In my early ill-advised Googling about Hodgkin’s lymphoma, I came across a terrifying procedure called a bone marrow aspiration that utilizes the aptly named (and trademarked) Jamshidi needle to bust into your bone and extract the needed marrow. When I read about this, I was obviously growing queasy at the mere thought of it, but quickly dismissed it as something that I wouldn’t have to deal with. I had enlarged lymph nodes. That can’t have anything to do with my bone marrow.
Oh, how wrong I was. Apparently this test is somewhat standard in making sure that the cancer hasn’t spread to my bone marrow. The sample also allows doctors to completely map my genome and see how I might respond to certain kinds of treatments based on my genes. I don’t need a flying car. This is Jetsons stuff!
So today was the day that I would meet the Jamshidi needle face-to-face…or more like…pointy end-to-lower back. This is diagnosis test 3 of 4 for those of you scoring at home, and it is definitely the one I most feared. Heck, this test was right up there with “what will chemo be like?” in terms of fear of the unknown.
This morning dawned with the increasingly familiar and incredibly welcome test-day buzzing of my cell phone. I can’t stress enough the stress-fighting ability of encouraging texts and Facebook messages and G-chats and greeting cards and e-mails that I’ve received every day. In addition to the firsthand support of my wife and my family, they help me to realize how many people care about me (in some cases, people I haven’t even spoken to or seen in a decade or more) and it helps me to feel like they are on my team, sharing the battle with me. There is no non-cliché way to say this. It helps so much. Thank you.
Armed with my aspiration doctor’s order and a new calm inspired by my inbox and Facebook wall, Theresa and I set off for the radiology department once again. I filled out the usual paperwork and we were taken to a staging area where they had me get into a gown and meet the fantastic Nurse Julie, who would be accompanying me throughout this process.
I never would have guessed that inserting the IV was arguably going to be the hardest part of the whole day. I’ve previously documented my overactive vasovagal response to needles, but I was feeling mighty proud of myself, as I hadn’t had a “spell” for the past several pricks of the needle. I figured my veins and my brain were toughening up from this endless testing. Unfortunately, they had used both arm veins already yesterday (once for an IV and once to take blood), so it was slim pickings for Nurse Julie. Also, because I had to fast from food and drink for 12 hours before the procedure, I was pretty dehydrated and my veins weren’t really popping. All of this basically led to Julie sticking me with the needle and failing to insert the IV. As I saw the droplets of blood coming out of my needleless arm, that old familiar coat of sweat wrapped me up almost instantly, and even Theresa’s usually distracting presence wouldn’t stop my vision from blurring.
Another nurse gave it a try after ice packs had been applied to the back of my neck and I returned to Earth, but she couldn’t get any veins to pop either, so she ended up using one on my hand, sort of between my thumb and index finger. It was not pleasant to me, but at least I didn’t freak out this time.
Needless to say, I had pretty much sweated out my initial calm and the dread was growing fast and furious as Nurse Julie wheeled me to the procedure room. The room had a big CT scan machine in the middle of it, with a long sliding bench where I would lie down on my side. I transferred from the cart to the bench and a tech named Jorge placed a soft triangular wedge pillow under my midsection, situating me at the right angle. They were going to needle their way into my iliac bone on the left side of my hip. It was actually more like my lower back and Jorge applied some sort of grid sticker (I think…I obviously couldn’t see) to the skin. Meanwhile, Nurse Julie stuck some oxygen device into my nose, put that “blood in your oxygen” measurement thingy on my index finger, attached a blood pressure cuff to my arm and EKG nodes to my back. Still no action on the IV. I was told there would be lots of sedatives?
The main doctor, techs and nurses all retreated into the next room while I was slid back and forth through the CT scan doughnut. Between my restless thoughts and fears, I could hear them chattering and assumed accurately that they were deciding on the precise incision point. The entire process is guided by the CT scan, so they know exactly where they’re shoving the needle and how much marrow they’re getting. I had the option of doing this procedure in a doctor’s office without sedation, but Nurse Julie told me that can sometimes result in not enough marrow being taken and the process needs to be repeated. No thanks.
After they had selected the spot, the team reemerged and went to work “freezing” my skin. The doc asked me if I’ve ever had Novocain, which I have, and told me I would feel the same sensation in my hip. He was right. It was a sharp needle feeling, which I didn’t mind too much, followed by a stinging that lasted a good 20 seconds as the anesthesia entered the skin. He put in a couple more rounds of that and Nurse Julie finally started pumping me with some happiness. I never fully passed out–this is conscious sedation, after all–and I still heard and felt (to some extent) everything they were doing. The next step was for the doc to “numb the edge of my bone.” This was most unpleasant, but a very difficult pain to describe. After that, I could tell that I was very numb back there.
“There’s going to be some banging now,” the doctor said. Sure enough, there was banging. This felt kind of like repeatedly hitting your funny bone with a hammer. I know the feeling was a dull shell of what I would have been feeling without the sedation, but the doc was really playing whack-a-mole on my hip. After that was over, I think everyone left except Nurse Julie. I looked over at the monitor next to the CT scan. “Wait…is that the needle inside?” Yep! I was feeling nothing, but the needle was inside me and I could see the CT scanner view of this on a screen above my head. Instead of being repulsed, I found myself being sedately intrigued.
The doctor returned with his minions and I was deeply sedated enough to not really even be thinking about the fact that the needle was about to come out. I felt some intense pulling that was also not very pleasant in a funny bone sort-of-way, but a few seconds later it was all over. I had survived a bone marrow aspiration! Everyone cleared out and Nurse Julie started cleaning up. She helped me move from the bench back to my cart, then she left for a while and I fell asleep. When I woke up, she was ready to take me to recovery, where I had to spend another hour and a half catching up on life on my phone while eating graham crackers and drinking apple juice.
All in all, this was not as bad as I had expected, even though I wouldn’t wish it on anyone and would rather not have to repeat the experience. I didn’t have any soreness immediately afterward and I still don’t really feel much.
It’s more that I’m expecting to be sore, so I’m still walking around the house like an old man. Hopefully I’m not jinxing myself and everything will stay as great as it is right now.
Tomorrow I will conclude “Matt Takes Tests” Week with a MUGA scan that will indicate the strength of my heart. I would think getting a Jamshidi needle shoved into my hip would indicate a strong enough heart by any measurement, but I guess they want to be scientific about it. This one should be pretty straightforward, though it does involve an IV, so we shall see.
Thanks again for all of the specific prayers for me today! I know they helped make it go smoothly and took away my pain. I’m also incredibly grateful for all the medical professionals that I have been meeting this week at Resurrection Hospital. I don’t want my (hopefully entertaining) sarcastic commentary to belittle the fact that they have almost all been fantastic. When you spend a lot of time in a hospital, it’s truly inspiring to see so many people who have devoted their workdays to just helping other human beings get better. I’m proud that so many of my friends have chosen healthcare professions as well. You are all amazing and I appreciate it so much.
“We have two lives, Roy, the life we learn with and the life we live with after that. Suffering is what brings us toward happiness….It teaches us to want the right things.” —from The Natural by Bernard Malamud (great quote, but I don’t recommend the book…see the movie)