Bone marrow, hemoglobin, and hep C

[mike716]

There's never a dull moment in Tango Town. No sooner did I start to calm down a little after getting hit last week with this jazz about having my gall bladder removed, than I am told by a hematologist that my high hemoglobin level (16 to 17) is weird and that I have to have a bone marrow puncture or something. Like, another biopsy only worse? On general anesthetic?

Oy! I'm getting punch-drunk from all this. I mean, are these people serious or are they using me to practice on because there's no one else around?

What the heck is a bone marrow puncture (or punction, or whatever), how is it done, does it hurt, and what are the nasty consequences that the MDs aren't telling me about?

Anyone know?

Mike
(on the verge of throwing in the towel and drinking myself to death with red wine)

[mike716]

What you say makes sense, the problem is that I don't really know why the hematologist ordered it. Some MDs don't tell you what they are doing. But several people have told me that doing pathology of the bone marrow can give indications of lots of body functions, and that sometimes things show up there that wouldn't have become symptomatic for a long time. So maybe it's a good idea just on general principles.

I'm still waiting to hear what my GP says about it. My hep MD had no comment (as usual).

Ho-hum, it's all a big roller coaster ride, and maybe you've gotta just go with the flow. I usually protest about any intrusion, even medicines I don't know. But this time I'm sorta curious myself to see what they find. So, if it doesn't hurt a lot and won't keep me out of the gym for too long, I think I'll do it.

Thanks for your perceptions.

Cheers!

Mike

[tashka]

I accompanied my father in law to several bone marrow biopsies. I was in the room when the doctor performed it. It is a simple procedure that doesn't hurt. Local anesthetic is used. The bone marrow is taken from pelvic bone while you lie on your stomach.

But I would not undergo it if the reason is just slightly elevated hemoglobin. If that is the ONLY reason it is suggested, I would just monitor your numbers. No matter how simple this procedure is, it is like a mini-surgery. It should not be done without valid reasons. Some people have higher values than others. My mom has high hemoglobin for her age. But she is doing fine and never had bone marrow biopsy.

[mike716]

Thanks again. I don't know what I would do without you and the other kind folks in this forum.

Mike

[Diamond_Lil]

Mike,
I am not in the heath care profession.  I'm another lost soul with hepatitis c who has failed treatment twice and because of that I have done a fair amount of research and asked many many questions of my doctors.  

There are some constants in the approach and treatment of hepatitis c but not everything holds true for all.  It is a very individual process and there are doctors who will push the envelope and others who administer treatment by the book.  What I have learned from failing treatment is that when the time is right to treat again my knowledge and understanding of this virus will make me better prepared to ask the right questions and that may be pivotal in achieving a sustained virological response.  

That is what we all want, no matter how we get there.

Diamond_Lil

[mike716]

Thanks again for your helpful and informative comments. I appreciate them. You sound very knowledgable. Are you a health-care provider, or have you studied biology and/or medicine?

M.

[Diamond_Lil]

Mike,

I wouldn't begin to know what they are looking for specifically.  The bone marrow is responsible for so many things.  I wanted you to know that if your docs are concerned about Hemochromatosis it can be determined by blood test.  If the HFE mutation is not present than you don't have it.  Since the biopsy sample used to determine hepatic iron index showed no iron accumulation I would take that as a positive indicator your liver is not experiencing additional damage from iron overload and no further biopsy is necessary.
Your doctor should have at least given you full reasoning for wanting a bone marrow biopsy.  Your hgb levels are not that high.  I'm a female and mine are 15-16 and my doctor has no concerns.  As I had previously said, it is not unusual for hepatics to have higher ferritin levels because the liver does not process the iron properly, fibrosis being one of the reasons.  And yes, with higher ferritin levels comes higher hgb but because you don't know what your doctors are looking for none of what I have said may apply.

Good luck and hope the Argentine docs get if figured out.
Diamond_Lil