After the Weekend

After the weekend, I will officially know if I am still anemic. I don’t remember if I got into the details on this blog about the anemia. I’m sure I mentioned it, in one of my update-ish posts from the time away from the house. I know I’ve mentioned it ad nauseum on Twitter.

Basically, during the diagnostic tests for the stomach issues, pain, and weakness, a CBC (along with lots of other tests) was done. Actually, a few were done. The first was on March 28, at the Emergency Room. My hemoglobin was at 9.0 g/dl. For a person of my age and gender (28 year old female), it should be over 12 g/dl. My hematocrit, MCV (blood cell volume), MCH (blood cell weight), MCH (blood cell concentration), and MPV (platelet volume) were low, while the cell distribution width and platelet count were high. All of that together plus a few other readings indicated that was anemia, specifically some type of iron-deficiency. At this point, my white blood cell and red blood cell counts were normal, but I did have a high absolute lymphocyte count.

On the 19th of April, as part of the investigation started by my family doctor, another CBC was done and my hemoglobin had dropped, as had many of the other values. It was now at 7.9, which was the lowest it would ever be registered at. My platelet count went up, but it was the only result of that test that I think ended up getting larger. But almost a month later, on the fourteenth of May, during an ER visit for near fainting spells, my white blood cell count shot up, as did my red blood cell count. My hemoglobin was back at 9.0. My other values were lingering around the past numbers.

In the meantime, I had more tests done. There were tests for Celiac, the H. pylori infection, occult bleeding, inflammatory bowel diseases, and an endoscope to look for an ulcer not caused by an H. pylori infection. The tests kept coming back normal. There were some urine tests where there were bacteria, red blood cells, hyaline casts, calcium oxalate crystals, and white blood cells present, but none of those results seemed to alarm the doctors, so I tried to ignore them. And when I fainted in July, after an allergic reaction to fire ant bites, there was a fairly high result for the white blood cell portion of the CBC and my absolute neutrophils and monocyte counts were high, though all other numbers stayed the same in that test. All the ER doctor could say about the results was that I had anemia of unknown origin and thrombocytosis.

Because the anemia was persisting, despite different attempts at oral supplementation and increased consumption of iron-enriched food, and my serum ferritin levels had gotten to 4 ng/ml (it should be between 13 and 150 ng/ml), meaning that my body had been depleted of its iron stores, I was put through a round of 6 iron infusions. I would sit for about 60 minutes every 2-3 days getting a bag of iron pumped into my body. I wasn’t feeling better, which was disheartening. Any improvements that happened were very short-lived. Even the nurses at the infusion clinic were shocked because I wasn’t really improving.

Early on, I had called a nurse for Humana to find out what I should do. She said to go to the ER and to demand to see a hematologist. (I later had a nurse in the endoscopy center suggest the same thing.) I eventually had gone to the ER (the May visit), but I never asked to see a hematologist until August after the infusions. I knew I should I have been feeling better. I begged the family doctor, who was a different family doctor than who I’d started with because my old doctor graduated from the UAB program. I told him I needed to see a hematologist and I mentioned the endoscopy nurse saying that it would be a good idea. Well, he got all huffy and said that it wouldn’t be a good idea and that we needed more evidence in order to satisfy the insurance company. I didn’t mention the insurance nurse also suggesting it because I felt very flustered at this point. I didn’t understand how the only evidence left (the CBC scheduled for September 10) could prove somehow that my anemia was persisting.

Well, now the evidence exists, either proving my anemia is persisting or showing that something else is making me so tired, achy, miserable, pathetic, etc. I won’t know what that evidence says until Monday, unless I get a letter over the weekend with the results in it. I also won’t know until Monday if I will face another stall tactic session with a doctor who is unwilling to send me to a doctor that I may need to see in order to get me out of this anemic funk.

For those who know I’ve had gastric bypass surgery and think it could be related to that, I had wondered that, too. I’m pretty sure that that isn’t it because it is so persistent. One of the oral supplements was a liquid form that was supposed to absorb quickly. Also, if it was gastric bypass related, then there would (from all study data I’ve read) have been a more significant improvement following the infusions.

For those who know I have had gynecological issues causing me to bleed excessively, that would make sense, except that from February until I was put on Ocella about two and a half or three months later, I had no period at all. During that time, my hemoglobin dropped.

With those theories taken into consideration and with all of the other crap I’ve gone through in the past six months related to this anemia, I’m concerned about the possibility of it still existing. If I’m still anemic, then that means it is possibly something more significant than just a lack of iron. And that truly worries me.

PS: I’m sorry if this entry is a bit all over the place,  but I’m really, really tired. I wanted to get this out before I went to sleep though.

 

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Janet Morris

I'm from Huntsville, Alabama. I've got as many college credits as a doctorate candidate, and the GPA of some of them, too. I have a boss by the name of Amy Pond. She's a dachshund. My parents both grew up in Alabama.