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)

[newleaf09]

P.S. My 87 year old mother had this done by her hematologist, so I imagine it is not too bad.  I wasn't with her that day but don't think it was too big of a deal and did not involve general anesthesia (they don't like knocking out people that old).  They were looking for a form of leukemia (did not find) and use it to diagnose all kinds of other things, too.

[Diamond_Lil]

How is hemochromatosis diagnosed?

Blood tests can determine whether the amount of iron stored in the body is too high. The transferrin saturation test reveals how much iron is bound to the protein that carries iron in the blood. Transferrin saturation values higher than 45 percent are considered too high.

The total iron binding capacity test measures how well your blood can transport iron, and the serum ferritin test shows the level of iron in the liver. If either of these tests shows higher than normal levels of iron in the body, doctors can order a special blood test to detect the HFE mutation, which will confirm the diagnosis. If the mutation is not present, hereditary hemochromatosis is not the reason for the iron buildup and the doctor will look for other causes.

A liver biopsy may be needed, in which case a tiny piece of liver tissue is removed and examined with a microscope. The biopsy will show how much iron has accumulated in the liver and whether the liver is damaged.  

Iron overload in the liver must be determined by liver biopsy; not bone marrow biopsy.  It is not unusual to have elevated ferritin and hgb levels in people with hepatitis c.

Diamond_Lil

[newleaf09]

I imagine they are looking to verify iron overload, hemochromatosis.   Bone marrow aspiration is considered less invasive than another liver biopsy and gives them a look at the red blood cells as they are forming, to get better information than just seeing iron deposits in the liver.  Looks like you may be getting those phelbotomies after all.

[mike716]

I'll keep you posted. I've got my GP working on this, and I'm gonna query my hep MD, too, although his opinion is worth zip. If I can't get some reasonable explanation before the 17th, I'll cancel on general principles.

Mike

[mike716]

Thanks for the helpful info. I don't like the sound of this biopsy at all. And I agree that my hgb just isn't that high. I'm going to pester my GP to find out what the hematologist's reasons for ordering the biopsy are, and if it's just the hgb I think I'll cancel it. which I believe is my right. I'll check with my hepatologist, too, although he always says that everything is unimportant (like even when my transaminases went up from 40 to 100!).

This hospital is always either too concerned and ordering pointless tests, or else completely indifferent and doing nothing. Bunch of weirdo extremists.

Mike

[mike716]

I clicked on the "Causes" link on that Mayoclinic site, and it gives "smoking" as one of them. That makes sense since smoking reduces the lungs' capacity to absorb oxygen. I'll bet that's why my hgb is high. Probably has nothing to do with my bone marrow at all.

M.