I got my 7th chemotherapy yesterday…my liver enzymes (specifically my bilirubin) were finally back to normal…they want me to come back in for blood work next Monday to determine if I need ANOTHER blood transfusion…my red-blood cells are still not cooperating…I’ve never taken the time to look up exactly what all of the initials in the blood test results mean…so last night I googled all of them and most of the definitions I found come from Wikipedia…I am sharing the technical information so that I have a place where it is written down (and it is a lot easier to cut and paste)…and maybe some of you will understand it…so the following is an overview of things in my blood work that is abnormal, and selected parts of their definitions…after that I will talk a little more in non medical terms about what I understand to be happening…so you might want to just skip down (wink, wink)RBC is low 2.87 normal is 3.50-5.50A red blood cell, (the cells that Give blood its distinctive red colour). A red blood cell’s (erythrocyte) function is to carry haemoglobin around the body. Haemoglobin carries oxygen which is required for cellular respirationHBC is low 8.4 normal is 11.0-16.0Hemoglobin (also spelled haemoglobin and abbreviated Hb or Hgb) is the iron-containing oxygen-transport metalloprotein in the red blood cells ofvertebrates  and the tissues of some invertebrates. Hemoglobin in the bloodis what transports oxygen from the lungs or gills to the rest of the body (i.e. the tissues) where it releases the oxygen for cell use.Hemoglobin deficiency can be caused either by decreased amount of hemoglobin molecules, as in anemia, or by decreased ability of each molecule to bind oxygen at the same partial pressure of oxygen. Hemoglobinopathies(genetic defects resulting in abnormal structure of the hemoglobin molecule)may cause both. In any case, hemoglobin deficiency decreases blood oxygen-carrying capacity. Hemoglobin deficiency is, in general, strictly distinguished from hypoxemia, defined as decreased partial pressure of oxygen in blood,    although both are causes of hypoxia (insufficient oxygen supply to tissues).Other common causes of low hemoglobin include loss of blood, nutritional deficiency, bone marrow problems, chemotherapy, kidney failure, or abnormal hemoglobin (such as that of sickle-cell disease).HCT is low 26.8 normal is 32.0-48.0The hematocrit (Ht or HCT) or packed cell volume (PCV) or erythrocyte volume fraction (EVF) is the proportion of blood volume that is occupied by red blood cells. It is normally about 48% for men and 38% for women. It is considered an integral part of a person’s complete blood count results, along with hemoglobin concentration, white blood cell count, and platelet count.Lowered hematocrit can imply significant hemorrhage.The mean corpuscular volume (MCV) and the red cell distribution width (RDW) can be quite helpful in evaluating a lower-than-normal hematocrit, because it can help the clinician determine whether blood loss is chronic or acute. The MCV is the size of the red cells and the RDW is a relative measure of the variation in size of the red cell population. A low hematocrit with a low MCV with a high RDW suggests a chronic iron-deficient erythropoiesis, but a normal RDW suggests a blood loss that is more acute, such as a hemorrhage.Groups of individuals at risk for developing anemia include:
- infants without adequate iron intake
- children going through a rapid growth spurt, during which the iron available cannot keep up with the demands for a growing red cell mass
- women in childbearing years with an excessive need for iron because of blood loss during menstruation
- pregnant women, in whom the growing fetus creates a high demand for iron
- patients with chronic kidney disease, as their kidneys no longer secrete sufficient levels of the hormone erythropoietin, which stimulates red blood cell production by the bone marrow.
RDW is high 71.7 normal is 33.8-50.8If the RDW level is increased and the MCV level is normal. This can be caused by the beginning stages of a decrease in vitamin B12 or folic acid (a type of vitamin) in the body. It can also be caused by the beginning stages of iron deficiency anemia.Lymphocytes are low 13.3 normal is 17.0-40.0A lymphocyte is a type of white blood cell in the vertebrate immune system.T cells (Thymus cells) and B cells (bone cells) are the major cellular components of the adaptive immune response. T cells are involved in cell-mediated immunitywhereas B cells are primarily responsible for humoral immunity (relating toantibodies). The function of T cells and B cells is to recognize specific “non-self” antigens, during a process known as antigen presentation. Once they have identified an invader, the cells generate specific responses that are tailored to maximally eliminate specific pathogens or pathogen infected cells. B cells respond to pathogens by producing large quantities of antibodies which then neutralize foreign objects like bacteria and virusesMammalian stem cells differentiate into several kinds of blood cell within thebone marrow. This process is called haematopoiesis. All lymphocytes originate, during this process, from a common lymphoid progenitor before differentiating into their distinct lymphocyte types. The differentiation of lymphocytes follows various pathways in a hierarchical fashion as well as in a more plastic fashion. The formation of lymphocytes is known as lymphopoiesis. B cells mature into B lymphocytes in the bone marrow, while T cells migrate to and mature in a distinct organ, called the thymus. Following maturation, the lymphocytes enter the circulation and peripheral lymphoid organs (e.g. thespleen and lymph nodes) where they survey for invading pathogens and/or tumor cells.Monocytes are high 11.7 normal is 0.0-10.0Monocyte is a type of white blood cell, part of the human body‘s immune system. Monocytes have several roles in the immune system and this includes: (1) replenish resident macrophages and dendritic cells under normal states, and (2) in response to inflammation signals, monocytes can move quickly (approx. 8-12 hours) to sites of infection in the tissues and divide/differentiate into macrophages and dendritic cells to elicit an immune response. Half of them are stored in the spleen. Monocytosis is the state of excess monocytes in the peripheral blood. It may be indicative of various disease states. Examples of processes that can increase a monocyte count include:
- chronic inflammation
- stress response
- immune-mediated disease
- infectious mononucleosis
- pyogranulomatous disease
- red cell regeneration
- Viral Fever
A high count of CD14+CD16+ monocytes is found in severe infection (sepsis)and a very low count of these cells is found after therapy with immuno-suppressive glucocorticoids LDH is high 443 normal is 100-190Lactate dehydrogenase (LDH or LD) is an enzyme (EC 18.104.22.168) present in a wide variety of organisms, including plants and animals.Tissue breakdown elevates levels of LDH, and therefore a measure of it indicates, e.g., hemolysis (blood loss/anemia). Other disorders indicated by elevated LDH include cancer, meningitis, encephalitis, acute pancreatitis, and HIV.Albumin is low 3.4 normal is 3.5-5.0Albumin is the main protein of plasmaLow albumin (hypoalbuminemia) may be caused by liver disease, nephrotic syndrome, burns, protein-losing enteropathy, malabsorption, malnutrition, late pregnancy, artefact, genetic variations and malignancy.So the long and short of it is that a lot of the things point to anemia which is a result of the chemotherapy and what has resulted in my getting two blood transfusions so far with a third possibly next week…normal HGB is around 11…10 is acceptable…I was at 9.1 last week after a blood transfusion…and I am now back down to 8.4 which is why I am perpetually tired…The other bigger thing that is worrying me is that my LDH is SO much higher than it should be…like TWICE as high…yesterday the nurse explained to me that a high number for your LDH is an indication of the disease…that is scary…just over a month ago I thought this whole process is winding down and then they find the “activity” in my spleen…then they order two more chemotherapies…and then I am having all kinds of low red blood cell counts (which I didn’t have the first part of my treatment)…What if something is coming back? a few of the above results talked about how they reside in the spleen…so I don’t know what that means as far as the cancer and the chance of it spreading…all I know is that I’m a little discouraged…and tired of being TIRED! Last night I slept from 8 to 5 and went back to bed at 7 am and slept until 1 (getting up just cause the dog needed to go out) I forced myself to clean my fan, do the dishes, and cooked supper (which was good, and about all I could handle) now it is 9 and I am ready for bed Fred…I’m hoping to feel good enough to take the dog for a romp in the cemetery tomorrow (I love that I found a place that is quiet ,empty most of the time where I can let her run around a bit..I think she really likes the freedom)…
Tally Heilke said…Wow, heavy stuff. My mom was battling Hepatitis C a few years ago and had to learn a bunch of technical stuff like this (as well has how to give herself shots – ick). Not to be glib, but a couple of those acronyms sound like banks to me. RBC, for example – where I live we have a Royal Bank of Canada that’s called the RBC for short. Odd that such an unrelated thing sprung to my mind when reading about bloodwork. I hope you beat this thing and make a full recovery. Best wishes,~TallysTreasury from swap-botElizabethMD Jewelery said…I can’t imagine how you must feel looking up all of those results. As a perm. resident of hospitals (because of sickness and the fact my father was a medical laboratory technologist). I knew alot and want to let you know that depending where you are in your treatments thats pretty avg. I have had sooo many ppl in my life go through chemo and radiation, and other crap. If you need an ear I’m hear to listen.Sincerely,ElizabethMD from swapbotAnonymous said…yikes, my friend. i would kick cancer’s butt for ya if i could…but since i can’t, i offer a large BOO HISS!love you!