Not All Bone Marrow Biopsies Are Created Equal

Well, it's been two weeks, and Wednesday was the dreaded bone marrow biopsy, so I should probably add a post to my blog.

The majority of the past couple weeks has been pretty uneventful. After I made my last post, my care coordinator, Rachael Beers, contacted me to let me know that in addition to everything else, I need to get together with my dentist and have any unresolved dental work done before February 12 (which is 1 week before I'm admitted to the hospital), if possible. I was told at my last dentist appointment in October that I have three cavities that should be filled. That appointment was two days before my "working diagnosis" of Chronic Lymphocytic Leukemia. I knew a cancer diagnosis was coming, so scheduling a time to get the cavities filled wasn't a huge priority for me, as you can imagine. Now it is a huge priority and my dentist is all booked up. There was a cancellation on Monday the 14th, so I got one cavity taken care of, but there was nothing else. Then another cancellation happened for yesterday, but I was running a fever of 102 degrees, so they didn't want me to come in. I have another appointment scheduled for the morning of February 13th, but that's after the one-week window has closed, so we're hoping to get two more cancellations for this coming week and/or February 11th.

Last Sunday, there was a 24-hour urine specimen I had to collect and turn in to the lab on Monday, but I won't go into any further details on that other than to say that the test results show that my kidney function is just fine.

So...Wednesday. I went in to LDS Hospital Wednesday morning and got to start with the "easy" stuff. First was an EKG and ECHO in the Cardiac center. My heart is in perfect health, which is great to know, considering all the major heart disease issues men on the Philpott side of my family have had. The ECHO was cool. It's a sonogram of the heart, for those who have never had one done. I was allowed by the tech (Linda) to watch the whole thing. The human heart is absolutely amazing. watching the valves all working in tandem seeing shots that showed the rate of blood flow, measurements of the different chambers, seeing all four chambers at once with the aorta right in the middle of them all...it was so cool. Another neat thing was listening to the different valves working. I wished I had my phone handy so I could record the sound for my kids; I think they would have thought it was pretty cool, too. After the heart stuff was a chest X-ray - something I'm all too familiar with after my two bouts with pneumonia - and pulmonary function tests where I breathed into a machine in weird patterns. Then we - Noelle was with me - went up to the BMT clinic.

The first order of business was to draw some blood. Um...scratch that. The first order of business was to draw a BUNCH of blood - about 20 or 25 vials! They need to check for any and every infectious disease known to man, as well as check any and everything else they can from blood. Then we were taken to a room to await the bone marrow biopsy. Now, I had a conversation with Rachael, my care coordinator, a while ago about my last experience with a bone marrow biopsy. I expressed my trepidation about going through it again, though I knew I had no choice in the matter. She explained to me that because all they work with is blood and marrow cancer patients, they do a ton of biopsies and are very good at it. They would also give me more to help with the pain than just two Lorazepam pills. I asked if I could be put under for the procedure, and Rachael told me they want to avoid that if possible, due to complications that can arise from anesthesia. She did a lot to put me at ease, though, and so I went into the procedure a lot more relaxed than I thought I would be. The person performing the procedure was Steve, a PA in the BMT center who I knew from several other visits. We talked through the procedure and decided to use Dilaudid, Lorazepam and something else I can't remember to help me relax and feel less pain. So, the drug I can't remember the name of caused the muscles throughout my body to twitch uncontrollably throughout the procedure. If the overall pain rating for the last biopsy was a '10' (and I'm sticking with that assessment, by the way), then this one was probably a '6.' The worst part was the aspiration, which is when they suck out samples of the liquid marrow. I just don't think there's anything they can do to prevent pain for that part of the procedure. On the other hand, it wasn't as painful as the aspiration during the first biopsy. Then, when he took the sample of the "core," or the solid part of the marrow, there was very minimal pain, by comparison. I listened to music on my iPod during the procedure to try to help me relax, but I was pretty tense through the whole thing. I kept waiting for it to turn into a '10.' It never happened, so when I have to do this again I'll definitely be a lot more relaxed, knowing what to expect. The rest of Wednesday was spent at home, relaxing, recovering and missing an appointment with my dentist.

Yesterday morning I woke up with body aches and a fever of 102.3 degrees. If I weren't a cancer patient, I'd just take some Tylenol Cold and Flu and do my best to make it through the day. Unfortunately, I am a cancer patient, and a fever like that means I have to go in to the BMT clinic. After spending a couple hours there, there was no definitive diagnosis, but a 24-hour blood culture was done to see if I have influenza. 26 hours later, I'm still waiting to hear. I don't think the test will come back positive, but I've been surprised by other things before, so we'll see. So, yesterday was spent resting and not eating enough food. I had NO appetite at dinner time. Last night I didn't sleep well at all. I woke up at 2:30 to go to the bathroom, and was awake for close to an hour. Then I woke up again at 4:10 for no apparent reason, and was never able to go back to sleep again. So, yeah...today I'm very tired and I still have a fever and body aches. After eating some lunch I hope to be able to take a nap. We'll see.