Relieved it's over!

Let me begin by saying that my husband is physically very tough. I am not. I truly believe that I'm a wimp. And I'll be the first one to tell you so.

Today was John's first bone marrow biopsy (there will be many more in his CLL future). John was fine. I was scared to death for him. When we scheduled this, they told him that he had three choices. He could receive local lidocaine injections. He could have local injections plus IV meds. He could be put under general anesthesia and not feel a thing. I guess I don't have to tell you which one of those options I would have chosen.

I have read about a wide range of BMB experiences. It seems that the degree of pain experienced by the patient depends on a couple of things. All our bodies are not alike. Some people are just born with a higher tolerance for pain. But beyond that, there are different skill and experience levels of those who perform these procedures. I have read about many patients who said their BMB was no big deal. And then there are those who describe it as brutal and excruciating pain. John didn't think he wanted to choose general anesthesia. I convinced him he might be wise to at least take the IV drugs along with the lidocaine. Since he did not elect to be knocked out, the BMB could be done right there in Dr. Flinn's office.

On the way to the office, I had a tremendous amount of anxiety. John was fine. Sitting in the waiting room, I looked at John with big, anxious tears and asked, "Do you want me to go in the room with you when they do it?" He asked what I wanted to do. I had such mixed emotions. On the one hand, I felt like I would rather be in there knowing he was okay than sitting in the waiting room wondering what was happening. But on the other hand, I didn't want my frazzled nerves to create any unnecessary stress for him. I didn't feel like much of a comforting presence and I wanted him to have the option of saying it might be better for me not to be in the room. But he didn't say that, so I went. I figured that if I couldn't handle it, I could just close my eyes.

I did not look at any pictures or watch any YouTube videos about bone marrow biopsies. I didn't want to add to my anxiety. In my mind, I pictured a large needle going into John's hip and withdrawing marrow into a syringe. I imagined a painful needle jab piercing his hip bone. After John received the IV meds (ativan and morphine), they had him lie on his stomach and drop his shorts ever so slightly to expose the upper portion of his hip. While I was feeling fear and dread, John was cracking jokes with the nurses. I have to tell you that John actually helped MY nerves to relax a bit with all the humor because he kept making me laugh. We know all of the nurses in Dr. Flinn's office by name after eight weeks of Rituxan treatment last summer. John was loose and cracking jokes but I made no secret of how nervous I was. One of the nurses asked me if I wanted some IV drugs and I said, "I would if I didn't have to drive us home."

The NP explained everything she was about to do. The nurse who assisted her had told John prior to the procedure that the instrument they use to withdraw the marrow is like a tire plug with a T on it. John understood the implication of that. I did not. I have no idea what a tire plug is. I was still thinking "big needle."

Let me add an aside here. I have compassion flowing through my veins. Not only can I not stand pain, I can't bear anyone else's pain or suffering. I could not inflict physical pain on my very worst enemy. When my sister-in-law, Cheryl, was having my niece, Lexi, at home, I had to go lie down on the couch and get a grip on my emotions while SHE was in labor because her soft moans conveyed to me just how much pain she was in. It felt like my heart was going to come out of my chest and I got very lightheaded. But it had nothing to do with having a weak stomach. I don't have a weak stomach at all. I just felt so sympathetic that I couldn't hardly stand up for several minutes. I could never be a nurse.

Anyway, I just thought that might help you to understand my emotional condition today as I sat next to John on the table with his hip exposed and looked at the "kit" and the "instruments" as they prepared him for the procedure. John told me later that he didn't think the IV meds did much other than to relax him. And the nurses explained prior to the procedure that there is no way to prevent the pain of piercing the bone and extracting the marrow because you cannot deaden the inside of a person's bone. The only way to avoid that pain is to be knocked out. But they assured him (and me) that the intense pain would be over in about ten seconds. John was positive he could stand just about anything for ten seconds. I wasn't sure I could even look.

The first thing the NP did was to administer the lidocaine just under the skin. Then she started poking the needle all over the place, hitting the outside part of his hip bone. She told him it would feel like a bee sting. John said it didn't feel too good, but he continued to crack jokes.

Then she picked up this "thing" that did not even resemble a needle (in my opinion). Here's what it looks like...

When I saw it, I instantly understood why the NP made an incision in John's hip with a scalpel. You can't really tell from this picture, but the metal "needle" is larger than a heavy nail. It looks like it could be about the size of a Bic pen (and I don't mean the point of the pen). After the incision, she picked up this instrument and at that point my eyes filled with tears, I closed them and started praying real hard that God would let it be over quickly and not let John suffer horrific pain. She told him everything as it was about to happen. She had already explained that the aspiration would be the most painful part and that it would last about ten seconds. So when she began counting down from ten, I knew she was doing the most painful part. (I was praying.) And the next thing I knew, she stopped counting after she said seven. John said, "Is the worst part over?" And she said it was. I opened my eyes and the "thing" was still sticking out of John's hip. From that point on, I was able to watch.

She inserted clear tubes into the metal object into which the marrow seemed to just naturally flow into (kind of like blood flows out into the tubes when you give blood). I think she filled a couple of those and then she said she had to chip off a little piece of bone. She said, "I'm going to wiggle this around and it's going to feel kind of weird, but I have to make sure I do it enough to get a piece of your bone. If it comes out without a piece of bone, I will have to do this all over again." John laughed and said he definitely didn't want her to have to do that.

After jiggling the "thing" around a bit, she withdrew a tiny little bone fragment and said, "We're done!" She then removed the "thing" from John's hip bone. And John said, "It wasn't a walk in the park, but it definitely wasn't as bad as I thought it might be." I asked, "Worse than the kidney stone?" And he said, "No, the kidney stone was a lot worse." I asked, "So you definitely would not consider being knocked out for this the next time?" And he said, "No. It was very tolerable." I then asked, "What if I had to have one? What would you suggest I do?" And he said, "I would tell YOU to get knocked out." LOL.

I was so relieved it was over and he hadn't considered it excruciating that I could have cried tears of relief. They made him lie still for a while just to make sure he wasn't woozy from the drugs and would be fine walking out to the car. He insisted he didn't really even feel those IV drugs. He was ready to go.

I realized just how bad my nerves had been as we were getting on the elevator and I started to get the chills. I was again on the verge of tears and said to John, "I am SO glad that's over. I can't stand to see you suffer." He smiled and said, "But I really didn't suffer. You were in worse shape than I was."

So, it's over. He probably won't have to have another one for six months (when treatment ends the BMB will tell us if he has achieved a complete response to chemo). This one will tell us just how much of his bone marrow is infiltrated with CLL.

I have to admit that even though John said the BMB was tolerable, I won't be that brave if I ever have to have one. I will choose to be completely sedated. John is WAY tougher than I am. He drove HIMSELF to the doctor's office (from the dealership in Shelbyville) while suffering from a kidney stone that had blocked his kidney 100%. I never could have done that. I would have called an ambulance. That is just one of the many differences between John and me. And I admire him so much; I truly wish I were more like him. But I am so thankful that he likes me just the way I am.

Thank you all so very much for praying. I truly believe that the countdown from ten was abbreviated by the mercy of God. (I know that I for one was saying please, please, please as I prayed.)

John admitted that if he had to endure a full minute of the pain he experienced for a few seconds, he WOULD consider being put under. That's all I need to know in the event that I have to make a sedation decision in my own future.