Wednesday, September 20, 2006

Six months and counting

Today was an exhausting day, both emotionally and physically. I had my 6-month check-up at Dana-Farber. This was my first appointment in 3 months. It was a little scary to have no blood results for a 3 month period. In addition to blood work, I also needed a bone marrow aspiration and biopsy. (More on this in a little bit.)

I have written before about what it is like to be in the outpatient unit at Dana-Farber. In some ways it is truly awful and in other ways it is amazing. The first thing you notice is how packed the place is. The fact that this many people have to deal with cancer is unbelievable. Then you start to look at the people. Many of them have no hair and are wearing masks and gloves. It is a frightening sight because it makes you think that this could be you if treatment does not go well. I always feel a little out of place and guilty since I have not had to go through any of the same treatments that most of these people have had to endure. I am very lucky with the CML diagnosis and the ease of the treatment so far.

My bloodwork came back with almost all counts within the normal range. This is the hematological response that I had within a month of starting Gleevec. One of my oncologists then did a physical exam and everything was normal. Next was the bone marrow work.

A bone marrow aspiration is an important part of monitoring treatment effectiveness. Although much information can be gained from peripheral blood (regular blood draws), much more can be learned by looking at the marrow. The marrow is where new blood cells form. If they are producing more healthy cells than leukemic cells, that is a good sign. There are a lot of complicated tests and statistics associated with these tests, but I will not have results back for a couple of weeks. I will write more about this topic then.

The bone marrow aspiration and biopsy is an uncomforable and somewhat painful procedure. The worst part for me was the novacaine to numb and area on my hip. As I lied on my stomach, the doctor gave me a number of shots of novacaine and then there was a burning sensation soon afterwards. I think that area of the back is particularly sensitive anyway, so the feeling is worse. I never have problems with giving blood or getting shots, but these hurt.

The next step is removal of the marrow. In order to do this, the doctor puts a rather sizable needle through my hip bone and into the area where the marrow is located. Getting through bone is not so easy and he really has to push and twist to get to the right location. The best way to describe this is to think if using a corkscrew to open a wine bottle. When he does reach the right area, he then removes the marrow by suctioning it out. This is the weirdest feeling because it felt like an intense vacuum. My doctor described it as someone pulling on your leg, but I didn't find it that funny (bad joke). After he removed 2 large vials of the marrow (which looks like red blood), he then needed to biopsy a small piece of bone. This felt like a quick pop. Not too bad.

That was the whole procedure. It only takes about 10-15 minutes. Relatively speaking, it was not the worst pain I have ever experienced, but it was not something I am ever going to look forward to either. Now that the procedure is over, the waiting game begins.