Hi,
I think it is a good idea to have a Bone Marrow Biopsy before treatment also. My O/H thought it unnecessary, but I asked for it to define exactly what I have. I was lucky my Senior Advantage Kaiser Plan paid for it I guess. But it showed I might “be transitioning from prefibrotic Myelofibrosis to Myelofibrosis” and not have ET. I have CALR mutation and still no symptoms, thank God. I have strange results on my blood labs I know. One thing constant is high platelets, so I take baby aspirin now. At first, O/H told me not to baby aspirin but to take only Hydrea twice per day which I never filled or took. Then she decided I could take baby aspirin. Honestly, the BMB did not hurt at all and I was not sore after. Our family did our evening walk together that evening as usual and all our usual exercise the following days. My lab on BMB day was the only one super strange time my lab showed low hemoglobin, high white cells and platelets high but almost 400 lower than first time measured two months earlier. My recent two labs have shown normal hemoglobin, lowering but still high white cells, and high platelets but not quite as high as first day measured measured in December 2024 when this blood cancer journey unfolded.
It will be interesting to hear what my O/H says in four days at my second appointment with her.