How to Minimize Pain and Anxiety During Your Bone Marrow Biopsy

Having a bone marrow biopsy can be uncomfortable and/or painful depending on several factors. Looking back 11 years later, I can think of things I could or should have asked beforehand, as well as steps I may have taken to minimize the ordeal of it all.

I was overwhelmed before my bone marrow biopsy

My biopsy occurred the day after I first met my hematologist/oncologist, a chronic myeloid leukemia (CML) specialist. At that meeting, he spoke to me about my diagnosis, the technical and genetic components of CML, and the available treatments called tyrosine kinase inhibitors (TKIs).

It sounded like a college lecture and was accompanied by drawings of chromosomes and other things on pieces of paper. Parts of this explanation were way over my head, and the whole thing lasted three hours. Yes, three hours.

The doctor suggested I have the bone marrow biopsy then and there. I’m glad I told him I felt overwhelmed and unprepared and had a headache. So, he agreed to do the procedure the next day.

What the doctor told me beforehand about the pain

When I questioned him about the pain levels I might experience, he rather flippantly told me he would dab a lot of local anesthetic around the area and I could scream if it still hurt a lot. The doctor also told me there would be pain because when the needle is inserted through the outer layer of bone, that part cannot be numbed.

Oh, if I only knew then what I know now.

My experience was not helped by the fact that I did not know this doctor. His attitude seemed sarcastic, and this introduction to the CML world felt rushed. Nonetheless, I reported for the biopsy the next day.

I can still see him holding up the vials of lidocaine. The doctor said something like, “Look at me with a lot of this to numb your ‘bone-crunching pain,’” because that was the fear I described the day before. If that was an attempt at humor, it didn’t help.

What are your options for sedation and anesthesia?

If you tend to be anxious and sensitive to pain, it could be worth asking for something like a relaxant beforehand. Or short-term anesthesia through an IV to put you to sleep.

In my case, I asked after the fact why this was not done. The hematologist said it often took the patient longer to come out of anesthesia than to do the biopsy itself. He also said many patients have complications while being “under.”

However, if you feel like this procedure may be too stressful and/or painful for you to handle, you can ask for one of these measures. If I had to do it over, that’s the route I would take.

Through this community, I’ve learned those are reasonable requests. Some people have bone marrow biopsies done in a hospital. That may or may not lead to more stress. Stress makes everything worse.

What is the procedure actually like in the moment?

Mine was done in the doctor’s office, lying on my side on a cot and facing a blank wall. To his credit, my hematologist gave me a “play-by-play” account of everything that was going on. It was helpful, although a bit too detailed. He warned me when the especially uncomfortable moments would play out and repeated that I could scream if I needed to, although in a more caring tone.

I may have wanted to, but I just grimaced and probably held my breath when feeling the needle jockeying around in my bone marrow. It hurt, no doubt about it. But it was over quickly, and I obviously survived.

What steps can you take to prepare and recover?

There are a few other things I wish I had done (assuming I would be awake during the event):

• I would ask if it was okay to take an over-the-counter painkiller before the procedure. It probably wouldn’t make a dent in that amount of pain, but maybe it would take the edge off.
• I would probably take deep breaths or use other relaxation techniques if possible — communicating with the doctor what I intended.
• I would ensure my questions were answered and I felt comfortable with the doctor prior to the procedure. Trust leads to greater ease.

Finally, in the aftermath: relax at home. Don’t plan on doing a lot and try to rest. Bone marrow biopsies are not a walk in the park, but they don’t have to be the end of the world.

What was your bone marrow biopsy experience like? Let us know in the comments below.