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Coping1,
Having two experts give you differing recommendations puts you in a tough spot while making a major decision.
Aplastic anemia and hypocellular MDS look very much alike - symptoms of low counts and too few cells in the bone marrow. The lack of cells makes it hard to look for the cell dysplasia that would be strong evidence of MDS. The third biopsy could help with the diagnosis, although with a previous bone marrow biopsy result of "clear dysplasia" and ringed sideroblasts it's unclear to me why they haven't both decided it's MDS. It's true that if you have to have a transplant then it may not matter what disease you have, but the catch is that knowing what disease you have lets you know what alternatives to transplant you have.
MDS can be classified several ways and I think you should know what classification they'd consider you to have. The includes an assessment of the relative level of risk. That's a factor in deciding whether "wait and watch" is worth the risk that things will get worse if you don't act.
Have you considered taking copies of your medical records, including the previous biopsy results, to another doctor or treatment center for a third opinion? We each have our stories, but anecdotes from forum members here may not give you enough information compared with another expert who is looking at your full history. Your unconfirmed diagnosis, long-term autoimmune disorder, and sepsis incidents no doubt make you unique, and that's when expert advice is most valuable.
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