Help/Advice

[Naturelover]

My white blood cell count has been steadily dropping since 1/2012 as has my red blood cell count and Hematocrit which are both now considered low. Hemoglobin (any lower and it is past the lowest number considered normal). Since May 2012, my Lymphocytes and Eosinophils have been steadily going up and are high now. Does anyone know what any of this means? What are Lymphocytes and Eosinophils?

More update:
I have IBS, severe constipation and dehydration issues. For dehydration I do IV 0.9% Saline solution at home fairly regularly using my implanted Port-a-Cath. For constipation I did a clean out and was using Miralax daily. The only thing accomplished with Miralax was a sore bum and some loose stools with a very, very, constipated tummy that was bloated so much that I couldn't fit into any of my larger clothing I keep for that purpose. I became very nauseous and my stomach acid has gotten out of control again. I'm going to be increasing my Nexis from one at night to one in the morn as well. I have started taking 4 Senokot to try to get things moving.

Any helps for the severe constipation etc?

Thanks!

Blessings to all! Naturelover aka Glo

 

[Naturelover]

I forgot to mention in the previous post that my Total Protein is low, so is my Globulin level. My A/G Ratio is slightly high and so is my Chloride level. My calcium level is the last low number on the chart before being flagged.

None of this would concern me except that I am seeing a consistency with these levels slowly dropping or increasing. With almost routine blood work, I would think the levels would vary up and down some. Not keep going either up or either down.

I just ate some cream of wheat and my stomach acid is acting up, and I'm feeling nauseous. Blah!

Again, any thoughts, advice etc.

 

[Gculk]

Why are you dehydrated?

Nathan

 

[Cat-a-Tonic]

I'm not sure what all that means. I have heard of Lymphocytes in regards to Lymphocytic colitis (a form of microscopic colitis that is a type of IBD, so in the same family as Crohn's & UC) but I don't know much more about it. Have you had a colonoscopy with biopsies? If by chance you did happen to have some form of microscopic colitis, that can only be found on biopsy - the scope looks normal on visualization. And like Crohn's, microscopic colitis also has a "skip pattern" so that the inflammation is patchy and not uniform, so they'd have to get lucky and biopsy the right place. I'm undiagnosed too and my GI has mentioned microscopic colitis as a possibility for me - he did a fair amount of biopsies on my scope a couple years ago, but I'm going to ask him to do a ton of biopsies the next time I have a scope done. Don't want anything to be missed if I can help it.

As for the constipation, I sent you a PM earlier about psyllium husks in response to your other question. My understanding is that psyllium can help regulate the bowels either way, so if you tend towards d or c it should help with either. I tend towards d when I'm flaring and I have normal/formed stools when I'm in remission, but psyllium has helped with the frequency of my bowel movements even in remission. It's definitely worth giving a try IF you can handle soluble fiber. I couldn't handle any fiber back when I was flaring - now that I'm in remission, I can handle soluble fiber and often eat oatmeal and take psyllium every day (insoluble fiber is still troublesome for me even in remission).

As for the stomach acid issues, I feel for you and can totally relate, but have no answers. I take Nexium, Zantac, and Tums every day and am still having GERD/reflux issues too. My GI is ordering more tests for me so maybe I'll know more then - he wants to check the pH of my stomach acid or something like that, and will probably run other tests too. Blah. I work out a lot and my GERD is worst when I'm exercising - I hate having to stop what I'm doing and rest just to get my stomach contents to stay put. So yeah, if you figure something out, let me know! I'm slowly failing Nexium, it worked great when I first started it and then it slowly started losing effectiveness. Yuck! Anyway, hang in there, I know how yucky it can be.

 

[khurram333]

Hey...I may be able to help...Well when you say I have low Hg you really have to put out the number, as they vary tremendously...It has always been difficult to define normal in medicine..we usually take by Standard deviations from mean...so if u tell me ur number and also MCV, MCHC then we may interpret..Increasing lymph mean nothing for IBD...it is the monocyes u need to look for crohns...Increase Eosinophils...again we really need to know how high may mean allergy?...But nothing spcific for IBD..

 

[Naturelover]

Nathan, appreciate you asking about my hydration. I have Complex Regional Pain Syndrome (CRPS), formally known as, and still referred to by the medical professionals as, Reflex Sympathetic Dystrophy (RSD). My sympathetic nervous system is in fight or flight all the times. It's like a car engine that is reeving. The symptoms can change from week to week, day to day, hour to hour and minute to minute. It is a bizarre condition. RSD affects the Sympathetic, Central and Autonomic nervous system.

I have had symptoms periodically since a child of sweating for no known reason during the night. Since RSD set in, I sweat intensely at night most nights. As I am falling asleep, I will start sweating and my muscles will go into spasms. Also, at times I will urinate more than I take in. This was observed recently while I was in the hospital for cellulites at my picc line site and two blood clots. My ADH levels were checked out about a month or so after my hospital stay and came up fine. Docs are perplexed. In a 2 1/2 hour time period I can wake up totally soaked with sweat from head to toe. The bed will also be soaked. People with rsd usually only sleep about two to three hours at a time. This is just a drop in the bucket of the symptoms I deal with with the rsd.

Since starting my IV hydration at home, I have been able to put back on the weight I had lost. My PT says my color is better and he saw me sweat for the first time in the eight months since I had started seeing him.

Cat-a-tonic, I have never had an endoscopy or colonoscopy with biopsy. I was diagnosed with IBS with no work up being done. Easy way out I guess. I am now with a new GI doc. He was going to do an endoscopy with biopsy but my neurologist asked me to hold off. He wanted me to see a specialist because I have some sort of Dystonia. Using anesthesia in a patient with certain forms of Dystonia can be deadly. Thank goodness I don't have a Dystonia that can be deadly if anesthesia is used. Once I had that issues cleared up, problems with my picc line cropped up and then there was a week in the hospital yada, yada, yada. Once all that was sorted out, I had a nurse contaminate my Port-a-Cath so that took a couple of months for me to recover from. I think now I can get back to seeing the GI doc. This is the short version of the story. LOL!

I have had a sore throat and inflamed uvula since July 2011. I have noticed that when my stomach acid is high at night, my asthma is worse in the morning. GERD with possible mild aspiration? I also am now swallowing a lot of air. A symptom of inflammation in the esophagus?

I will have the endoscopy first. The GI doc wants to run some stool samples and once he gets the results, we will go from there. Possibly endoscopy with biopsy. Due to the blood clots, I am on the blood thinner Warfarin. Hopefully I can stop taking it at the end of August, beginning of Sept. My liver can't decide on how it's going to process the Warfarin, and it's driving my PCP nuts! We have to do bi-weekly and sometimes weekly INR test. She will be glad when I'm off Warfarin. I don't know if I have to wait until I'm off Warfin to have the endoscopy or not.

Sounds like you're not alone with your GERD. Have you tried Sulcrafate for break through GERD? My doc gave me that. Nothing completely resolves the stomach acid issue. Just minimizes it so I'm not vomiting. My stomach burns almost all the time.

My son had to have a Nissan fundoplycation w/g-tube placement just before he turned two years old. He was having GERD with moderate to severe aspiration and damaging his lungs. Strange thing was, he never had pneumonia. He would just get pale and short of breath when he aspirated into his lungs. I'm sure you can imagine the battle we had with GI trying to convince them that he was aspirating.

We now have a battle on our hands with my daughter. She is having severe constipation issues that may be contributing to her coccyx pain. Her colon is more than twice the size it's supposed to be.

I think I'm just rambling. I'm very tired. I wasn't able to sleep last night due to the severe muscle contractions and sweating through out the night. I had PT today. How exhausting. I have lost more range of motion. Grrr... I'm sure my PT will get it back soon. He always does. It's a constant battle. I fell asleep right after supper for a couple of hours. I was hooked up to my IV hydration at the time. I woke up totally soaking wet and cold. Burrrrr.

Thank you to all who responded. I really appreciate it. Blessings and prayers coming your way. Naturelover

 

[Patricia56]

I would love to help you better understand the results of your lab tests. I have spent a lot of time over the past several years trying to understand my son's lab results and some of what I know might apply to your lab results too.

But.

It's not as simple as it sounds.

I will give you a couple links that will help you answer your own questions in basic ways. I will also give you the reasons why I can't just tell you the answers to your questions.

First, there are like a bazillion factors that can distort the results of those tests. That's why the doctor treats the patient not the test results. One big factor in assessing the results of a CBC is the patient's hydration status. Here's a link that briefly addresses the impact of hydration on the results of a CBC w/diff.

http://www.rnceus.com/cbc/cbcover.html

You may find the information helpful.

Second, most of the time you cannot say anything meaningful about a single result or even a group of results when taken out of context. For example, you mention that the lymphocytes and eosinophils are elevated. Are the absolute values elevated or the ratios? Since your overall white count is down the absolute lymphocyte count must be down too - or maybe not. I cannot possibly tell without looking at all the numbers from the differential on the WBC's. Which includes not just lymphocytes but also eosinophils, monocytes, basophils, and neutrophils (aka polys, bands). Here's some info on the different kinds of WBC's for you.

http://www.rnceus.com/cbc/cbcdiff.html

Sometimes the context isn't even there. For example, I know that ferritin is the protein that the body uses to store iron. If the ferritin level has not been measured you don't have one piece of information that could be important in understanding why someone appears to be anemic. Ferritin can be particularly important when you are trying to distinguish anemia of chronic disease (i.e. inflammation) from anemia due to more acute issues (i.e. bleeding) when the anemia is not yet severe.

Third, reference ranges matter. By that I mean that you cannot compare results between different labs or sometimes even from the same lab at different on different dates. You have to check to make sure that the tests you are trying to compare use the same reference range and measurement scale. If they don't - well I for one do not have the expertise to feel confident about interpreting your results.

Fourth, margin of error also matters. Most of those tests have a "normal" range that covers 2 standard deviations from the mean but there is still a margin of error. So a result that is slightly out of the normal range may actually be within the normal range. That's why doctors don't get all excited when a result is just outside the normal range.

Fifth, a single test result does not a pattern make. Your observation about trends over time is a good one. If you are able, I suggest you set up a spreadsheet and enter your lab values for the past year so you can accurately track them over time. Your doctor's office may already be doing this if they have started doing electronic charting. If so then do not duplicate their work. Ask them for a copy of your labs for the past year. Then if you want to create a chart or graph that shows the progression over time do that and take it to the doctor as a way to talk about your concerns.

We are not doctors and, even if we were, a good doctor doesn't treat the lab results. He/she treats the person. The lab results inform the doctor's clinical judgment, but they are only one part of the equation.

I truly hope this information has been helpful to you Naturelover. When in doubt - go talk to your doctor. He/she has been through many years of very dreary and costly college classes just so they can answer these kinds of questions. You wouldn't want your doctor to feel like he wasn't needed would you??

 

[Naturelover]

Update:

I saw my pcp Friday. She said I was right that if the Hematocrit drops one more number, then I will be considered anemic. She is concerened about the trend of my warfarin numbers going down. It took forever to get it up to 2.7 and each time she checked it since then it has continued to go down. Last check it was at 1.2; meaning it's not at theraputic level again. To add insult to injury I had to stop the warfarin for the endoscopy then restart the warfarin with double dose for two nights and then back to usual dose. We will recheck the warfarin levels, cbc, and electrolytes etc as well this Tuesday. Can't wait. I'm so tired.