11 replies to this topic

[JoshLee]

Hi All,

     I went into have a BMB and everything went fine except for my onc. was having trouble getting aspirate. He tried in two different places and said it wasn't a dry tap, but that it was "fatty". What does this mean? I am trying not to freak myself out, but it's hard not too. Does this mean I have progressed? My CBC is completely normal, but I know that doesn't always mean anything. WBC 5.4 RBC 5.0 HGB 15.4 PLT 191 BASO ABSOLUTE 0.0 ANC 3.1

[Trey]

I would wonder how the Onc knows for certain that it was fat -- I assume the Onc could not get the fluid to suck up into the syringe, so concluded it was too viscous, like a fat.  However, normal marrow has fat in it.  Marrow is of two types, namely red marrow (cell making marrow) and yellow marrow (inactive marrow).  Red marrow is 40% fat, and yellow marrow is 80% fat. 

You are making plenty of blood cells as shown by your CBC numbers.  So you obviously have plenty of red marrow, and I'm sure that includes the pelvis.  But the Onc found something that should be explored, so you should have an MRI done on the pelvis.  It is possible that the Onc was just unlucky and hit two areas of yellow marrow sequentially and missed the red marrow (I assume the Onc did not poke two holes in the pelvis).  Whatever happened, an MRI is needed to help clarify the issue.  I would not assume that it is something dire.

http://radiographics...uppl_1/S27.full

[CallMeLucky]

From the little that I read about this, it does not seem reasonable that the doctor could diagnose this the way that he did.  Extensive imaging seems to be the protocol to assess something like this.  It would seem he was either stating an opinion or using the term loosely/incorrectly.  I would go back and ask him to clarify.

[JoshLee]

Yeah, I am mostly just concerned that he couldn't get any aspirate. It's concerning to me because I had a "dry tap" the first time when I was diagnosed and haven't had a problem with it since then. I had a stable PCR drawn on the 6th and then I go in for a BMB and this happens. I am just worried and bummed. I would like to take comfort in my excellent CBC, but I am sure someone would chime in and tell me it wasn't a very good indicator for anything. Just sad today.

[Marnie]

Geez, Trey. . .how do you know all this stuff?  Are you an alien from another galaxy???

[Susan61]

Hi:  I would also go back and ask him to Clarify what he told you like Lucky said.  You should find comfort in the fact that your blood work itself was where it should be.  Try not to stress on this issue,  I would just ask to have whatever test is needed to evaluate what your Oncologist stated.

     It seems like eveytime I go to  any of my doctors, I leave and then later on I am asking myself tons of questions.

    Sometimes we try to look for things beyond what we need to look for.  Most likely its not anything of great concern, and I would take Trey's advice and ask to get a MRI just to put your mind at ease if nothing else.

Susan

[Trey]

Marnie,

I don't reveal which Galaxy I came from due to privacy concerns.  But I'm in Texas now, and it is the best place I have seen in my intergalactic travels.  Nanu Nanu.

[Marnie]

What did the alien say to the book??

- - -take me to your reader!!  (Yeah, yeah, my 6th graders didn't think that was very funny, either)

[CallMeLucky]

Josh,

While in general CBC is not good for tracking CML, in this case I would think it is more relevant.  The concern here would seem to be that there could be something wrong with your bone marrow, however if you did in fact have a problem with bone marrow you would be more inclined to see issues in the blood counts.  Your counts are excellent.  So while it is possible there is an issue, it is also likely there is no issue and it is a) just the way you are made up, a characteristic of your disease that may not have any impact on your life.  This is why I say you need to go back and clarify.  Doctors don't realize that they don't think about the things you talked about until the next time they see you, where we the patient think about what they said everyday until the next time we see them.

[SunNsand]

I was diagnosed Jan. 2009 and have had three BMBs. Everytime my Onc has tried to aspirate, he was unsuccessful. He always says he doesn't know why because he KNOWS he was in there! My CML is responding well to Gleevec so I don't worry about it so much anymore.

[JoshLee]

My onc. was actually more concerned than he let on, but everything was normal with the marrow and I just got my cytogenetics back. Still CCyR. I had an appt last week with Dr. Talpaz and it went very well. I believe I will be switching to Sprycel, but am not 100% on that. Seeing a specialist was the right thing to do and worth every penny.

[CallMeLucky]

That's great Josh - it sounds like you got some reassurance which will hopefully give you some peace of mind.  I'm finding the peace of mind, rather the lack there of, has been the hardest part for me in dealing with all this crap.

Glad you are still CCyR - if you have not already read the post regarding how Dr. Cortes treats CML, you should read it and check out where he talks about CCyR being the Gold standard and that overall people in MMR or even CMR have not been shown to fair much better than people who get CCyR and hold it.