I have to say though the highlight of the week was getting to see the operation for the collection of bone marrow for a bone marrow biopsy. Sadly, I was unable to take pictures because I was watching an actual patient but I can describe the operation a bit.
Of course the operation starts with numbing the area (usually with lidocaine) just under the skin and then closer to the bone. The bone marrow is typically drawn from the Iliac Crest which can be seen in red below.
The patient usually lies face down and a scalpel is first used to make a small incision. Next a very very long needle (6 or 8 inches) is inserted.
For the bone marrow biopsy two samples are taken a fluid and solid (core) sample. As you can see from the top of the needle (the end not going into the bone) you can attach different things to it. For the liquid sample, a syringe is used to draw up the blood from the bone marrow. For the solid core portion, a drill is attached (which cannot be seen in the picture above) and a 0.5 cm to 1 cm core sample is taken out. Normally the slides aren't prepped for analysis during the operation but thankfully they were at the operation I was viewing. For the liquid portion, a cotton swab is used to basically press the blood onto the slides and for the solid portion, they take a tweezer and press the core against the slides.
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| Liquid |
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| Core *Note these are not pictures I took |
Last but not least I got to sit in on this bone marrow meeting among a bunch of doctors. The first part of the meeting was educational (but this was more of a formality since everyone there excluding me knew all the stuff being presented) and the second part was the hematology team going through all the patients that were seen that week. Listening in on that conversation or reading patient clinical notes I feel like I understand 75-80% of the stuff right now, which is much higher than when I started. Anyways, see you guys next week!
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| Meeting room |
Hey Justin! Wow this week seems like it was so much fun! Also, that's really cool that you got to sit in on a bone marrow biopsy! I had no idea that bone marrow was taken from the iliac crest! Are all types of bone marrow taken from the iliac crest like when someone needs a bone marrow transplant?
ReplyDeleteActually most stem cell transplants I are given from peripheral blood stem cells. Basically, they give you a drug that causes your stem cells to migrate out of the bone marrow and then take them out of the peripheral blood. For bone marrow transplantation only the liquid portion of the bone marrow, containing stem cells,is used.
DeleteNice Justin. I wonder if It was strange to see an actual patient be performed on, but it may have been just normal for you. Do you find that attending meetings where you sometimes don't know some of the content is beneficial?
ReplyDeleteI was a little weird considering it was the first operation I've every seen up close and in person, but I'm not really bothered by blood or anything so it was really cool to watch! And of course those meetings are beneficial! That's how I learn new stuff
DeleteHi Justin.
ReplyDeleteWhat an eventful and fun week. It's exciting that you got to watch the bone marrow biopsy operation. What factors from the bone marrow biopsy can make the patient unable to get a transplant? Great post this week and I am looking forward to next week!
The bone marrow biopsy is usually for diagnosis of the patient disease. But often age is a huge risk for transplantation simply because cannot tolerate as much or heal as well when you are older. However, for transplantation to occur, you also need the disease to be in remission from the chemotherapy (for malignant diseases) and you need to be on an immunosuppressive regimen so your body will accept the donor graft.
DeleteHi Justin! I think that it is really cool to watch a bone marrow operation. How is a bone marrow biopsy necessary for a transplant? I'm looking forward to hearing more!
ReplyDeleteYou need to get a bone marrow biopsy to check what's wrong with your bone marrow. From that point, you can decide what treatment you need (in some cases you don't need a stem cell transplant).
DeleteHi Justin. I was just wondering how people got myelofibrosis? Hope next week is as eventful as this one.
ReplyDeleteIt's caused by genetic mutation, though not one mutation in particular (a common one is the JAK2 mutation though). As for the cause of the mutation, it's pretty much impossible to pinpoint.
DeleteThat is pretty interesting Justin. While you were looking through the procedure did you think any steps could have caused some weight loss?
ReplyDeleteNot really. The bone marrow biopsy isn't a huge operation and there are really minimal problems (mostly with bandaging the wound properly). I would say the weight loss is due to factors after you get the biopsy (e.g. what chemo regimen you get/ length of hospital stay, etc.)
DeleteHey Justin. It seems this week was very fun. How does the process exactly help the patients? Hope to see you next week!
ReplyDeleteWell the biopsy doesn't help the patient by itself. It's for diagnosis of the underlying disease.
DeleteHey Justin. It seems like this week was really interesting for you. I hope the next week is just as exciting for you.
ReplyDeleteHey Jusin! It's awesome that you are actually learning the mechanics of a transplant. Hopefully, this knowledge will help you with your final presentation at the end of the project.
ReplyDeleteHey Justin! This week seemed so interesting, how was your initial reaction experiencing the bone marrow biopsy? And how is this knowledge eventually going to help you with your own research? I can't wait till next week on what you are going to share! :)
ReplyDeleteI don't think this will contribute to the weight loss study really but I still think it's really important to understand the full mechanics of transplant. And I really wanted to see this operation because it was my first ever!
DeleteHi Justin! It seems like yu had a very interesting and eventful week. So glad to hear you've performed an operation on a real patient already. Just wondering though, did you have any experience with this sort of biopsy or was the first time you did it on a patient? Thanks and looking forward to next week's post!
ReplyDeleteWell I didn't actually perform the operation myself but no, seeing this operation was a first!
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