Procedures for Bone Marrow Biopsy & Aspiration

The procedure is actually 2 in 1: it's a Bone Marrow Aspiration and Biopsy.
quick definitions:
To aspirate is to remove (a fluid) from a body cavity by use of an aspirator or suction syringe.
A biopsy is a sample of tissue collected from an organ or other part of the body. A biopsy can be done by cutting or scraping a small piece of the tissue or by using a needle and syringe to remove a sample...
so ...
Bone marrow Aspiration removes a small amount of bone marrow fluid and cells through a needle put into a bone. The bone marrow fluid and cells are checked for problems with any of the blood cells made in the bone marrow. Cells can be checked for chromosome problems. Cultures can also be done to look for infection.
Whereas ...
A bone marrow Biopsy removes bone with the marrow inside to look at under a microscope. The biopsy of bone marrow is done first, and taking fluid (aspiration) is often done after the biopsy.
http://dictionary.reference.com/browse/aspirate
http://www.webmd.com/a-to-z-guides/Bone-Marrow-Aspiration-and-Biopsy

Adults usually have a sample of bone marrow fluid taken from the back of the pelvic bone. In rare cases, a fluid sample is removed from the breastbone (sternum) or from the front of the pelvic bone. Babies and young children may have the sample taken from the front of the lower leg bone, just below the knee. A bone marrow biopsy is only taken from the pelvic bone.
http://www.webmd.com/a-to-z-guides/Bone-Marrow-Aspiration-and-Biopsy?page=2

You will lie either on your side or face down, on your belly, for the biopsy.
(they put me on my belly)
(see image of gal on her belly getting the procedure)

The skin over the aspiration site will be cleaned with a special solution and a medicine (local anesthetic) will be used to numb the area. Then the aspiration needle will be put through your skin and into your bone to reach the bone marrow. You need to lie very still while the sample is taken.

The needle is then taken out. More than one sample may be needed, possibly from more than one place on your body, such as from both sides of the pelvic bone. This is more likely to happen if the biopsy is being done to stage a condition, such as lymphoma.

A bone marrow biopsy uses a special tool that twists into the bone.

(see image of new tool)

I love this tool! it's not as scary as it looks! see how small it looks in the doctors hands (above) and on the tray (below). This version does not require the doctor to twist the whole tool, just push the lever and the tip of the toll twists. On the tray below you see the same basic tool but with a handle that requires the doctor to push down and twist at the same time. Even though the tool and the hole it makes is never as bad as i imagine the twisting part really bugs me! i wonder why?
(see image of tray)
It is normal to feel pressure at the site and hear a crunching sound as the tool twists into the bone.

(this part always freaks me out as i feel the twisting and hear the crunching and it's just too creepy - a good time to practice self hypnosis!)

After the samples have been taken, pressure is put on the site to stop any bleeding. A bandage is put on the area. Each biopsy takes about 20 minutes. After the biopsy, you will remain lying down for 10 to 15 minutes.

(this has never happened for me at Kaiser! up and atom make room for the next customer!!!)

If the bleeding has stopped, you may do your normal activities. If you have been given a sedative, you may need several hours to rest. If you have an aspiration and biopsy from several places on your body, you may be given pain medicines to take at home or you may need to stay in the hospital overnight. How It Feels You may feel a sharp sting and burn when the anesthetic numbs your skin over the aspiration or biopsy site.

(i don't want to scare folks but i don't think it's fair to minimize. for me it's more that a Novocain needle at the dentist. I feel them smash into the bone it's quite sharp pain!)

You may hear a crunching sound and feel pressure and some pain when the needle enters the bone. The pain usually lasts for only a few seconds. During an aspiration, you may feel a quick, shooting pain down your leg as the sample is taken. This pain stops as soon as the sample is removed.

(the last Aspiration i had this really hurt. i had not been bothered by this before and i hope it was just the once as it felt like the sample of what they were taking was being sucked out all the way from my knee or something! usually for me the dramatic stuff is the drilling into the bone)

The biopsy site may feel stiff or sore for 1 or 2 days after the biopsy. You may have a bruise on the site. http://www.webmd.com/a-to-z-guides/Bone-Marrow-Aspiration-and-Biopsy? page=2

from the mayo clinic:
What happens after a bone marrow biopsy and aspiration? After your bone marrow exam, a large pressure bandage is applied to help minimize bleeding. If you had IV sedation, you'll be taken to a waiting area to recover from the effects of the sedation. If you're returning home after the procedure, have someone else drive you. Because the anesthesia may cause impaired judgment, memory lapses or slowed response times, you may be unable to resume all of your normal activities for another 24 hours.

If you had local anesthesia, you may have to lie on your back for 15 to 30 minutes to apply pressure to the biopsy site. You can then leave and go about your day, returning to normal activities as soon as you feel up to it.

Whether you had IV sedation or local anesthesia, you may feel pain or mild discomfort for a week or more after your bone marrow exam. If the pain is intolerable, ask your doctor about what kind of pain relievers you can take.

You can also try to control pain without medications if you're concerned about the health risks of pain relievers. For instance, applying a cold compress to the biopsy site may reduce pain. Light exercise, such as walking, may also help.
(oh i like that!)

Site care
Keep the pressure bandage on and dry for the next 24 hours. Don't take a shower or a tub bath and don't swim or use a hot tub. After 24 hours, it's OK to get the biopsy area wet and to replace the pressure bandage with a regular adhesive bandage. A small amount of bleeding is normal. However, if bleeding soaks through the bandage or doesn't stop with direct pressure, contact your health care team as soon as possible.
Other situations in which to contact your health care team include:

• * Developing a fever above 100.4 degrees Fahrenheit
• * Unrelenting or worsening pain or discomfort
• * Swelling at the biopsy site
• * Increasing redness or drainage at the biopsy site

Although you can often return to normal activities after a bone marrow exam, avoid heavy activity or exercise for the next 24 hours. This will help minimize bleeding and discomfort. http://www.mayoclinic.com/health/bone-marrow-biopsy/CA00068 kayla garelick daydreaming arts kaylagarelick@mac.com http://daydreamingarts.blogspot.com/