The word anaemia means a low red blood cell count, or less of the red blood pigment (haemoglobin) in your blood. A good red blood cell count is important because red blood cells carry oxygen. Every breath we take fills our lungs with oxygen. Our red blood cells pass through the lungs, soak up the oxygen and carry it to the rest of the body.
There are many causes of anaemia some of which include kidney or bowel disease, bleeding post-surgery or heavy menstrual periods.
Iron is one of the essential building blocks of red blood cells. If you don’t have enough iron you will not have healthy red blood cells and your blood will carry less oxygen. You may experience: tiredness, shortness of breath, lack of energy to work or exercise, pale skin, light headedness, poor memory and fast heart rate.
Iron infusion is necessary for patients where iron tablets are not powerful enough to build up iron stores adequately or their body is unable to absorb any of the iron taken as tablets. Some patients have injections to treat their anaemia but these injections are different from iron and do not replace the need for iron. In fact the iron infusion is needed for these injections to work properly.
Your iron infusion will take approximately 15 minutes and you will be kept for observation for a further 45 minutes. An intravenous (IV) drip will be put into your arm. A very safe form of iron (iron polymaltose) with very few side effects is used for the infusion. The iron itself does not hurt. Iron infusion is always delivered in a supervised medical environment as, on very rare occasions, serious allergic reaction may occur. A nurse will check your blood pressure and pulse during the infusion. Please let the nurse know if you feel unwell at any time.
Side effects are rare but they may include headache, nausea, vomiting, joint or muscle pain, shortness of breath and itchiness. There is also a small risk (< 1%) of permanent skin staining which can occur if the infusion leaks into surrounding soft tissue. If you experience any of the above seek medical advice or contact the hospital on 9411 7557 and ask them to contact your specialist. Around 10% of patients will develop a mild fever and sore joints 2-3 days after the infusion. This is not serious and will usually disappear with 1-2 doses of Panadol.
On the day of your appointment it is important to arrive on time.
| Food | Eat and drink your usual meals before coming to hospital |
|---|---|
| Medication | Take your usual medications and bring any you may need during the day with you |
| What to wear | Please wear a top with sleeves that roll up easily. (Pyjamas not necessary) |
Bone marrow biopsy is an essential investigation recommended by your haematologist.
It is a minor procedure, performed under local anaesthetic and light sedation by a Haematologist or the Haematology Registrar. You will need to fast from midnight on the night before the biopsy (unless sedation is contraindicated or not required).
Bone marrow is generally obtained from the pelvic bones and the procedure usually takes less than 15 minutes. It is a sterile procedure; the skin is first cleaned with antiseptic followed by injection of local anaesthetic. A small incision of 1-2mm is made through the skin to permit insertion of the bone marrow biopsy needle which is then inserted to remove some bone marrow and a piece of bone tissue. The specimens are then sent to pathology for analysis and the results may take up to two weeks to be finalized.
After the biopsy a sterile, waterproof dressing is applied over the site and should be kept in place for at least 24 hours. You may have a shower but no baths for the next 48 hours. You will be kept for observation for at least an hour after the biopsy - all in all, you can expect to be in hospital for half a day.
You are required to have someone take you home from hospital. Public transport is not recommended. It is illegal for you to operate any machinery or drive a vehicle for 24 hours following light sedation.
Bone marrow biopsy is a very safe diagnostic procedure. Some of the common adverse events include, but are not limited to, pain at the site of injection, mild bruising and/or oozing or bleeding. Other complications, such as infection, are very rare. A simple pain killer such as paracetamol is usually sufficient for pain control. You should notify your doctor if there is severe pain or bloody discharge on the dressing.
It is important to let us know if you are taking Insulin or any other diabetic medications, Aspirin, Clopidogrel (Plavix), anti-inflammatories (e.g. Neurofen, Voltaren, Voltaren gel), blood thinners (e.g. Warfarin, Heparin, Clexane, Pradaxa, Xarelto). Do not cease any medications prior to the test unless you receive specific instructions from your Haematologist.
The Australian Myeloma Treatment Guideline: PDF
The following websites provide information on specific conditions and general information that may be of benefit to our patients: