Posts by Peter Rogers

Thanks 🙂

Thanks for giving it a shot, but I usually only end up posting here after I've already sat through doctor consultations and we're still left with a bunch of unanswered questions.
Right now, everyone involved is basically stuck in this massive limbo trying to decide if we should actually go ahead with the antibiotics or not.
I’m going to try to get the CRP and ESR levels checked tomorrow just to see if they’re trending down or spiking again—though honestly, I'm wondering if there's even any point in rushing to repeat them that fast.

As far as the lab results go, the odds of everything hitting my inbox on the exact same day are pretty much zero.
Sometimes my results pop up in the middle of the night, and other times it takes a couple of days depending on how fast the admin decides to release them.
Also, you should probably check both the lab section and the specialist section, because sometimes the system bundles the lab work under specialist reports. Actually, most of the time, it does.

👋
So, I had my blood drawn six days into my third round of chemo, which was happening just thirteen days after I tested positive for COVID. I wasn't even getting tested for routine stuff—I did it because I was feeling off due to the illness—but honestly, right up until the infusion, I felt totally fine, no symptoms or anything. After the treatment, though, the side effects dragged on for a while. It was pretty uncomfortable, but I guess I wasn't exactly shocked by that.
But then, about four days after the chemo session, these cold-like symptoms started creeping back in. I’ve got this super mild fever (peaked at 99.3°F), a bit of a cough, some nasal congestion, and a slightly scratchy throat... and then my blood test results came back looking like this:

Does this automatically mean there's an infection that needs antibiotics, or could it be something else entirely?

👋

After finishing my first round of chemo, they wanted me to get some bloodwork done (there's actually another set scheduled right before the second round starts).
The results came back as:

Do you think these monocyte levels are going to mess anything up during the next phase of treatment? Is there anything I should be doing or looking into?

So, I’m kicking off the AC chemotherapy protocol this coming Monday, which means we've been running around like crazy getting everything ready.
Most of my labs look pretty decent.
I could upload photos, but honestly, there's enough info floating around already and I don't want to clog up everyone's feed.
My hemoglobin is actually back to normal—two months in a row now—even though I'm still going through my treatment cycles and have stopped taking iron supplements.

My Vitamin D came back at 46.1, while they really want to see it above 75.

Everything else looks mostly fine.

However, my white blood cell count is hovering right near the bottom limit. It's sitting at 3.8 (with a reference range of 3.4 - 9.7)—I'll find out what the verdict is on Monday since they scheduled a sit-down with my doctor before we start the therapy.
In terms of absolute values, my neutrophils are slightly low (1.90, ref: 2.06 - 6.49), though the percentage looks totally fine (49.8%, ref: 44 - 72).

The one thing bugging me is that my glomerular filtration rate is still low. This has been an issue for me since last year, and my primary doctor ordered a whole battery of kidney function tests, but nothing unusual ever popped up; even my abdominal ultrasound from four months ago showed everything was perfectly fine, just like always.
(eGFR CKD-EPI mL/min/1.73m2, GFR categories: G1: >= 90, G2: 60 - 89)

I also went to see the cardiologist. They told me everything is okay, even though they can hear a tiny murmur, but apparently, that's normal and won't get in the way of treatment. My EKG was fine. The ultrasound looked good too, aside from a note about the Doppler showing some mild mitral regurgitation and a trace of tricuspid regurgitation.
Hopefully, I won't totally crash and burn.

Emma is such a total idiot.
I honestly couldn't even get into Dorian Gray's stuff either, especially since I had to go out of my way just to decipher his writing style, which felt... I don't know, just unnecessarily provocative?
I haven't finished everything they've written, but from what I have managed to get through, I wouldn't say they were all just being hateful for the sake of it.
It’s been years now and I still struggle to actually sit down and finish a book properly; instead of actually absorbing the story, I’m just staring at the pages, panicking, trying to check off a box so I can say I "read" it, while my mind is drifting off into space somewhere else entirely.

Maria Fisher46 said:Hey there,

I honestly can't stand seeing split lymphocyte counts on a lab report, it just sets me off, you know? But hey, thank God it’s only a tiny fraction of the total count this time around. Still, if I were you, I’d definitely go grab a consultation with the hematologist who’s actually managing the diet and seeing everything play out in person. Better safe than sorry, right?

Thanks.
I finally reached out to my hematologist, but I still haven't heard back yet—honestly, I'm just crossing my fingers that they didn't see anything worth worrying about.
It’s finally time for another follow-up, but since we’ve been dealing with this nasty cold, we had to push the blood work back a few days. We’ll see if everything is settling down or if there’s still some other nonsense popping up on the labs.

Maria Fisher46 said:The current lab results are pointing straight to sideropenia, and honestly, given that previous hemoglobin was sitting at 97 g/L—and now we're looking at this through the lens of breast cancer—I still firmly believe you need to get this fully worked out. Why take any chances? I’d strongly suggest showing that old result where the hemoglobin was 97 g/L to your oncologist. It's just common sense at this point, right?

Thanks for this too.
So, I haven't really had anything to say until now because I just finally sat down with the oncologist today. Honestly, asking any questions about this whole situation felt like a total waste of breath; the entire consultation was centered around my breast issues, and when I tried to bring this up, the doctor basically brushed me off, acting like it had absolutely nothing to do with everything else. He actually had the nerve to suggest that my LOM could be the reason for any gastrointestinal bleeding and told me I should just stick with my hormone replacement therapy. Like, seriously? Is that all I get?
My primary doctor isn't showing any real interest in following up on this or actually digging into why I'm dealing with this anemia issue, so honestly, I'm at a total loss here. What am I even supposed to do besides just popping supplements all day?
So, I’ve been prescribed Tamoxifen for five years to deal with my breast cancer therapy, and honestly, I’m already bracing myself for the fallout. I’ve been doing some reading, and from what I can gather, this stuff can really mess with your red blood cell counts. Is it just me, or does it feel like every time you start a new treatment, you're basically just signing up for a whole new set of headaches? I'm fully expecting the next round of issues to roll in any minute now.

Does anyone have any advice on what else I should get checked out in the lab given everything going on? I’m definitely planning to ask about checking my Vitamin D levels, but I’m just sitting here wondering if I should be keeping an eye on anything else—you know, like specific things in my blood work, minerals, vitamins, or whatever else might be worth looking at. What am I missing here?

I honestly just need to vent for a second because my kids haven't caught the reading bug yet.
My oldest is actually pretty great about it—but hey, if they only want to touch a book during summer vacation, fine—but the other two? It’s like we’ve never even owned a single book in this house.

The school reading list gets nothing but massive resistance from them, whereas I personally make sure to finish every single one. I guess it's my way of staying sharp, or maybe just a way to get to know all those stories I missed out on back when I was just a kid growing up in the States.

I've been dealing with low hemoglobin and iron levels for ages now, but my doctor just brushes it off, blaming it on my heavy periods and refusing to send me for any actual follow-up testing.
I’ve been taking Heferol every now and then, and things seem to improve slightly before they tank again—just a constant cycle. Lately, though, the side effects from the Heferol were getting so bad that I actually switched over to Kendural.
The blood work was done after I’d finished half a box of Heferol and ten days of Kendural as part of my pre-op screening, so there wasn't really a break in the medication before the labs were drawn. Before I started this therapy, my hemoglobin was sitting at 97.
Nicholas Myers suggested getting more tests done here, but since I'm facing cancer treatment and my doctor won't refer me out, I haven't been able to do anything except start these supplements.
I mean, sure, looking at the numbers, the hemoglobin seems fine under these circumstances, but it's the red blood cell count in the results that's really messing with my head.
I'm heading in for breast cancer surgery in a week, and honestly, I don't even know if I have the headspace to deal with all this right now. The only person who actually looked at the results was the anesthesiologist, who basically said everything looks good enough for surgery and didn't care about the rest; she told me I could stop the Kendural until after the procedure, but that was after we had already finished our consultation.

New follow-up on a male patient with lymphadenopathy.



Can I get a second opinion on this cytology smear? What's the deal with those slit-like lymphocytes and the low monocyte count, especially considering his medical history up to this point?
The atypical lymphocytes have cleared out of the picture for now.

Problem again, and I actually made sure to check the box so it wouldn't delete everything this time 😕

What am I supposed to do with these hemoglobin levels and all the other results?
The whole thing came up during a routine checkup, and my occupational health doctor was adamant about getting this looked into right away, but then the GP suggested I just take some Heferol for three months and wait for a follow-up blood count.
Since I'm getting two completely different stories here, I figured I obviously needed a third opinion to make sense of this mess.🤷

I was hoping someone could take a look at this cytology smear result from a breast discharge.
The exam was done six months after the last one, where they only found some foamy phagocytes.
Does this still point toward "idiopathic galactorrhea"?
Thanks.

Here I am again....

We got called back to the outpatient clinic pretty quickly to go over some follow-up results, though we haven't actually received all of them yet.
From what we do have in hand, I can see that the erythrocytes are still a tiny bit low, but honestly, it’s not even a major deviation from the reference range (4.20 (4.34-5.47)), nor is the hemoglobin (120 (121-145)) or the hematocrit (0.355 (0.366-0.452)); the hematology specialist didn't even bother asking any questions or making a big deal out of it. The percentage of neutrophilic granulocytes is also minimal, staying either just below the reference range or right at the bottom edge for quite a while now (today it was 34%, while the absolute count is within the normal range at 2.29).
The urine test came back clean, aside from an erythrocyte finding of 10/umol/L (1+) and a microscopic sediment exam showing 3 erythrocytes /mm^3.
The main focus during the check-up was on those atypical and reactive lymphocytes found in the blood smear, so they're going to repeat the smears and an ultrasound in a couple of weeks to compare everything against the other results we're still waiting on and the ones we got last time.

So, that’s the summary of where things stand, and I should probably mention that the kid is actually doing great—he's cheerful, well-rested, and has a totally healthy appetite.

Emily Ortiz27 said:Hey there.
So, we went ahead and redid the blood work just like you suggested, though we were a little behind schedule on getting it done.
The erythrocyte and hematocrit levels are still showing a very slight dip below the normal range, but the hemoglobin, iron, and ferritin levels look fine. There’s also a tiny bit of deviation in the white blood cell count, and as usual, the IgA is low.

The hematologist actually thought we might be able to scale back the frequency of the check-ups now, since everything seems pretty much stable. What do you guys think about that?

There’s one more important thing to add—the cytology smear just came back, and it included a note saying we should contact the hematologist.
I’m going to reach out to them today, obviously, but I’d love to get your take on this too.
What exactly should we be looking for here? In what direction do you think this finding might go, or could this just be some one-time fluke that doesn't mean anything?

Hey there.
So, we went ahead and redid the blood work just like you suggested, though I guess we're running a little bit behind schedule on the timing.
Looking at the results, the erythrocyte and hematocrit levels are still showing this tiny, slight dip below the normal range, but the hemoglobin, iron, and ferritin all look perfectly fine. There’s a minor little deviation in the white blood cell count, and predictably, the IgA is still running low.

The hematologist actually mentioned that since everything is basically holding steady without any major changes, we might be able to start spacing out the check-ups a bit more. What do you guys think about that? Is that a reasonable move?

Larry Walker24 said:Basically, if you've got a 74, you're pretty much screwed and won't get into any decent school.🤦

Look, we aren't even talking about every single school out there, we're just looking at the top 20 most competitive institutions in the country.

Maria Fisher46 said:Hi there,

As far as I can recall, wasn't anemia absent in your previous labs? Now we're seeing normocytic anemia—it's borderline, sure, but it's still a shift compared to what you had before. I'm not sure how often you're getting blood work done, but if I were you, I'd run the CBC again in about four weeks just to see which way the wind is blowing. If it looks like things are trending downward, then we'd probably want to check those reticulocyte counts next.

Thanks.
We basically monitor everything every 2-3 months, though my hematologist actually mentioned we could even wait longer between checks now.

I haven't dealt with anemia until now, but looking back at my smears, there’s almost always a note about hypochromia.

So, we’re back for our regular check-up—it’s an eight-year-old with lymphadenopathy. I’m looking at this slight shift in the erythropoiesis levels and wondering, is this actually something to worry about, or just normal fluctuation? We’ve got more testing scheduled in a few months regardless, but still.
On top of that, looking at the same sample, the lymphocyte count on the cytological smear came back at 55%, which is a pretty significant jump from before and sits just a bit above the upper limit of the normal range.
The ultrasound results haven't changed; there are still plenty of enlarged nodes, but they all look like they're just reactive in nature.
Other than that, nothing else seems to be bothering them.

Thanks, he actually got it sorted. He managed to stay on the line with support long enough to get the right fix, which was apparently just opening Chrome in incognito mode—and wouldn't you know it, that did the trick perfectly. I guess those damn cookies were just messing with the whole system somehow.