Tuesday, March 2nd, 2011 Last Thursday I went into Fairview Southdale for a bone marrow biopsy. They took two trephine samples (core samples), one from each side, and one aspiration sample. The marrow was extracted from the iliac crest of my pelvis. You can see the tiny incisions here.

The procedure was quick and uncomplicated. The doctor numbed up my ass with lidocaine, which of course burned like hell, and was probably the most painful part of the procedure. The needle was inserted down to the surface of the bone, where the doctor continued to inject lidocaine and probe until he could see that I wasn't reacting, and was therefore totally numb.

After numbing and swabbing the area with disinfectant, a scalpel was used to make a small incision down to the bone, then the doctor used the large bore needle with the green t-handle to poke through my bone into the delicious marrow filled center. The green handled needle is for trephine samples, and the slightly smaller blue handled needle is for aspiration (drawing liquid marrow with a syringe), however my doctor said that he prefers to use the green one for both because the blue one is too flexy.

As you can see from the picture, the biopsy needle has lots of parts. It is a hollow needle with a sharp end like a hypodermic so that it can be pushed through the marrow to cut a sample. In the hollow of the needle, there is a solid shaft with a V chisel tip so that is doesn't clog or kink while boring through the bone. In order to get through the bone, the doctor leans hard on the needle and twists. I could feel him pressing me into to bed with what felt like quite a bit of force. He commented a couple of times at how healthy my bones are. The nurse commented that it was a good thing that Dr Berntson was doing the biopsy, and not the other doctor who usually does them. I took this to mean that the other doctor is slighter of build, and would have had a tough time getting at my bone fillings.

Once through the bone, the solid penetrator is withdrawn, and the hollow needle is pushed in another couple inches to cut a sample. I could feel this because it's not possible to numb the insides of bones with a local anesthetic. To extract the sample, the rod with the yellow end is inserted into the needle. It is also hollow, and has a split end that slides over the sample and then grabs it. The biopsy needle is then pulled clear. It sticks a little because it's a very tight fit. The rod with the white end is a solid plunger used to poke the sample out of the needle into a jar.

After taking the first trephine sample, the doctor reinserted the big green needle into the same hole, and then screwed a syringe onto the handle and drew a sample of liquid marrow. I was surprised at how painful this was. As the plunger was drawn, I could feel a spreading pain up my back and down my leg.

The doctor then added more lidocaine to my other side, and repeated the trephine procedure. At some point, the nurse complimented me on how well I was doing. I guess that the last patient the had was, "a screamer". The nurse said, "She was 90 some years old. Usually those old broads can take anything, but she was screaming the whole time." I asked why she wasn't under general anesthetic, because I was offered the procedure with general or local. The doctor said, "It's interesting that you asked that. Actually, she was under mild sedation. Some people just don't react well to pain."

Unfortunately, provided everything goes smoothly, this is the last stop I'll be making in a hospital for a while. I really enjoy hospitals, they're full of such interesting machinery and gadgets. Even the toilet, which I forgot to get a picture of on my way out was weird. The bowl had strange indentations around the rim to hold sample collection pans or something.