Tuesday, March 15, 2022

Bone Marrow Biopsies a team effort

This story originally appeared in Horizon Star. Written by Kris McDavid and edited by Sonya O’Reilly and Buggy, it was submitted by New Brunswick Union member Joe Costello for publication on the NBU website.
Providing excellent health care to New Brunswickers requires a total team effort, regardless of the setting or application.
Horizon’s physicians, nurses, administrative staff, laboratory technologists and indeed every health care worker within the organization, rely on one another to get the job done.
This fast--paced, collaborative approach to the delivery of health care is highly visible in public-facing spaces such as the Emergency Department, Diagnostic Imaging and ambulatory care clinics.
But Joe Costello, a long-time laboratory technologist based in the Haematology lab at Horizon’s Dr. Everett Chalmers Regional Hospital (DECRH), says it never ceases to amaze him the way that Horizon physicians and staff from different departments come together behind the scenes.
This is particularly true, he says, when it comes to one of the more under-the-radar procedures that takes place within Horizon, one that is critically important in helping to diagnose different forms of blood disorders or cancers.
The DECRH is one of four Horizon hospitals that offers bone marrow biopsies and aspirations. These procedures involve taking small samples of bone, fluid and cells removed from a patient’s marrow before being analyzing under a microscope for any irregularities.
Where many hands often make light work, in the case of bone marrow biopsies, Costello says the specific role of Horizon staff from departments like oncology, pathology, the lab and more are helping put patients at ease and improving outcomes by providing exceptional care.
“I can honestly say that the patients thank people like myself from the lab, the nurses, pathology staff, our admin staff and oncologists for delivering exceptional heath care,” said Costello, who has taken part in over 4,000 bone marrow biopsies over his career, said. “Patients are often frightened and anxious about what must happened to them, but truly feel they are in good hands. They are mostly pleased and totally relaxed, and it is a pleasure to serve them.”
The majority of the 100 or so bone marrow biopsies performed at the DECRH each year are overseen by veteran medical oncologist Dr. Saleem Raza, who Costello says patients are very fortunate to have by their side throughout the process.
‘While bone marrow biopsies only take around 20 to 30 minutes to perform, for the patient’, Costello said ’there’s a lot of fear of the unknown.’
The procedure itself involves taking samples taken from the patient’s hip bone using a special needle that penetrates the skin and bone to access the spongy marrow that lies within.
While the procedure is taking place, Costello is also set up in the clinical suite with his cart and specialized lab equipment to help prepare slides for analysis.
He’s seen countless bone marrow biopsies take place over the course of his career. Although Costello but says he always marvel at the way physicians like Dr. Raza and his team have of putting patients at ease.
Samples are taken to the lab and once analyzed, can help diagnose certain types of cancer, such as leukemia, multiple myeloma, non-Hodgkin lymphoma or Hodgkin lymphoma cancer.
In terms of the role the lab team plays in the process, it’s critical.
After the aspirate is withdrawn, Costello collects it and divides it up for the analysis of flow, cytogenetics and molecular genetics, while also creating slides.
From there, the oncologist goes in to collect the actual biopsy – a small amount of bone with the marrow inside – which is eventually examined in the histology lab and by a pathologist, who ultimately helps establish a diagnosis.
As of early February 2022, Costello said 13 bone marrow biopsies have been performed at the DECRH so far this year.
Even with the additional challenges of working in a health care environment during a global pandemic, Costello said the team takes every precaution to ensure IPC protocols are being followed rigorously, for the safety of patients and staff.
‘At the end of the day’, he said ‘offering quality health care is all about people. And everyone who plays a role in helping ensure these biopsies are carried out safely and successfully all have one thing in mind – the patient’s wellbeing.’
“Everyone is involved for the patient to receive the best quality care that we can provide, and I think we’re doing that consistently,” Costello said. “I’ve seen people who have gone in for the bone marrow biopsy, they’re scared, they’re nervous about the needle, what the procedure means, and by the time they walk out of there they’re thanking us for the excellent and care and wishing us a great day ... it’s quite something.”
The high level of teamwork involved in performing bone marrow biopsies, he noted, is just one of countless examples of talented, dedicated staff from across Horizon coming together in the name of providing outstanding patient care day in, day out.
He wants patients to know they’re in exceptional hands and that everyone who plays a part always has the best interests of the patient at the forefront.
In addition to the DECRH, bone marrow biopsies are also performed at Horizon’s The Moncton Hospital, Saint John Regional Hospital and Upper River Valley Hospital.