In the present day, there can be a possibility of several underlying diseases that can prove to be fatal if not properly taken care of or well diagnosed. One among several other complications in humans are caused by the damage to the bone marrow which can result in numerous complications such as organ damage, bacterial infections, cataracts, infertility, new cancers and sometimes even results in death. Therefore, taking the quote “precaution is better than cure” it is better to be weary and act before anything serious happens.
Some of the known and common symptoms for a bone marrow failure could be persistent bone pain normally in the back, hips or ribs. Other symptoms include shortness of breath, tiredness and fatigue. But if properly taken care of and acted early upon it, considering the fact that “health is wealth”, one can have a conscious mind and avoid such complications by properly taking care of their body.
Anything related to bone marrow complications are not supposed to be taken lightly because this one condition yearly, results in 67 per cent of deaths throughout the world.
Even if one contracts bone marrow complications/bone marrow disorder, the underlying problems can be detected through a bone marrow biopsy.
1. What is Bone Marrow?
The soft tissue found inside the hollow of your larger bones is called bone marrow. A fluid and soft, sponge-like tissue make up the bone marrow.
The bone marrow produces various bone marrow cells each performing specific tasks. These bone marrow cells are:
- Red Blood Cells (RBCs) that is responsible for delivering oxygen throughout your body.
- White Blood Cells (WBCs) that acts as a defense mechanism against pathogens and infectious diseases.
- Platelets that clump together to form clots and helps control bleeding.
2. What is Bone Marrow Biopsy?
The removal of soft tissue that forms blood cells known as marrow, from inside the hollow parts of large bones is known as a bone marrow biopsy.
The ability of your bone marrow to produce healthy levels of blood cells can be determined through a bone marrow biopsy and a bone marrow aspiration. While a hollow needle is used for extracting a sample of the solid component of the bone marrow during a bone marrow biopsy, a small needle is used for collecting a sample of the fluid component (liquid bone marrow) during a bone marrow aspiration.
These techniques are used by doctors to detect and monitor blood and marrow disorders, including certain cancers, as well as fevers with no known cause.
3. Why is a Bone Marrow Biopsy Performed?
If blood tests results are suspicious or don’t reveal enough information about a suspected issue, your doctor may arrange a bone marrow biopsy.
A bone marrow examination (marrow aspiration and biopsy) is performed for it provides comprehensive information on the health of your blood cells and bone marrow.
There are various reasons for your doctor to perform a bone marrow biopsy. Listed below are few among other reasons for this examination:
3.1. Diagnose or examine a health issue
If a blood sample reveals an unusually high concentration of blood cells (red blood cells, white blood cells or platelets), your doctor may suggest a bone marrow biopsy. Bone marrow biopsies can assist in the diagnosis of a variety of conditions, including blood cancer (like leukemia or lymphoma), blood disorders, infections, etc.
3.2. Cancer staging
Cancer staging determines the extent of the disease’s growth. If your cancer has infiltrated to your bone marrow, a bone marrow biopsy helps reveal this. A bone marrow aspiration and biopsy can indicate whether a bone marrow tumor is expanding or not. If cancer cells are discovered in the bone marrow, it means that the disease has likely advanced to other regions of the body and has spread from the original site.
3.3. Monitoring Treatment Progress
A bone marrow sample can be taken to determine whether or not the treatment is effective. Take for example; if you are undergoing cancer therapy then you might have routine bone marrow biopsies that helps determine your response to chemotherapy i.e. if your bone marrow is being able to generate enough healthy blood cells.
Bone marrow aspiration and biopsy can also be opted for other causes like:
- Unexplained anemia (lack of red blood cells )
- Iron deficiency
- Cancers that affect the blood-forming tissues (lymphoma or leukemia or multiple myeloma)
- Hemochromatosis-a condition that leads to excessive iron buildup and subsequent organ malfunction.
Additionally, a bone marrow biopsy can identify vitamin deficiency and genetic abnormalities that can cause your bone marrow to create red blood cells which are distorted or disproportionately large.
4. How is the Bone Marrow Test Performed?
Both a hospital and a doctor’s clinic are options for a bone marrow biopsy. In most of the cases, the sample of the marrow will be collected from the pelvic bone or the breast bone.
The following procedures are used to perform a bone marrow biopsy:
4.1. Before the Procedure
To guarantee the best possible care, a specialist will ask questions about the patient prior to the bone marrow biopsy. Therefore, it is important that you mention your doctor if you have any medication allergy, what medicine you have been talking of late, if you’re pregnant or have any bleeding disorders.
Also, be sure to bring a friend along or it will be difficult to go home after taking the anesthetic shots.
4.2. During the Procedure
During the bone marrow tests the doctor may use an anesthetic to numb the pain. Generally a local anesthesia is used for this process.
You will then be asked to lie on your side or your belly (posterior iliac crest), depending on your biopsy site.
In order to numb the surface of the bone, your health expert will first wipe your skin with an antibiotic before inserting an injection.
After which, a small incision will be made and a specific biopsy needle will be inserted into your bone.
Further, a hollow needle will be used to remove a small sponge-like tissue (bone marrow tissue) sample. Since the hollow needle extracts a “core” or cylinder shaped tissue, this type of biopsy is thus called a “core biopsy”.
The needle and the sample will then be taken out and some pressure will be applied on the procedure site to stop any bleeding after which a bandage will be applied on the site.
The extracted bone marrow samples will therefore be sent to the lab for examination purpose.
4.3. After the Procedure
Since the bone marrow biopsy is done on an outpatient basis, you will return home on the same day the test is conducted.
Once you’re home, it’s crucial to keep the biopsy site dry and clean.
You will receive special bathing instructions from your healthcare practitioner. Keep the bandage on for as long as directed by the physician.
For pain reduction, it is advised you take the pain relievers as prescribed by the physician only, for consumption of other painkillers and aspirin may result in excessive bleeding.
If the pain still continues then you may take a non-prescriptive pain reliever.
5. How Painful is a Bone Marrow Biopsy?
Whilst performing this surgery, although the biopsy site will be numbed, you are most likely to feel a sharp pain or a discomfort.
Unfortunately, the bone cannot be numbed so one might experience a stinging sensation when the biopsy needle is being inserted or pulled out.
The bone marrow biopsy or the bone marrow aspiration is frequently made more uncomfortable by anxiety and nervousness about the operation.
Note that if the pain still continues even after several days of the biopsy or if there’s any complication contact your doctor as soon as possible.
These complications include:
- Biopsy site prolonged bleeding (hemorrhage)
- Increased pain, discomfort or fever.
- Biopsy site infection
- Biopsy site swelling
Depending on your situation, your healthcare practitioner may give you additional instructions that will help your body fight infection or swelling.
The lab results are often handed to you in a couple of days after the test has been performed.
A pathologist or hematopathologist who specializes in the analysis of biopsies will review the samples in the lab to ascertain whether your bone marrow is producing enough healthy blood cells and also checks for abnormal cells.
Once the results are out, the information provided in the results come in handy for the doctor who can now use the information to identify several conditions. Various disorders can be indicated by various biopsy results such as blood cancer, anemia, thrombocytopenia and thrombocytosis.
Thus, bone marrow biopsy and bone marrow aspiration is a short process that includes extraction of bone marrow tissue or the liquid portion with the help of biopsy needles, for diagnostic purpose.
These samples are used to diagnose numerous blood conditions, anemia, and blood disorder including specific kinds of cancer like blood cancers.
Although pain arises during the treatment, it can be minimized under proper medical supervision.
The operation however, carries a slight risk, especially for those taking blood thinners or those who have had a medical history. Yet, it is the sole way to learn with enough accuracy about several important factors that contribute to the aberrant development of white blood cell.
Hence, let us remember that while a bone marrow biopsy might be painful, it is a safe and crucial diagnostic procedure that can assist in the detection and monitoring of a number of illnesses, including leukemia, lymphoma, and specific blood diseases.
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