Jul 10, 2009

On Lumbar Punctures and Bone Marrow Harvests

Left: image of bone marrow harvesting courtesy of Wikipedia

If you ever hear a physician use the words "bone marrow harvest" or "bone marrow biopsy" or "lumbar puncture," I recommend that you discreetly sneak out the back door of whatever institution in which you might be present at that moment.

I'm just sayin'.

There can be nothing pleasant when a doctor inserts sharp pointy needles in your back, that's for sure, and despite all the promises that "Lidocaine will numb you up," there are some bizarre and painful sensations when those needles run into stray nerves. My physician assured me that I would only feel "heavy pressure," but there were some moments when the sharp pain in my back radiated down my left leg like a lightning strike.

Even stranger than the electrifying nerve sensations is the sound of hearing the T-handled trephine needle being twisted into your posterior iliac crest. This is a crunching and grinding noise that I assume is akin to that which accompanies a Velociraptor making quick work of your bony carcass.

The funny part was when the nurse said that "it's usually after the Lidocaine wears off in 3-4 hours that people feel pain." Oh, goody: you mean the real pain starts later?

If there is anything positive about such procedures, it is that they last about 10-15 minutes. This time will be reduced if you can manage to keep from tightening up your back muscles, though this is much easier said than done. Bone marrow harvesting also goes faster if the physician does not produce a "dry tap," which is when the syringe fails to suck out sufficient marrow.

I learned that term the hard way, I might add, as the first two suction attempts failed to produce any meaningful amount of marrow.

Luckily I have the weekend off, with the exception of some grading and lecture prep, so if I feel like bayoneted Jacobite Highlander after the Battle of Killiecrankie later today, I at least have the solace of knowing that work can wait another day.


Anonymous said...

Why are they doing all that backstabbing, Mikey?


historymike said...

Meh, they are looking to rule out anything in the hematological neoplasm family of happy-happy joy-joy syndromes. Some of my numerous symptoms and diagnoses could be explained with a hematologial/oncological diagnosis.

Ltlop said...

I had a spinal tap 2 yrs ago,the dr. said he uses a smaller guage needle. It will take longer but there is a lower risk of severe headaches afterward

historymike said...


I must have had the better needles, because the dreaded post-puncture headache and "flu-like sympotms" did not materialize. I actually felt halfway decent, save a moderate back ache.

Middle Aged Woman said...

For most of my numerous back punctures, I have been put out with magic happiness. For the next ones, though, they need me awake. I am not looking forward to these (radio frequency rhizotomies, if you care to look them up.

Mad Jack said...

Some of my numerous symptoms and diagnoses could be explained with a hematologial/oncological diagnosis.

Right. And what if the symptoms are not explained by this somewhat uncomfortable process? Does the practitioner get a dose of their own medicine (so to speak), or do they simply break out the next stainless steel plaything from their highly specialized toy box and tell you to brace yourself, as there may be some discomfort?

My suggestion is that you hire two or three gorillas and have them attend this medical augury, with the understanding that if said augury results in a divination of 'cloudy, ask again later' or some such, the high priests, assistants, apprentices, sycophants and subordinates will each and individually have a stainless steel roto-rooter inserted into their lower digestive tract without benefit of lubrication.

I'm only half-kidding. I've seen some of these practices and they can be filed under the category 'never again', but the part that bothered me was the casual air of non-suffering indifference the medical personnel displayed during the process. As for me, I always ask for alternatives and the ramifications of not having the work done. I've avoided pain and monetary suffering that way.

Anyway, I'm genuinely sorry you have to suffer through it.

Anonymous said...

If you're adding to the list of "medical tests to sneak out of the room for," I'd recommend avoiding an EMG at all costs too.

(It involves needles stuck into muscles and electric shocks. Ick...don't even want to think about that anymore, now that its over.)