Our Story Continues...With Photos!

So here we are, more than two months since my last post, with continued good news to report. Torger's latest biopsy shows that he is 100% engrafted with donor cells, and there are no signs of rejection or leukemia. While he continues to have an occasional spot of GVHD, it's all been very minor. And he was finally able to receive his first round of vaccinations this month! He's on roughly the same vaccination program that a newborn follows...he'll go in for shots every couple of months over the course of this coming year before they'll consider him up-to-date. But little by little, he'll be able to fully reclaim a normal life.

If you're squeamish, you might want to stop reading now. But I thought it might be interesting to show exactly what a bone-marrow biopsy looks like, so I took some pictures while Torger was undergoing his latest round. It's a relatively quick procedure that begins with Torger taking some pain killers, then lying face down on the table as the doctors shoot some additional painkillers into his back to numb the point, around his hip bone, from which they'll extract the sample. Here's a photo of the instrument tray in the procedure room, all ready for the process to begin. The instrument with the blue grip is what they will be pushing into his bone once he's numbed. Below is a better view...as you can see, it's a pretty long needle, which is why Torger really doesn't look forward to this procedure. (I just showed him this photo and he screeched, "I never saw what it looks like! Now I know and I can remember the pain! I can remember EXACTLY how it felt!And it hurts!!" He REALLY hates the biopsies.) Even with the numbing, he can always feel the drill going in and the extraction, and he's typically sore for the next few days. The next shot is of the doctor actually pushing the drill into his bone. You can see Torger's white knuckles gripping the edge of the table, but what you can't see is me, standing near his head with what we affectionately call a "puke bucket" in case he gets nauseous. The doctor pushes the needle/drill into his bone and extracts several tubes of blood and what is essentially a "core sample" for testing. The doctor actually has to position herself carefully above him so that she can push down at exactly the right angle and exert the necessary amount of pressure...this procedure takes some upper body strength. (One doc was short and actually had to stand on a stool while doing the biopsy.) We've heard many times that Torger is an excellent body weight for biopsies. They actually have much longer needles for severely overweight patients, and one patient was even too large for that needle...it took a lot of work, and the doctor wasn't able to reach his bone. These aren't the kinds of things you normally think about, but this is the type of problem that's standard in the Bone Marrow Transplant Unit. The next picture is of the extracted sample, as the nurse preps it for submission to the lab. They were all very proud of the quality of this sample. While it just looks like a blob of blood in the photo, as they pull it out, you can see that it's a long, thin strand from his marrow. The last photo gives another view. After that, they put a bandage over the hole, make Torger wait a few minutes before standing, then send us on our way to wait for the results. Fortunately, they were all positive, so Torger won't have to do this again for awhile.