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Pain & blood clot after bone marrow biopsy

by nancy524 on Sat Aug 25, 2012 10:58 am

I have a bit of an emergency and would really appreciate some quick advice about it.

I had a BMB on 8/10. A few days later I started having pain below the site. Atfer 6 days of excruciating pain, the worst I have ever had in my life, I found out from my doctor I was bleeding under the skin and I had a blood clot the size of a baseball in my right buttocks that was pushing against the sciatica nerve causing pain in my hip, thigh, calf and toes. It never let up and I could not sleep, walk, sit, stand or do much of anything except scream and cry in pain.

On Friday when I seen the doctor the pain had finally started to subside. But this morning when I woke up I have some pain in the lower leg, hip and pain shooting from where the blood clot was. Can this blood clot come back? Does it dissolve on its own? Or is this just after math pain from being like this for 6 days? I forgot to ask my doctor these questions, hope someone can answer for me. i will call him on Monday if this does not let up.

Nancy

Has anyone else ever had this and what did you go through?

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

Re: Pain & blood clot after bone marrow biopsy

by Dr. Edward Libby on Sat Aug 25, 2012 11:46 am

Generally clots like this will dissolve on their own and therefore surgery is usually not indicated or performed.

It takes many months clots like this to be reabsorbed by the body. No, you usually would not rebleed (causing a clot) weeks or months after a previous bleed (which ultimately causes a clot).

The pain may come and go and get better or worse, without warning or reason, especially in the first few weeks. If this pain feels different or is a lot worse than the previous pain you need to go to an Emergency Room immediately.
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: Pain & blood clot after bone marrow biopsy

by nancy524 on Sat Aug 25, 2012 1:27 pm

Thank you Dr. Libby, you are most helpful, I always appreciate the advice I get. I will be sure to watch for any changes. Nancy

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

Re: Pain & blood clot after bone marrow biopsy

by Dr. Ken Shain on Sat Aug 25, 2012 5:16 pm

I composed my advice below before I saw Dr. Libby's very pertinent advice. Since some additional thoughts might be helpful, I am posting what I wrote just in case:

It is difficult to assess this situation and help through the forum. So I would first recommend calling your hematologist office and speaking on the phone with an on call MD.

More than likely you irritated the nerves in that area again. This much pain and a hematoma (blood clot) are rare but can happen. The pain may be from the hematoma or a direct effect of the bone marrow biopsy if it was done a little too centrally. I have seen too many patients who have a very difficult time after a marrow biopsy where the nerves are impacted. This is usually a procedure with pain but only during the biopsy, not for days or weeks after, but it always a risk.

The recurrance of pain is concerning. It may be a number of things, including further inflammation or irritation of the "sciatic nerve", you may have caused a little more of a bleed somehow during the night that will stop spontaneously. However, hematomas can be quite significant in in the lower extremities- a lot of blood can pool there. So if you have become quite fatigued, pale, dizzy when you stand up I would be concerned about a significant bleed and you should get to ER. Another significant concern is infection. If you are having fevers, notice redness, tenderness, and increased warmth in that area you should go to the ER.

Again, the first thing to do is to get an MD on the phone if possible. Also, oxycodone or a similar medication for acute pain may be a good idea.

Please keep us updated. Hopefully this will remedy soon and without any significant issues.

Ken
Dr. Ken Shain
H. Lee Moffitt Cancer Center & Research Institute

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Ken Shain
Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor

Re: Pain & blood clot after bone marrow biopsy

by nancy524 on Sat Aug 25, 2012 7:59 pm

Dr. Shain, I have none of the symptoms you have mentioned. At this time I am having pain around the knee area going down side of right calf. At times during the painful 6 days, I was losing feeling in my toes and foot, then it came back, and lose again off and on during all this. My entry point was almost dead center of the back just below the belt line. It was usually on the right side of my hip the other 3 times and never had a problem.

I appreciate all of the help, and take it very seriously, as I know clots can also break off and travel to other parts and kill instantly. I will probably wait until Monday to call my doctor unless things get worse before then, I hope they don't.

This was the most horrible thing I have ever encountered in my life. I do take Vicodin [hydrocodone and acetaminophen / paracetamol / Tylenol] for the multiple myeloma, but it does not even phase this pain and my doctor will not give me anything stronger, says I don't need it, he cannot do it as he is being watched on what he gives out and he can't condone anything stronger.

Thanks, Nancy

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

Re: Pain & blood clot after bone marrow biopsy

by Nancy Shamanna on Sat Aug 25, 2012 10:31 pm

Hi Nancy,

Sorry to interfere, but wouldn't you think that there will be doctors 'on call', either at the emergency ward OR at your cancer centre? The medical residents and staff doctors will be right there to look after your health issues. At our emergency wards, there is a system of 'triage' in place so that people with serious concerns do not have to wait too long! Also, at the cancer centre, there may be a system in place taking calls 24/7. Believe me, medical people are used to the concept that medical treatment goes on around the clock!!

If this is the worst situation you have been in medically, I think you owe it to yourself to get it checked out and not suffer unnecessarily. There may be a treatment available to relieve your symptoms. Blood clots can also cause strokes, so you would want to rule that out!

I had some nerve damage too from BMBs ... kind of a buzzing sensation that went on for a long time, and which still recurs at times. I am sure that sometimes nerves get damaged during that procedure. Also some ongoing hip pain, leg pain, but not sure why ... not really as intense, though, as what you describe.

Nancy Shamanna
Name: Nancy Shamanna
Who do you know with myeloma?: Self and others too
When were you/they diagnosed?: July 2009

Re: Pain & blood clot after bone marrow biopsy

by nancy524 on Sun Aug 26, 2012 12:25 pm

Well ended up calling the squad this morning, pain woke me up at 2 a.m. and sat around hoping it just might of been something aggravated from the way I slept, but by 6 a.m. the pain was so intense and back the way it was last week, I couldn't stop crying so I called the squad and went to the ER.

Put an IV in and gave me Dilaudid [hydromorphone] and that didn't do much so 20 mins later gave me more Dilaudid and Toradol [ketorolac tromethamine]. Both of these only took the pain down by half. Kept me a couple hours and seen how I did and sent me home with a prescription for both.

The ER doc said it should clear up in a week. I hope so, but have my doubts. Nancy

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

Re: Pain & blood clot after bone marrow biopsy

by nancy524 on Mon Aug 27, 2012 1:49 am

OMG it's 1a.m. Monday morning and I am ready to scream. I have taken Dilaudid, Toradol and Vicodin all night and no relief from the pain at all. I do not know what to do anymore, I can't sleep, can barely walk. I can't find a comfortable way to lay, the pain is excruciating.

Is this ever going to stop??

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

Re: Pain & blood clot after bone marrow biopsy

by Nancy Shamanna on Mon Aug 27, 2012 8:49 am

Hi Nancy, I am so sorry to hear of this terrible pain that won't let up. It just sounds really awful. There must be some specialists who can help you, and it seems like back to your regular doctor, oncologist and the Beacon advisers too, to steer you in the right direction here. Hope you can get some help soon!

Nancy Shamanna
Name: Nancy Shamanna
Who do you know with myeloma?: Self and others too
When were you/they diagnosed?: July 2009

Re: Pain & blood clot after bone marrow biopsy

by nancy524 on Fri Aug 31, 2012 11:58 am

Just to update on what has been going on with me.

I saw my chiropractor on Thursday & Friday. He has helped me greatly with the pain. He said we need to get the blood moving and infection if there is any before this will start to heal. So he actually gave me a butt massage, he said where the blood clot was needed to be massaged to get blood flow back and the sore areas.

My coworkers liked that one -- a butt massage. But he's a doctor and sure while thinking how weird it was, it did feel good and right now I will do anything to help this. It helped by probably 85%. I actually had my first nights sleep without excruciating pain in 2 weeks. Who knew?

He said it will take quite a while to heal. My onc doc is sending me for a nerve test on the 4th, to make sure there is no nerve damage. My chiro thinks there is no nerve damage, that they just got too close to the sciatia nerve and screwed up. Hopefully this will heal in time, as of now this relief is very good.

Just taking it day by day right now and taking it very easy. Thanks, Nancy

nancy524
Name: Nancy Schwartz
Who do you know with myeloma?: me
When were you/they diagnosed?: diagnosed Dec. 2007
Age at diagnosis: 53

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