BMB disappointment

I've been on a 10 year medical journey trying to figure out the driver of my many systemic symptoms (namely, a hyperadrenergic POTS flavor of tachycardia, temp dysregulation), telangiectasia, livedo reticularis, and rare, microvascular liver abnormalities. I recently found out that my telomeres were in the less than 1st percentile which prompted a bone marrow biopsy to check for any abnormalities.

For additional context, I am 42 years old and my CBC has always been pretty normal with some occasional mild elevations in WBCs, platelets, and absolute monocytes.

I thought the biopsy would reveal something that would be THE definitive diagnosis I've been seeking, but from the amateur researching I've been doing on the results while I wait for my doc appointment, I am feeling disappointed. Whatever small abnormalities were found seem like they may be explained away by having an ordinary occult iron deficiency, having some as yet undiagnosable autoimmune issue, and being on mycophenolate for the past 2 years.

There are still some smear tests pending, but what has been found so far are:

Mild hypercellularity, approximately 70%
Mildly increased granulopoiesis
Mild left shift of granulopoiesis
Approximately 20% granulocytic dysplasia
Abnormal granulocyte nuclear segmentation
Clumped granulocyte chromatin
Granulocyte nuclear projections
Mildly increased megakaryopoiesis
Occasional atypical/dysplastic megakaryocytes
Occasional erythroid atypia
Monocytes described as prominent/accentuated
Small focal lymphocyte aggregate
Rare hemophagocytosis
No detectable marrow iron stores
No increase in CD34-positive hematopoietic precursor cells
No monoclonal B-cell population
No abnormal T-cell population based on surface-marker expression
No abnormal blast population identified

I'm feeling super pessimistic and want to cry ...like my hope has been shattered yet again...and I'm wondering if there really is any point in spending thousands of dollars to go to Mayo. 🙁