Posts by Nicholas Myers

Karen Sullivan40 said:I NEED HELP RIGHT NOWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW!!!!!!!!!!!!!
Can someone convert an FT4 of 0.53 ng/dl to pmol/l !!!!!!!!!!!!!!!!!!!!! I am soooo worried!!!!!!!

The conversion factor is 12.87, so:

FT4 [pmol/l] = FT4 [ng/dl] x 12.87

That works out to:

FT4 [pmol/l] = 0.53 x 12.87 = 6.82

Essentially, the FT4 levels are low. Reference ranges vary slightly depending on the lab, but a general guide would be:

FT4 9-23 pmol/l or 0.7-1.8 ng/dl.

In any case, please consult with your doctor. For some moral support, you can check this thread:

Best regards. 🙂

redeagle96 said:So, here's the situation. For an allergy follow-up, I had blood work done and everything looked fine except for my MCV, which was 78.5 (normal range 83-97), and my MCH, which was 25.6 (normal range 27.4-33.9). Red blood cell count was 4.93 (range 3.86-5.08). Because of the microcytosis, my allergist suspected iron-deficiency anemia and sent me for iron levels, TIBC, UIBC, ferritin, and reticulocyte tests. I've already had the blood drawn. I only have my ferritin result right now, which is 9 (range 13-150), because the lab sends the rest directly to my doctor. I saw her today, and she told me the red blood cell volume is still low, reticulocytes are at 22 (she said they're at the upper limit of the range), TIBC is elevated (I don't know by how much, just that it is), and iron is 10 (I think the range is 8-30). I was prescribed Feosol, one 100 mg tablet daily in the morning, and folic acid, one 5 mg tablet daily in the evening. Now I'm wondering: how do I increase that red blood cell volume? Does it go back up once the iron deficiency is "corrected"? What role does the folic acid play here? (I had anemia about 2.5 years ago too, but didn't take anything then). Also, am I allowed to take Nexium (esomeprazole) before taking the iron, since I have active erosions in my duodenum and stomach? My doctor says I absolutely must take it, but three ladies working at the pharmacy told me there's no way I should be taking them together 😕. As for symptoms, I'm dealing with weakness, occasional tachycardia, and shortness of breath during exertion (though pulmonary tests were normal). Thank you in advance for the help, and sorry for the long post. Best, 😉

Dear redeagle96,

The reason those pharmacists confused you is based on the fact that medications like Nexium inhibit gastric acid secretion. This lowers acidity in the digestive tract, which can lead to poor absorption of certain iron compounds.

Consequently, iron supplements might be less effective if taken simultaneously with drugs that suppress stomach acid.

However, with the specific tablets you've been prescribed (Feosol), the iron is in a complex form. This increases bioavailability, meaning the interaction with acid-suppressing drugs should be minimal compared to other iron supplements.

To wrap this up: Your doctor is right! You can and should take both medications!

Don't worry about the red blood cell volume; it will normalize along with the rest of your blood work.

Follow your doctor's instructions and take your therapy exactly as prescribed.

Best regards. 🙂

Alex Foster6 said:My mom had a fine-needle aspiration on a lump in her left breast. Could someone help me interpret the results before she undergoes a biopsy? Specifically, can we determine if it's malignant from this report?

The aspirate smears show degenerative, suspicious glandular epithelial cells, along with clusters and traces of connective-fatty stroma, numerous E and L cells, and fat droplets. A biopsy is recommended.

Thank you for the replies!

Dear Chris Kim,

The report indicates that the cytologist identified cells with a suspicious appearance. They couldn't definitively say whether these changes are malignant or benign, which is why a biopsy is necessary to clear things up.

Unfortunately, it isn't possible to tell from this specific finding whether the breast change is benign or malignant.

Best regards—I'm keeping my fingers crossed that the final diagnosis shows it's just a benign issue. 🙂

Alex Foster6 said:I'm in my 39th week of pregnancy and had some blood work done the other day (need to prep for an anesthesiology exam). For the most part, everything looks okay—white blood cell counts are slightly elevated and lymphocytes are a bit low, which is normal during pregnancy—but the sedimentation rate is confusing and a bit scary: mine is 40, while the reference range is 4-24. My doctor said it isn't anything concerning. 😕

Dear Alex Foster,

Generally speaking, the sedimentation rate is used as a marker for inflammation in the body. However, in pregnancy, that metric loses much of its utility because it naturally rises physiologically. In these cases, doctors rely on the patient's reported symptoms, a complete blood count (CBC), and CRP levels to decide if further testing or treatment is needed.

An elevated sedimentation rate is physiological during pregnancy. If this is your only outlier, there's no reason to worry; such a result is entirely expected.

Best regards, and all the best to you and your baby.
🙂

steeltiger10 said:Hi there!

Maybe someone could help me interpret these results; I haven't run into anything like this before...

(...)

I’ve been feeling poorly lately—sort of weak, dizzy, and exhausted—so I went in for blood work again this morning to see where things stand (my baby is 13 months old, so I definitely haven't taken iron in at least 10 months) and these were the results:

RBC 4.29
Hemoglobin 131
Ferritin 19

But then again,

Iron 30.2 (normal range 8-30)
WHO 10 L (26-59)
TIBC 40 L (49-75)

So what does it mean to have high iron alongside low WHO and TIBC?

Thank you so much!!

Dear neobična,

I have to admit, these results are quite unexpected; they don't follow the usual logic.

Specifically, while the iron is at the upper limit of normal, the TIBC and WHO are low. That part makes sense, as those levels typically rise during an iron deficiency and drop as iron concentration increases. What is confusing, however, is the relatively low ferritin, which doesn't align with an iron concentration sitting at the top end of the normal range. One would expect the ferritin to be higher.

Serum iron concentration itself can fluctuate significantly based on many factors, so it isn't a definitive indicator of the body's overall iron status.

All in all, I believe you should definitely have the Iron, Ferritin, TIBC, and WHO retested.

The question remains how much the iron levels are actually responsible for your current symptoms.

A thorough physical exam is certainly necessary, and likely a specialist consultation as well, to get to the bottom of these new symptoms.

Best regards. 🙂

steeltiger10 said:Could someone explain these results to me? I'm going crazy here....

Dear steeltiger10,

From what I can see, the blood work is improving; the CRP and white blood cell count have dropped, and the skin issues are clearing up. That is a very good sign.

I'm not sure if you actually have an enlarged liver (which is determined via abdominal exam or ultrasound) or if you are referring to slightly elevated liver enzyme levels, like ALT or AST?

If your condition is improving, I don't see any reason for concern.

Best regards. 🙂

Sandra Green38 said:I had to get a chest X-ray, and the results show some bronchopneumonic infiltration on the left side of my lung. Is that dangerous?
It hurts really badly when I cough.

Dear William Price,

Even if you're already on the mend and this answer isn't urgent anymore, I'll leave it here so the question doesn't go unanswered: it’s a form of pneumonia, usually bacterial in nature, which is why it’s treated with antibiotics.

Typically, you'll see improvement within about 1 to 2 days of starting antibiotics (fever drops, white blood cell counts decrease). The cough tends to linger longer, and the X-ray usually clears up in about 2 to 4 weeks.

Best regards. 🙂

Sandra Green38 said:I got my allergy test results back. My pulmonologist sent me over to the local hospital to get those specific tests done.
Here is what I got:

IgE 343 H
RAST g 6 (Timothy grass) conc. 98.0 H
class +5 H
RAST w 6 (Mugwort) conc. 3.40 H
class +2 H
RAST t 3 (Birch) conc. 1.75 H
class +2 H
RAST w 1 (Ragweed) conc. 4.26 H
class +3 H

I assume "H" means high; everything looks way outside the normal range. It seems I'm highly allergic, but I don't quite grasp what these numbers actually mean 😕 and I won't be seen at the hospital for another two weeks.

Dear Benjamin Martin65,

An elevated total IgE indicates an allergic predisposition—essentially, you are an allergy sufferer. The RAST results confirm allergies specifically to: Timothy grass, ragweed, mugwort, and birch.

To put it simply, the higher the concentration of specific IgE, the more severe the allergy. These concentrations are categorized into classes from 0 to 6. A 0 means the result is undetectably low, while classes 1 through 6 represent increasing levels of severity.

In your case, class +2 (which applies to your mugwort and birch allergies) signifies a low reaction, class +3 (ragweed) is moderate, and +4 or +5 (Timothy grass) represents a very high positive result.

Which specific condition develops—allergic rhinitis, allergic asthma, atopic dermatitis, or hives—depends entirely on your clinical presentation (your actual symptoms) and other diagnostic tests (ENT exam, spirometry, dermatology, etc.). Based on those, the appropriate treatment will be prescribed.

Best regards. 🙂

ruggedpilot16 said:29 years old. Running a low-grade fever for nearly six months now. Around that same timeframe, I’ve been noticing blood in my stool—my proctologist thinks it’s likely not just hemorrhoids. On top of that, there’s bloating, increasingly intense abdominal pain, and digestive issues. No weight loss to report.

Over the last few months, I’ve been running various blood tests...

(...)
My primary care physician suspects Irritable Bowel Syndrome, but my proctologist is pushing for a colonoscopy due to the symptoms I've been dealing with. Does anyone with actual medical expertise know if a more serious condition would show up on a standard blood test within the next few months while I wait to address these concerns?

Can anything concrete actually be concluded from these results? Is there any other test I should consider first, or am I at the point where I really need to face a colonoscopy?

Thank you.

🙂

Dear ruggedpilot16,

GI bleeding—specifically seeing blood in your stool—isn't a typical symptom. It doesn't fit the clinical picture of Irritable Bowel Syndrome.

Standard routine lab results aren't enough here. Given the recurring blood in the stool, they don't provide sufficient evidence to rule out an underlying organic disease.

Clearly, we're looking at symptoms that demand a specialist's eye and a thorough workup. If you find yourself second-guessing the proposed diagnostic plan, go find a second opinion from a gastroenterologist.

If I were dealing with symptoms like those, I’d grit my teeth and just go ahead with the colonoscopy. That’s just my take, though—you should definitely consult with your own doctors.

Greetings. 🙂

Drew Roberts412 said:Thank you for the quick response. On a side note—and I apologize for the tangent—back when I was a kid, Quote: Felix the Cat was my favorite comic strip.

It’s good to hear from you, Nicholas Myers. Quote: Felix the Cat It took me back to my childhood, if only for a moment. Take care out there. Wishing you all the best. Regards. 🙂

fadedtrucker5 said:Hey everyone. Does anyone here have experience interpreting a PET CT scan? Could someone help me make sense of these results? Thank you.

Try reaching out to the forum member. wanderingcobra76Maybe reach out to her—she’s a radiologist, so she might actually be able to help you make sense of this. Best regards. 🙂

Megan Ross36 said:So, we had the bloodwork done today. After three days, the white blood cell count is at 4.5🙂....

It’s good to see those white blood cell levels slowly returning to the normal range. Thanks for the update. Wishing you and your daughter all the best. Best regards. 🙂

Megan Ross36 said:I need some help interpreting a sperm analysis...😢
Diagnosis: Asthenoteratozoospermia.
Does this mean I’m in for a real struggle with my diet? Is this lab result actually as bad as it looks to me? 😢My doctor told me things are looking relatively good. 😢

To whom it may concern,

The diagnosis is asthenoteratozoospermia. Essentially, it means there's a reduction in both the number of progressively motile sperm and those with normal morphology.

One thing that bears emphasizing: evaluating male fertility requires analyzing more than just a single semen analysis.

You also need to schedule an appointment with a urologist. They’ll determine if you need microbiological testing—specifically for aerobes, anaerobes, Chlamydia, or Mycoplasma—and whether further andrological workup is required, such as a testicular ultrasound, testosterone levels, FSH, LH, and so on.

Since this isn't my area of expertise, I wouldn't dream of offering any estimates.

Your urologist will provide more specific details once they've had a chance to review these results, perform an exam, and determine the next steps for your treatment.

Greetings. 🙂

Megan Ross36 said:Thank you for the quick reply. I forgot to mention that we also ran a CRP test back then, and it came back low—I assume it was under 8 since there wasn't a specific number listed. Could a blood count like this point toward the flu? There were only 8 kids left out of a group of 25 at the daycare this week, so I suspect we're dealing with a particularly nasty virus going around.🤷Heading in for blood work tomorrow. If we're looking at a virus, should I expect any noticeable changes since Monday's labs?
Since the last time I took Clavulin, my white blood cell count returned to normal. Or does the process still need more time?

Dear Anthony White8,

That CRP result you mentioned only reinforces the suspicion that we're dealing with a viral infection. I won't speculate on the specific virus, though—based strictly on the individual parameters from the labs provided so far, pinpointing it isn't possible. That said, influenza is certainly on the table.

The main thing is that the child is feeling better, the fever has broken, and the signs of infection are fading. It’s only logical, then, to expect the blood work to follow suit—specifically, in this case, seeing that total white blood cell count start to climb back up. You usually see things normalize a few days after recovery sets in.

Greetings. 🙂

Charles Alvarez67 said:Hey everyone, could someone clarify this for me:
WBC unsegmented 13 (high)
segmented 66
lymphocytes 16 (low)
monocytes 4
SE 61
Hb 136
L 9.2
E 4.65
I think it might be some kind of viral infection; I’m not feeling great. Headache, sore throat, coughing...
Is it normal for lymphocytes to be low during an infection like this? I read somewhere that low lymphocytes only happen when you have HIV.?? 😲

Hello,

First off, it is WRONG to assume that low lymphocyte counts in the blood only occur with an HIV infection. If that were true, there would be no point in HIV testing because a diagnosis could be made immediately from a standard CBC based on lymphocyte levels—and we all know that isn't how it works, right?

In untreated HIV infections, there is a decrease in CD4+ T-lymphocytes, which is a specific subset of cells. You won't see those reflected in a routine blood count; they require specialized testing. So, there you have it—you were misinformed.

As for your blood work, what stands out most is a "left shift," meaning there is a higher number of immature neutrophils. This suggests your body is ramping up its defenses to fight off an infection.

A CRP test, which measures inflammation, could also help us determine more precisely what kind of infection we're dealing with.

You should consult with your primary care physician.

Best regards. 🙂

Charles Alvarez67 said:I'd like your opinion regarding my low platelet count. Mine is 144 (ref. range 158-424). Sedimentation rate 6; Blood Sugar 6.9; total cholesterol 5.9; LDL cholesterol 3.9.
AST, ALT, GGT, HDL cholesterol, and Triglycerides are all normal.

Dear Drew Roberts412,

Looking at the results you provided, the elevated blood sugar level is quite noticeable. Assuming you fasted for at least 8 hours before the draw, that value should ideally be under 6.0 mmol/l. You will definitely need to retest your glucose and follow any other testing recommended by your doctor.

Furthermore, your cholesterol levels are also mildly elevated, and I believe you should look into lowering them in coordination with your physician.

A slight drop in platelet count is often discovered incidentally during a routine blood count. Your values are only marginally outside the normal range. Unless you are experiencing symptoms related to bleeding issues—such as skin bruising from minimal trauma, easy or repetitive bruising, or frequent nosebleeds—the only necessary step is to repeat the test after a period of time to monitor the trend (whether they are rising or continuing to fall).

Please discuss all of this with your doctor.

Greetings. 🙂

Megan Ross36 said:Hi 👋

We are talking about a 3-year-old child.
Because of swollen lymph nodes and a high fever, a CBC and ALP were ordered, along with a test for infectious mononucleosis.
Mononucleosis was ruled out, but the lymph nodes remain visibly enlarged, and the ALP is 25% above the upper limit of the reference range.

After a course of broad-spectrum antibiotics, they were sent for follow-up testing of ALP, AST, ALT, GGT, CRP, and a CBC.

What is the goal of this kind of diagnostic workup?

Dear Enzo Ferrari,

The tests requested aren't specific; doctors order these kinds of panels every day for patients with various suspected illnesses or as part of routine checkups. Because of that, it isn't possible to pinpoint a specific target based solely on the information provided.

There are infectious disease specialists on this forum, including one user, Khan, so you might want to try reaching out to him via private message. Once you provide him with a more detailed history—what happened with your child, which specific tests were run, and what the results actually showed—he should be able to explain the different possibilities being considered.

Best regards, and I hope your child feels better soon. 🙂

Megan Ross36 said:These are my results. I pretty much understand the cholesterol part... but could someone tell me about the CRP, Sedimentation rate, and pH levels?

I have fatty liver, though my values from a year ago have dropped by half now, which is great.

Lab report copy/paste:
...

Dear silvertiger95,

CRP (C-reactive protein) and Sedimentation rate are non-specific markers of inflammation. "Non-specific" means that based on elevated levels alone, we can't determine what kind of inflammatory process is occurring or where it is located in the body.

The values in your report are only very mildly elevated. It might just be a trace of a minor infection you had when the blood was drawn (like a mild respiratory virus, for instance).

In any case, since these elevations are quite slight, I don't think you need to worry. It should be enough to simply coordinate with your doctor to repeat the tests after a short period—maybe two weeks—to see if the levels have returned to the normal range.

Urinary pH measures acidity; it typically sits around 6, with a standard range between 4.5 and 8.0. Essentially, urine is normally slightly acidic to slightly alkaline.

Your cholesterol and triglyceride levels still aren't where they need to be. Given the fatty liver you mentioned, these should ideally be lower, so you’ll need to consult with your physician to adjust your management plan.

Your liver enzymes are slightly elevated, but the fact that they are trending downward is definitely a good sign.

In short, the results show that your cholesterol and triglyceride levels are still off—you'll need to focus on driving those down further. Your liver enzymes are only slightly elevated, though the fact that they're trending downward is a positive sign. There are also some lingering indicators of mild inflammation.

Consult with your primary care physician.

Greetings. 🙂

Megan Ross36 said:...Can Clavulin really tank your white blood cell count that much when you're dealing with a virus and using fever reducers? Can someone else help me interpret this blood work?
How many days should pass before we recheck the little one's blood work? I was thinking maybe 3 or 4 days. Is that too soon?
She hasn't had a fever since yesterday. Just a very congested nose now.

Dear Anthony White8,

Leukopenia can show up alongside severe viral infections, and it’s also been noted as a rarer side effect of Clavulin. Essentially, a heavy virus could trigger this drop in white blood cells all on its own, and the Clavulin might have just added fuel to the fire.

Your daughter’s blood work—specifically that drop in white blood cell counts alongside the spike in lymphocytes—could suggest she's fighting off a more significant viral infection.

In any case, if the low white blood cell count is linked to a viral infection, you should expect those levels to stabilize within a few days of recovery. It is absolutely critical to monitor the results.

It’s certainly not too early to get a blood count checked. Not at all. Make sure you double-check everything. It's essential.

Best wishes to you and your daughter. 🙂

Dear Bryan Davis,

Generally speaking, I would consider this complete blood count to be within the normal range. There are no indicators of anemia here.

Regarding the slightly elevated fibrinogen levels, before jumping into any deep diagnostic workups to find a cause, you should definitely repeat the fibrinogen test along with a full CBC, a CRP test, and perhaps other parameters as suggested by your doctor.

Fibrinogen might just be temporarily high; it’s important to monitor the trend—whether it's climbing or dropping. Elevated fibrinogen can be seen in smokers, individuals with higher body weight, or even in some perfectly healthy people.

It is also possible this relates to some form of inflammation or an infection (if that 5.0 figure refers to percentages, then the unsegmented granulocytes are only very slightly elevated at 5%).

Unfortunately, without a physical exam, it isn't possible to determine the exact cause.

Best regards.🙂

Sarah Bennett12 said:Pathological analysis of a colon polyp:

Based on two biopsy samples (0.2 cm diameter)...

"Histologically, there are portions of a polypoid formation composed of mildly dilated crypts lined by regular mucinous cylindrical epithelium. The surrounding stroma contains abundant inflammatory infiltrate consisting of lymphocytes, plasma cells, eosinophils, and neutrophils."

Thank you,

Best regards

Dear Ronald Green31,

From the portion of the findings you quoted, it appears that neither suspicious (dysplastic) nor malignant cells were found in the samples. This is an excellent indicator and arguably the most important part of the whole colon polyp situation.

However, determining exactly what kind of polyp this is—which is crucial for deciding if follow-up monitoring is necessary—cannot be done based solely on that single sentence from the report.

Best regards. 🙂

Sarah Bennett12 said:A few numbers in my results are off:
Fibrinogen activity: 4.4
Unsegmented neutrophils: 5.0
Platelet count: 6.4
Hemoglobin: 350
MCV: 80.0

Is it possible my fibrinogen is high because I have a Cold and have been coughing quite a bit lately? I assume I'm not pregnant. 🙂
As for the rest, am I anemic or is the quality of my cells just low? Can this be fixed? 😕

Dear Bryan Davis3,

It isn't possible to answer your questions based on these few parameters alone.

As I mentioned in a previous comment regarding another report, an elevated fibrinogen level doesn't tell us much on its own. It can indicate an inflammatory process, but it doesn't have to; fibrinogen levels rise during pregnancy, among many other conditions, so we can't conclude anything about your status from that number alone. I don't think it's likely that a simple Cold would cause such a spike.

Whether or not this is anemia can only be determined after looking at hemoglobin concentrations and red blood cell counts. If those are normal, then it isn't anemia. Your Hemoglobin and MCV results, as well as your Platelet count, are practically normal.

The number of unsegmented neutrophils is slightly higher, but only in percentage terms; without knowing the total white blood cell count, it's impossible to say if the absolute count is also high.

Overall, one could say some parameters deviate only slightly from standard ranges, but nothing concrete can be concluded without a full clinical review.

Therefore, you should consult with your primary care physician.

Best regards. 🙂

Olivia Edwards23 said:Can someone help me out?🙂My lab results show😁Neutrophils at 73.71% (reference range is 50-70), so I assume my white blood cell count is a bit high, and MCHC is 347H (50-70)—I have no idea what that means.

Three weeks ago, I had a sore throat which I treated with Clavulin. Even after that, my throat still feels a bit sore, specifically when swallowing. I saw my doctor a few days ago, and she said there was no need for antibiotics regardless of the slight inflammation in my throat.

Now, my throat is still bothering me and I've started coughing, though I don't have a fever. Just to clarify, I had my blood drawn for liver function tests, so they did a full blood count at the same time. I'm not sure what to do about this throat pain—should I go back to the doctor for another look??

Olivia Edwards23 said:Also, my fibrinogen is elevated, which is why I can't take birth control pills. Could the elevation be due to the lingering throat inflammation? Thank you.🙂

Dear Jerry Vaughn8,

Regarding the white blood cell count and the differential, it’s important to know the total white blood cell count along with the breakdown of specific types. You only provided the percentage of neutrophils, which is only marginally elevated. It's difficult to draw any real conclusions from that alone. If your total white blood cell count is within the normal range, then this result is essentially normal.

MCHC represents the average concentration of hemoglobin in the red blood cells. It should be interpreted alongside your red blood cell count, hemoglobin levels, and other indices like MCV and MCH. MCHC is typically measured in g/L, with a standard reference range of 320-345 g/L. This would mean a value of 347 g/L is practically normal. There seems to be a typo in your report (likely that "50-70" range listed next to the MCHC value).

As for the fibrinogen, it is well known as an inflammatory protein. An elevated level can indicate some sort of inflammatory process in the body, but it's worth noting there are many other possible reasons for such a spike.

Finally, regarding the sore throat, it's hard to give definitive advice from a distance. The symptoms you described—coughing and a normal temperature—don't necessarily point toward strep throat, which would require antibiotics. Whether you should see a doctor is best left for you to decide. However, since these issues have persisted for quite a while (if I understand correctly, it's been over three weeks), a follow-up with your primary care physician seems like the smartest move.

Best regards. 🙂

Olivia Edwards23 said:GLAUCOMA? - Help me interpret these results

Sent you a PM.

Sophia Adams63 said:Hi, I could use some help translating a diagnosis from a discharge summary. I have a general idea of what it means, but I’m looking for an exact translation of the clinical terms used in the report. The diagnosis reads: subileus. NLP abdominis. Ascites-carcinosis perinotei. I assume the treatment plan was: Laparotomy exploratory. biopsy of the greater omentum. Thank you in advance for the help...

Dear Nicholas Doyle91,

I will attempt to address your inquiry.

Subileus refers to an obstruction in the intestinal passage caused by various underlying conditions.

I am not entirely sure what "NLP abdominis" is intended to mean. However, if we are looking at NPL abdominis, that would refer to a neoplasm—essentially a tumor or abnormal growth—located in the abdomen.

Ascites refers to the accumulation of fluid within the abdominal cavity.

Peritoneal carcinomatosis refers to the spread of malignant cells throughout the peritoneum. It typically occurs when cancer from abdominal organs—such as the intestines, ovaries, stomach, liver, or pancreas—migrates across the lining of the abdominal cavity.

Exploratory laparotomy: an operative procedure where an incision is made through the abdominal wall to open the cavity, specifically to determine exactly what's going on inside.

Omental biopsy refers to taking a tissue sample from the greater omentum for microscopic analysis. Think of the greater omentum as an apron-like structure that hangs from the stomach, draping over the front of the intestines; it contains varying amounts of fatty tissue.

I hope your doctors gave you a clear explanation of what's actually going on.

Based strictly on this data, drawing any firm conclusions is difficult. What can be inferred is that a patient presenting with an abdominal tumor and bowel obstruction—likely confirmed via X-ray and other diagnostic imaging—underwent surgery. During the procedure, free fluid was detected within the abdominal cavity, along with peritoneal changes suggesting the process has spread from the primary organ throughout the abdomen. Tissue samples were also collected during the operation for microscopic analysis.

Greetings. 👍

Sophia Adams63 said:How do you perform a 24-hour urine collection?

Dear George Clark19,

Get some clean bottles ready. Wash them thoroughly with water—plastic ones work best.

Handle your first morning bathroom trip just like any other. Use the restroom as you normally would.

From that moment on, collect all urine in a container throughout the entire day and night, including the very first morning sample after you wake up on the second day.

To ensure the analysis is accurate, you need to calibrate the collection process so that you start and finish at the exact same time.

For instance, on day one, make sure to empty your bladder. Exactly. 7:00 AM, in the restroom. After that, collect all urine in a container until the following morning when you need to provide the sample. Exactly. At 7:00 AM, empty your bladder completely and collect the urine in a specimen bottle.

Once that’s done, drop the sample off at the lab sometime that morning—just make sure you get there before they stop accepting collections for the day. In the meantime, keep the specimen in the fridge.

One detail is crucial: on the first day, you use the restroom for your first morning urine, but on the second day, you collect that first morning sample in a container.

Best regards. 🙂

To those concerned,

Based on what you've described, it’s possible you’re dealing with a form of physical urticaria.

Essentially, this is a group of allergic conditions where the skin reacts hypersensitively to specific physical triggers—things like cold, pressure, heat, or UV exposure from the sun. This category also includes Cholinergic Urticaria, which kicks in when your body temperature rises due to things like hot showers, sweating through exercise, or just getting too warm.

Heat urticaria is quite rare; it occurs specifically when the skin comes into contact with hot objects or warm air.

Diagnosis usually involves a heat challenge test. It’s straightforward: warm water (around 107°F) is applied to the skin on the inner forearm for 10 minutes, then the area is monitored for redness, swelling, or other reactions.

If Cholinergic Urticaria is suspected, the "challenge" might involve doing push-ups or running to induce sweating, followed by an observation of how the skin responds once the perspiration starts.

You should seek a consultation at an allergy clinic or see a dermatologist for a full workup. I'd suggest asking your primary care physician for a referral to a specialist.

Best regards to all. 🙂

Karen Grant54 said:Just one simple question... I was scheduled for a surgical consultation regarding a hernia during my 8th month of pregnancy. The doctor who saw me gave a very brief opinion; it felt as if he didn't quite know what to say. Honestly, even my OBGYN had more to offer...
It doesn't make sense to me—if I'm seeing a surgeon, shouldn't a surgeon actually examine me?😕Logic would dictate that, wouldn't it? (Wouldn't his title reflect a surgical specialist rather than just a general MD?)
I have zero background in medicine, so the titles and specialties escape me, but things like this stand out. Thank you for the response.🙂

Ma'am,

By all accounts, you were seen by a general surgery resident.

Residents are physicians who have graduated from medical school and earned the title MD. After completing their mandatory internship and passing their boards, they begin their residency—in this case, likely in general surgery, which typically lasts about 54 months. Once they finish that training and pass their specialty exams, they earn the official title of specialist in that specific field.

swiftbison92 said:That’s exactly why he’s losing it. It feels like they lack expertise; they don't know how to handle him, just point him at an eye chart and call it a day.
It wasn't until his third visit that they actually performed some kind of dilated exam😕, though I'm not entirely sure of the specifics.
They sent him for a brain CT, and once that came back clear, they were still at a loss—so they suggested an MRI, basically saying, "We aren't sure what to do, maybe let's try an MRI next."
What would you recommend?
Thanks much

To whom it may concern,

From what I can gather from your description, a thorough strabological evaluation hasn't actually taken place.

I suggest asking your primary care physician for a referral for a full diagnostic workup at a specialized strabology clinic or an orthoptics and pleoptics department. These specialized units are typically housed within larger hospitals or clinical centers under an ophthalmology clinic.

Depending on where you are located, you could seek an evaluation at the Mayo Clinic, St. Jude Children's Research Hospital (if you are in the Washington, D.C. area), Cedars-Sinai Medical Center, Cleveland Clinic, Johns Hopkins Hospital, or other major medical hubs (such as a General Hospital in cities like St. Louis or Pittsburgh).

The specialists in these clinics are ophthalmologists who have specifically sub-specialized in strabismus issues—essentially disorders involving eye alignment and motility, double vision, amblyopia, and more. They will conduct a comprehensive assessment to determine your husband's exact eye positioning and movement, whether there is an imbalance in the ocular muscles, the presence of diplopia, if all muscles are functioning correctly or if one is weakened, and his depth perception capabilities.

Only after this extensive battery of tests will a concrete diagnosis be possible. Often, a neurologist is brought into the diagnostic team as part of this process.

I hope that this time, your husband can see specialized ophthalmologists who will take his vision issues seriously.

Best regards. 🙂

Sandra Martin72 said:Could someone please offer some advice:

I have a 3-month-old baby. We went in for a routine urine checkup, and everything looks normal except for:

cloudy urine
hyaline casts: 1 with amorphous salts per 10 fields
crystals: some amorphous salts and a few calcium oxalate

pH is fine, erythrocytes, leukocytes, volume, etc.—everything else falls within the normal range.

Thanks in advance for any insight.

Dear rustyrider99,

Based on what you've shared, it’s impossible to determine exactly what is happening with your child. All I can say is that you should consult with a pediatrician (hopefully you already have).

Best regards to you and your little one. 🙂

Sandra Martin72 said:I had some labs done a few days ago. My hematology isn't quite right—Sedimentation rate is 50 at 1 hour and 80 at 2 hours, plus an RDW of 15.8. In my differential blood count, basophils are slightly elevated at 0.02. Biochemistry is fine, aside from triglycerides at 3.16 and cholesterol at 9.5. Is this concerning? Why would basophils be high, and is there a link to the sedimentation rate? Looking for opinions! Thanks!

Dear Ryan Allen4,

The elevated cholesterol levels (total cholesterol for individuals without heart disease, vascular issues, or diabetes should ideally be under 5 mmol/l) and triglycerides (which should be below 1.7 mmol/l) stand out immediately. You will certainly need to manage this in coordination with your primary care physician through lifestyle changes, exercise, dietary adjustments, or medication if necessary. It will also be important to monitor your blood pressure, calculate cardiovascular risk, confirm smoking status, check blood sugar levels, body weight, BMI, waist circumference, and other related lab values.

An elevated sedimentation rate is a non-specific finding, meaning it doesn't point to a specific cause on its own.

As for the basophils, I don't see an issue if you transcribed the result correctly (0.02), as the reference range is typically 0-1%, or an absolute count of 0-0.2x10^9.

Best regards. 🙂

Sandra Martin72 said:I have a question and am looking for answers.

During my pregnancy, I was regularly monitoring my platelet count due to thrombocytopenia. They were normal in the third trimester, but my white cell count was elevated at 16-something. A urine culture came back clear. After a couple of days, they repeated the test and it was 17.6. Sedimentation rate was 33. I was prescribed antibiotics (Ceforex) and took them...

One week after my last dose of Antibiotics, the results came back: WBC at 22 point something, segmented neutrophil granulocytes at 15.30% (normal up to 6.49), making them 80.1% (normal up to 72
.
Other tests were fine, except for CRP which was 7.2—though for pregnant women, anything up to 15 is usually tolerated, and I was pregnant at the time
.
Sedimentation rate was 26 (normal up to 24) and fibrinogen was 5.6 (normal up to 3.5)
.
Urine cultures were clear three days in a row, and cervical swabs and Pap smears were all normal
.
AST (antistreptolysin titer) was positive at 297 (normal up to 200)
.
I didn't have any fever
.
Why would the white blood cell count be high? What’s your take, especially since this was despite the Antibiotics
?
I've already given birth, but I just haven't gotten around to going back for a follow-up check yet
.
Thank you
.

Dear Jerry Booth10,

It would be best to recheck your white blood cell count, your general blood work, and your CRP. If those numbers come back normal, there's no reason to worry. Even though you mentioned you aren't feeling particularly motivated to go right now, I still strongly recommend you do it.

It will be difficult to determine the cause of leukocytosis from a pregnancy that has already passed.

Best regards. 🙂

Sarah Wells23 said:Looking for feedback on this spermogram.

volume 5.2
pH 7.9
concentration 137
sperm count 712
liquefaction 2
vitality 53
motility 50
progressive
non-progressive
stationary
immotile 50
white blood cells 1-2
morphology normal 42
abnormal head shape 54
abnormal midpiece shape 3
abnormal tail morphology 1
zinc 3.2
fructose 20.4
citrate 45.8

Thank you.

Key parameters for a spermogram include:

volume ---------- normal is above 2.0 ml
concentration ----- normal is above 20 million/ml
motility ------ normal is above 50%, with progressive motility above 25%
morphology ------- normal is above 30% normal forms
white blood cells --------- normal is less than 1 million/ml

While this isn't my specialty, I'd say your results fall within the normal range, though some numbers could be better.

White blood cell counts are slightly elevated, which might suggest some inflammation. You should consult your urologist.

Best regards. 🙂

Roger Rodriguez said:Please provide feedback on these results.🙂

ESR (Erythrocyte Sedimentation Rate) - 1h: 40 mm/3.6 hrs (4-24)
White blood cells: 10.4 (3.4-9.7)
Hemoglobin: 351 (320- 345)
Neutrophils: 6.70 (2.06-6.49)
Sodium: 124 (137-146)
Potassium: 3.2 (3.9-5.1)

White blood cells in urine: 25
Squamous epithelial cells Mass

Everything else looks normal. The urinalysis doesn't specify what is considered "normal," so I only copied the white blood cell count since everything else was negative. It also mentions the color is dark yellow, but I'm not sure if that's normal or not.

I had my blood drawn after a week of severe nausea and vomiting.
The abdominal ultrasound came back clear (gallbladder, liver, pancreas, spleen) and noted: Both kidneys are normal size and parenchymal thickness, central sinus shows more prominent echoes, and there are microcalcifications in the parenchyma and parapelvic area (nephrocalcinosis? renalspongeiform?).
Only my stomach hurts, nothing else.
Since I still don't have a diagnosis and now I have a fever (which I didn't have before) and I still feel unwell, I'm wondering if these results point to anything specific or if they are considered normal?

Dear Roger Rodriguez,

These results don't point to anything definitive, even with the deviations.

The low sodium and potassium levels could likely be explained by intense vomiting, causing electrolyte loss.

Finding a high number of squamous epithelial cells in the urine can indicate sample contamination (usually when the specimen isn't collected properly, such as being mixed with vaginal secretions or coming into contact with skin), so it's hard to tell from this alone if it indicates a urinary tract infection or not.

The abdominal ultrasound shows microcalcifications in the kidneys, so further investigation would be needed to determine the cause (this is often seen alongside hypercalcemia—elevated calcium levels in the blood).

Please consult with your physician regarding any follow-up steps.

Best regards. 🙂

swiftbison92 said:mm has been dealing with double vision for at least five years now.
It gets noticeably worse when he's tired. He holds his phone out at arm's length just to see it. His visual acuity is perfect, yet they've bounced him from one specialist to another without any real answers.
He had a brain scan, everything came back fine, and two months ago—following a recommendation from his primary care doctor—I finally scheduled an MRI, though it isn't set until March 25th.
At this point, he doesn't even view it as an issue; the double vision has just become part of his daily reality.🤣
He was resistant to the MRI, so I had to step in and book it myself.
The appointment is on the 32nd, so hopefully, we get some clarity then.

Dear swiftbison92,

Double vision is a symptom that requires a thorough investigation by both a strabology clinic and neurology.

Has your husband undergone a full strabological workup (including the Hess-Lancaster test for diplopia, motility testing, Maddox wing, Maddox cross, cover tests, etc.)?

Patients often claim their vision is perfect, pointing to ophthalmologist reports showing 20/20 acuity. However, in your husband's case, checking visual acuity is insufficient. He needs an extensive evaluation by an ophthalmologist subspecialized in pediatric ophthalmology and strabismus, as very few specialists possess deep experience in this specific field.

The fact that the double vision intensifies with fatigue could suggest heterophoria—essentially an imbalance in how the eye muscles function together.

Given that you mentioned he struggles to read characters on his phone and compensates by holding it further away, near vision must also be assessed; it could potentially be hyperopia.

Without a complete strabological and neurological evaluation, reaching an accurate diagnosis will be difficult.

Best regards. 🙂

mistymaker8 said:Looking for some insight:
Female, 42, overweight.
Three days of fever reaching 104°F, accompanied by chills and tremors, frequent urination, blood in urine, general weakness, and pain in the right flank area.

L 14,1,,E4,8,,Hgb 128,,Hct 0,403,,MCV 84,,Platelet count 256,,AST 40,,ALT 29,,AF 72,,GGT 39,,Glucose 5.5,,urea 10,,creatinine 246,,bilirubin 25,,CRP 342.2.

Urine culture - sterile

Kidney ultrasound shows bilateral thickening of the parenchyma, somewhat hyperechoic, but no obstruction, cysts, or stones. X-ray shows nothing significant, just visible spiral patterns.

Thank you in advance!

Dear mistymaker8,

Based on the symptoms and lab results provided, this could point toward acute pyelonephritis (a kidney infection).

However, the urine culture doesn't quite fit the picture; it came back sterile when we would typically expect to see bacteria present. That said, a false negative is entirely possible, especially if the patient started taking Antibiotics before providing the sample.

It is important to emphasize that this could be something else entirely—something impossible to determine through an online forum.

Perhaps someone here who is an infectious disease specialist or a urologist can weigh in.

Best regards. 👍

Megan Jones27 said:I'm curious about these low and high values:

Hematology
K - RDW: 11.8 (14.6 - 16.5)

Metabolites and substrates
S - Glucose: 6.1 (4.2 - 6.0)

Trace elements
S - WHO: 63 (26 - 59)

I read that WHO increases when iron is low... mine is currently 13 (8 - 30)

About a year ago, specifically in November 2009, my WHO was normal at 38 (26 - 59) because my iron was 29 (8 - 30).

I have no idea why it shifted so much now...

Dear Zachary Gomez,

You have correctly identified and explained the link between low serum iron and elevated WHO.

If hemoglobin and erythrocyte levels are normal but WHO is high, it’s possible you have latent anemia. To confirm this, ferritin levels need to be checked; low ferritin would be the indicator.

Alternatively, it might not even be latent anemia yet; the results could still be within a borderline range, though there is a risk of developing iron-deficiency anemia if the trend of depleting iron stores continues.

As for the cause behind the declining iron levels, it isn't possible to say without a detailed clinical history and physical exam. In women before menopause, the most common culprits are heavy menstrual cycles or other reproductive system issues, though dietary iron deficiency is also a factor. Other causes exist as well. Please consult with your physician.

Given that your fasting blood sugar came back at 6.1 mmol/l after an 8-hour fast, I'd suggest you touch base with your doctor to schedule a follow-up glucose test just to be certain.

Best regards. 🙂