March 09, 2011

Bone Marrow III – The Big Needle

Need I include the disclaimer that I don’t normally write about my real life? Well, I don’t, but I don’t normally let people take my internal organs out for use elsewhere…

Sign up to the registerhttp://www.anthonynolan.org/

2006, summer and 2011, March

People are fascinated by the Big Needle. The Big Needle is a symbol. The Big Needle is a celebrity. The Big Needle is only part of the bone marrow donation process anyone seems to know about. Both in 2006 and now in 2011 it’s what I hear most often from people when I tell them what I am doing.

“Doesn’t that involve a Big Needle?”
“I hear it hurts when they use the Big Needle.”
“Wow, I wouldn’t do that, not with that Big Needle.”


Stabbity.

The Big Needle appears to be the iconic element of the process, a sharp, stabby certainty, headed straight for the hip bone of those willing to give. I knew about the Big Needle when I signed up for the process, but like all the unpleasant elements of donation I blithely ignored it because I really didn’t think I would ever be called upon to donate and thus worrying about the specifics wasn’t worth it. I do a similar thing with my legs – I have one leg longer than the other and my hips are out of alignment. A doctor once told me there was a good chance I might need a hip replacement at a relatively young age (40s?!) but they weren’t sure. They could be right, but there’s no point fretting about it if it’s not certain. And merely being on the bone marrow list wasn’t a guarantee that Big Needle would be part of my life so I ignored it.

And when I couldn’t ignore it anymore, I discovered that as with so many icons, the Big Needle had lost relevance in recent years.

Ever had tuberculous cervical lymphadenitis? Probably not, it’s more commonly known as scrofula, and is the sort of disease which modern historians get to read about and modern doctors don’t get to treat very often. When it does pop up it gets beaten down with antibiotics. In the old days the cure was more elaborate, the monarch of the day was required to touch the sufferers. Scientific advances ensure that we don’t need Elizabeth II to high five the contagious, and funnily enough scientific advances have resulted in the Big Needle losing some influence in the world of bone marrow extraction.


“I cannot believe I have to touch you scrubbers. Helen Mirren wouldn’t stand for this shit.”

I found this out courtesy of the booklet Anthony Nolan sent me. It was full of happy smiling pictures of donors and recipients. How can anyone refuse a process where the outcome is glossy smiling photos, complete with inspirational captions? Ok, I’m being flippant, but these booklets will have been market tested and designed to perfection, they are precision tooled to make the donor feel less apprehensive about the process, to banish Big Needle.

There are two ways of donating.

I didn’t know this. The other way was even presented as the preferred method. Above Big Needle. The fearsome beast wasn’t even first choice, it was sat on the medical substitute’s bench, kicking its heels and periodically running up and down the side of the hospital, waiting to be called on. A plan B.

Plan A was much more futuristic. The donor would be injected with human growth hormone to make their marrow overproduce stem cells. The spongy mass of the marrow is less important than the tiny parts of marrow yet to come. After a few days the recipient would travel to a hospital where they would be hooked up to a machine, one tiny needle in each arm, with blood drawn out via one tube, filtered through a machine to remove the stem cells, before being put back into the donor’s body via the second tube in the other arm. I may or may not have made this up, but I came away convinced the process involved a centrifuge, with the prospect that my blood would be spun around, with stem cells flying out of it into the collection point, before being returned. The idea that my vital fluids might enjoy a ride as part of the process sounded fun.

The Big Needle was for when this didn’t work. No problem, I thought, if it happens I’ll just produce lots of stem cells. I’ll sit at home, producing really hard. In 2006 I figured I could study in the library, but produce stem cells at the same time. Essays and stem cells. Not a problem, and you don’t even have to footnote the stem cells. Now, in 2011, I’ll produce them while I work, or while I stand outside as the fire alarms go off, a strangely frequent event at work right now.

And hey, even if the Big Needle was needed, there was general anaesthetic for that.

stabbyneedle
Actually, the Big Needle is pretty big when you put it like that…

Knowing the procedures made them less scary. Is this what my ancestors felt the first time they found a dead boa constrictor and thought “Wow, I know it’s eaten half the tribe, but look, it’s just a tube with a silly face, that’s not scary”. Mind you, my ancestors ended up in Ireland, one of only two countries worldwide with no native snake species, so perhaps that’s a bad example.

Whatever, even if it did involve the Big Needle the equation was simple: stabby needle-induced hip pain for a week is less painful than dying of leukaemia. There is no other way to look at this. If I was a match I would do it, no matter what the short term pain. The person who needed marrow needed it more than I needed a pain free week.

But I would probably whine about the pain anyway. I’m not a saint.

And in the ebbing days of summer 2006, the last really good summer I remember us having in Britain, I waited to see if that one-in-four chance was going to come in. Was I the match? Would I meet the Big Needle or have to sit in the library producing stem cells?


- One comment Not publicly viewable

  1. Jemma

    Holly I love your blog! I can’t wait for the next edition! Your writing is hilarious but poignant – a perfect balance when talking about this subject.

    09 Mar 2011, 10:44


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