oh boy: going under the knife

[nutmegs]

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Finalizing the plans to undergo an iliac bone marrow harvest in a few weeks. 😱 So far am going for autologous blood donation and got the OK to get Toradol. Just curious what experiences people have had with regional anesthesia for this (no, I don't want general. yes, I'm sure) and if you were to undergo it/provide care for it yourself if you'd go with a spinal or epidural.

I always wanted to make a thread with a cookie icon.

 

[jwk]

Finalizing the plans to undergo an iliac bone marrow harvest in a few weeks. 😱 So far am going for autologous blood donation and got the OK to get Toradol. Just curious what experiences people have had with regional anesthesia for this (no, I don't want general. yes, I'm sure) and if you were to undergo it/provide care for it yourself if you'd go with a spinal or epidural.

I always wanted to make a thread with a cookie icon.

Interesting - I've done harvests here and there over the years, but we've never done one with a regional as far as I know, which is surprising considering the number of epidurals we do each year for other types of cases.

I guess the main thing that comes to mind is the big blood loss in a short period of time after you've knocked out your sympathetics. Our guys usually draw off 1000-1500cc of marrow in 30-45 minutes, and we're doing good to keep up.

 

[nutmegs]

Interesting - I've done harvests here and there over the years, but we've never done one with a regional as far as I know, which is surprising considering the number of epidurals we do each year for other types of cases.

I guess the main thing that comes to mind is the big blood loss in a short period of time after you've knocked out your sympathetics. Our guys usually draw off 1000-1500cc of marrow in 30-45 minutes, and we're doing good to keep up.

the propaganda I got says about 75% are done under general, 25% under either spinal or epidural- about evenly split. my recipient isn't huge, so I think it's going to be closer to one liter. it'll be done at a hospital that is renowned for their regional program, and the marrow doc said they do them under regional often. 👍

 

[OB1🤙]

However it works out, let me know, because I'm probably going to get one of these in the next few weeks too.

If given the choice, I think I'll personally go with GA, though thinking about it, maybe regional would be an interesting experience.

Let us know how it goes.👍

 

[Fastrach]

We've done these under an epidural, but I'd think a spinal would likely be more than adequate for this, which at our institution is an outpatient procedure, or at the most an overnight stay with d/c in AM.

 

[nutmegs]

However it works out, let me know, because I'm probably going to get one of these in the next few weeks too.

If given the choice, I think I'll personally go with GA, though thinking about it, maybe regional would be an interesting experience.

Let us know how it goes.👍

I don't particularly want to be proned by anyone. Are you being given PBSC as a choice? I was given the option- which initially seemed like a no brainer- but the more I thought about it the more I didn't want to face the next 40...50...60? years of being a neupogen experiment. I'll let you know how it goes. We're trying for Nov 13th.

 

[Tuohy]

If it's being done at a big regional place, is there any anesthesiologist there who can do this with some lumbar PVB's? That is how they have done sometimes in the past where I am at-plus no/minimal sympathectomy-Typically, 3-4 segments should cover it...

 

[OB1🤙]

I don't particularly want to be proned by anyone. Are you being given PBSC as a choice? I was given the option- which initially seemed like a no brainer- but the more I thought about it the more I didn't want to face the next 40...50...60? years of being a neupogen experiment. I'll let you know how it goes. We're trying for Nov 13th.

It's very early on in the process for me so we haven't gotten this far yet- as of yet they're still reviewing some additional health info they asked for, but they have told me that they have a match and that it will likely go down soon once that review is done.

 

[zippy2u]

Outpatient ASC away from teaching institutions, GA with LMA by CRNA with anesthesia doc supervising, local infiltration by surgeon with plenty of long acting LA---it ain't brain surgery. Regards, ---Zippy

 

[badasshairday]

Going under the knife sucks. I'm going to have to get a right tonsilectomy..

 

[periopdoc]

If it were me,

2-chlorprocaine spinal. +/- a little propofol sedation. Local by surgeons.


-pod

 

[urge]

However it works out, let me know, because I'm probably going to get one of these in the next few weeks too.

If given the choice, I think I'll personally go with GA, though thinking about it, maybe regional would be an interesting experience.

Let us know how it goes.👍

Are they paying you guys for this?

 

[OB1🤙]

Are they paying you guys for this?

Yeah, in karma points.

 

[urge]

If it's being done at a big regional place, is there any anesthesiologist there who can do this with some lumbar PVB's? That is how they have done sometimes in the past where I am at-plus no/minimal sympathectomy-Typically, 3-4 segments should cover it...

Why would you want to do that?

 

[nutmegs]

Outpatient ASC away from teaching institutions, GA with LMA by CRNA with anesthesia doc supervising, local infiltration by surgeon with plenty of long acting LA---it ain't brain surgery. Regards, ---Zippy

ASC isn't an option, the regional collection center for the national marrow registry is at a big teaching place. You do a lot of prone LMAs?

 

[militarymd]

ASC isn't an option, the regional collection center for the national marrow registry is at a big teaching place. You do a lot of prone LMAs?

I do some prone LMAs....depends on case, body habitus, and co-existing dieases.

 

[Jalopycat]

Let us know how it goes. That is so great you are sacrificing yourself to do something like that. Were you on the bone marrow registry or did you know somebody and you turned out to be a match?

 

[Code Brown]

Finalizing the plans to undergo an iliac bone marrow harvest in a few weeks. 😱 So far am going for autologous blood donation and got the OK to get Toradol. Just curious what experiences people have had with regional anesthesia for this (no, I don't want general. yes, I'm sure) and if you were to undergo it/provide care for it yourself if you'd go with a spinal or epidural.

I always wanted to make a thread with a cookie icon.

Had wrist surgery under regional... kinda weird hearing the drilling and all but it wasn't a big deal...

 

[nutmegs]

So... harvested. BIG thumbs up to the spinal. I remember 2 of midaz being pushed and blips of the spinal going in... remember the prep and her saying "ok, I'm injecting" but not any pain with the lidocaine or needle itself. Sort of like a lot of heavy drinking. Great block, time flew in the OR and I was awake the whole time. Level was a bit high... had some sensory changes in my arms. 😱 2L LR and 500 of hespan, plus my autologous PRBC in the PACU. Finished a little hypotensive with a hemoglobin of 10.5. Started to have some soreness as I left the hospital but nothing a little oxycodone can't handle. When I say a little, I mean a little- the guy wrote for 2.5mg tabs. Which don't exist. The funniest part of the day is that I had the procedure at a neighboring teaching hospital, and my attending anesthesiologist had been a resident when I interviewed there, sat next to her and her husband for dinner.

In summary, HIGHLY recommend a spinal if you ever get the option. I feel great now. Out of the hospital and had Jimmy John's for lunch by 12:30. Marrow made its 11am flight to somewhere.

 

[primadonna22274]

So cool that you did this. My father-in-law donated bone marrow to a teen with leukemia about 15 years ago. Kid now has a family and sends him a Christmas card every year. Pretty neato.

 

[dhb]

👍 big karma points for you bro

 

[Gimlet]

Strong work, nutmegs! You've inspired me to add myself to the bone marrow registry next time I go donate blood.

 

[nutmegs]

Strong work, nutmegs! You've inspired me to add myself to the bone marrow registry next time I go donate blood.

yay!!

 

[nutmegs]

👍 big karma points for you bro

haha... the karma already arrived, actually. I was on call tuesday night so I could go to my pre-op labwork and appointments wednesday. slept from 9:30-6 o friggin clock without a single page or code. awesome.

 

[proman]

Did you have to pay the $52 for HLA typing? I can't donate blood (lived in Europe too long) but I might do this.

 

[OB1🤙]

Very nice, glad to hear it went well. 👍

I'm still waiting to hear back- after telling me they had a match they seem to have fallen off the map completely. Dunno why. I'm here if they want...

Well played on your part.

 

[nutmegs]

Did you have to pay the $52 for HLA typing? I can't donate blood (lived in Europe too long) but I might do this.

I didn't... I signed up during a drive at my college. I saw somewhere that they had a "free kit" week over Mother's Day. I think if you look, you'll find a free typing.

 

[nutmegs]

Very nice, glad to hear it went well. 👍

I'm still waiting to hear back- after telling me they had a match they seem to have fallen off the map completely. Dunno why. I'm here if they want...

Well played on your part.

I first heard the "maybe" on September 11th and got the "the one" call on October 10th. Did you go for your second typing? You can always call the person from the registry back and find out what's up.