.  I was making quite a bit of involuntary noise throughout this.  Dr. W. had made Krissy wait outside the room during this procedure, and I was glad that he did.  I would have hated for her to hear me gasping and groaning in pain like that.

Finally he got all the way through the hard part of the bone.  Dr. W. told me that there was no way to numb the very sensitive marrow, and warned me that taking the marrow sample would hurt a lot, as if up to that point the biopsy had only tickled.  I braced myself and was certain that this time I would be strong and take it quietly.  But when he took the sample, I actually shouted with agony.  That finished the biopsy for the moment.  He cleaned up the area and put a dressing on the site.  He then explained that he had to do another bone marrow biopsy on the other side of my back, and that it would be best to get it over with quickly.  I won't bother describing the second procedure. 

The biopsy sites hurt for a week.  All totaled, I think I've had 11 bone marrow biopsies done on me.  

At last the time came to hear the results of the tests.  A nurse led Krissy and me into a very nice room which had a sofa and comfortable chairs; the room was reassuringly decorated and utterly relaxing.  Dr. W. came in and started explaining the facts.

I had Non-Hodgkin's Lymphoma, a slow-growing cancer of the lymphatic system.  The cancer was at stage 3B, which meant that it was in an advanced stage and was located in two distinct parts of my body.  They couldn't cure it, but with chemotherapy they could give me more time, maybe five years or so.  He went on to explain how NHL would progress and gave me other details, but I don't remember much about that now.  I do remember that he never used the word "terminal."  I'm glad he didn't; the word has an ugly sound.

Dr. W. said that the sooner I started chemo the better it would be for me.  He seemed to be waiting for a response from me, but I sat there feeling like someone had hit me.  The man had just told me that I was going to die.  That's why they had such a comfortable room:  to tell patients the bad news.

Eventually I agreed that starting chemo would be a good idea, though privately I wondered what I was getting myself into.

 

Some helpful notes about bone marrow biopsies --

If you ever must have a bone marrow biopsy, ask for an injection of morphine and 1 mg of ativan.  Put the ativan tablet under your tongue so that the medication goes quickly to your brain, where you want it to go.  The morphine will help a lot with the pain, of course, and the ativan will relax you so that you don't tense up during the biopsy.  Being tense will only make the pain worse than it has to be.   

Some of my oncologists have allowed me morphine and ativan, while others have refused.  At the very least, try to get the ativan.  That alone will help quite a bit.  But if you do get either of these drugs, be sure to have someone to drive you home from the biopsy.  Both drugs will impair your driving ability. 

I sincerely hope you never need to use this information.

Tags: bone marrow biopsy, oncologist, morphine, ativan, Non-Hodgkin's Lymphoma, chemotherapy, blogplugs