Roxanne, et al, regarding the bone marrow test ... what my specialist said to me was that if my PV progresses how will I know if I didn't have a baseline from which to measure? At her urging, I decided to have a bone marrow biopsy and am glad I did. Now, if my PV changes, we have something from which to measure the progression.

I was so lucky , no problem with Bone marrow biopsy

Maryann, please be careful with Meloxicam because there are warnings of blood clots, heart attack and stroke with use of it.

Personally I believe it depends on who does the bmb!
My first time, under anesthesia( didn’t feel a thing)
Second and third time by Hematologist( was alittle worse third time as shexwss rocking me to get needle out of position)
Fourth time was in a cancer hospital where the person doing the procedure did bmb
And was the “best “ as that was her specialty every day!
It’s really painless just some pressure and they anesthetize area first.

Roxanne, I too have never had one being Jak2 positive and from that and typical RBC, WBC and Platelets I was Dx’d with PV. As well I wondered why I haven’t hadn’t and especially because I have back problems and what feels like fragility starting in my bones. They say it’s due to degenerative disk disease, osteoarthritis and bone spurs, bone marrow edema (at one point) bulging etc, not PV. I think it’s due to the PV, and everything that comes with it. I have had this for 6-8yrs dx’d in, oh my 🤔 TODAY, 2017. These spine difficulties started a massive decline 2 years ago. I agree with MaryAnn it’s important to get a baseline. I haven’t complained, cause who wants to get a needle shoved into your bones anyhow but it seems an important part of a good treatment. Hmmm