vacuolated neutrophils

Hello! For several years now I have had an elevated wbc (12,000-18,000) and elevated platelets (400,000-700,000). I am seen by a hemotologist once a year just to make sure nothing is out of line. He just says I "run high". I have recently been feeling run down and have been getting sick often so I went to my PCP. He did a CBC and again found elevated wbc(14.6) and platelets(684), along with an elevated absolute neutrophil count (9.2). My bands were also elevated It also says that vacuolated neutrophils are present. Does anyone know what vacuolated neutrophils means or what the results could indicate?

[Dr Sharma]

Hi there. Your elevated wbc along with neutrophils could be due acute infection, gout, rheumatoid arthritis thyroiditis, acute stress, trauma, myelocytic leukemia etc. vacuolated neutrophils may have associated with severe infection, chemical poisoning and other toxic states. Bands are immature neutrophils and an increase is called left ward shift due to acute infection.
High platelet counts could be due to reactive thrombocytosis, due to a bone marrow disorder or essential. Causes of reactive are infection, inflammatory disorders,like rheumatoid arthritis, blood loss, tissue damage from trauma or surgery, underactive or absent spleen like celiac disease or sickle cell disease.
Certain myeloproliferative disease, chronic myeloid leukemia, essential thrombocythemia there is increase in platelet producing cells or megakaryocytes  in the bone marrow . hope this makes some sense to you. Take care.