Are RDW/RBC counts important?

I have had 4 procrit shots and my HGB is happy again (11.9 from a low 0f 9.7). I'm starting to get very winded again though, my cough is back, and I am having frequent heart palpitations, just as I did when my HGB was low.
My recent CBC tests are:
Hematocrit - 37.6
HGB - 11.9
WBC - 1.9
MCV - 104
Platelet - 177
RDW/RBC 18.4 (this is the one that seems high to me)
Red blood cells count - 3.6

Seems to me from researching other posts on this forum, I shouldn't worry about the RDW/RBC count? Just wondering if that is what could be causing these symptoms again.

Thanks for any insight.
June

[spectda]

I hope someone is monitoring your procrit and hgb carefully. Your hgb should not go over 12 with procrit. The doctor may have you skip an injection and spread them out further, wbc low but plenty safe for now. How's your anc (absolute neutrophil count)? your platelets are great!

[Junebug812]

I hope to speak to my doctor before my next Procrit shot on Tuesday. He didn't do an ANC the last two lab tests. I was at 0.8 ANC at the end of January and then it went up to 0.9 and then he stopped ordering that test. He now does a manual neutrophil. It's at 48 which I believe is in the normal range.

[Junebug812]

Oh, and as for monitoring the procrit, I get blood work every two weeks. I'm supposed to have another shot this Tuesday. To be honest, I feel so bad that I don't want to take it just in case the procrit is making me feel this way. My heart feels as though it's going to jump out of my chest at times and the shortness of breath is pronounced again. Also feeling lightheaded when I stand or walk. I wonder if it has anything to do with blood pressure. I have high blood pressure but it's controlled with meds. My eyesight is a bit wonky too, only in the last two days.

[Fnzol]

"My heart feels as though it's going to jump out of my chest at times and the shortness of breath is pronounced again."

You may need the shot, then.  That's how I was feeling at the start of treatment when my crit started tanking.  

[Bill1954]

June, dehydration can also cause rapid heartbeat; are you keeping your fluid intake up?

If you have any doubts, the emergency room can run a CBC very quickly, and in a matter of minutes can take corrective steps if needed. They’re a pain in the butt, but if you think you need help, by all means check in. If you do go that route, be sure to bring along a couple of day’s meds with you just in case; hospitals don’t routinely stock ribavirin or interferon as part of their formulary.

Be sure to let your doctor know what’s going on too, if you haven’t already. He should have someone taking messages through his exchange. Especially if you have existing cardiovascular issues!

Good luck, and let us know how it goes,

Bill

[Trish77]

" My heart feels as though it's going to jump out of my chest at times and the shortness of breath is pronounced again. Also feeling lightheaded when I stand or walk. I wonder if it has anything to do with blood pressure. I have high blood pressure but it's controlled with meds. My eyesight is a bit wonky too, only in the last two days."

Hi June....this describes the symptoms I had when I went hyperthyroid during treatment.  My heart was beating very fast, my vision was unreliable where I couldn't reliably step on the escalator stair step going down anymore at work and my hands got shaky (don't know if you have that last one when you hold your hands out in front of you.)  I don't know if your thyroid levels are being monitored but it might be worth at least checking.  

Trish

[Junebug812]

@Fnzol, that's what I was thinking was happening, but then I saw my lab results from Saturday blood draw and my hgb is at 11.9 right now. I was feeling these symptoms when my hgb dropped to 9.7 so this is confusing to me.

@ Bill, I don't have cardio issues, in fact I had a stress test 2 months ago and they said my cardio system is in excellent condition. I don't feel this is an emergency situation; I'm wondering more if anyone else has had this happen once on procrit and what did they do for it. Or maybe it has nothing to do with the procrit. I've left an email for my doctor. I do drink lots of water, in fact I can't go anywhere without it. I need to drink constantly it seems, as I know is true for most on tx.

@Trish, I have Hashimoto's for about 15 years now so my thyroid is being looked at often and I am on medication for it. My general practitioner checks it every 6 months. Had it checked a little over a month ago and it was great so I don't think that is it.

Thanks guys. I guess I'll just see what happens.

[Trish77]

Well, a hyperthyroid episode on treatment can come on relatively quickly and having thyroid checked over a month ago won't be sufficient to tell you if you're hyperthyroid now - depending on when these episodes you're experiencing started.  It tends to be temporary but it does need to be addressed when it happens.  When my hepatologist realized I was hyperthyroid, he immediately put me on beta blockers. I was hyperthyroid during treatment for a period of about 3 weeks at least and then flipping over to hypothyroid and then it remaining post treatment. You might want to consider having this tested to rule it out.  

[Junebug812]

How funny. Right after I read your comment about hyperthyroidism I got an email from Kaiser letting me know another test result posted on my Kaiser profile. My doctor apparently did a TSH test at my last blood draw on Saturday. My thyroid looks good. You're right though, when I first became hyperthyroid (and didn't know it), I had all kinds of crazy symptoms, including palpitations, etc.

[Junebug812]

My doctor emailed me back this morning and told me these are probably just normal sx from the tx and that I might be feeling more anxious, which can cause palpitations. I do feel a little anxious when it's happening and when I'm having a hard time catching my breath, but most of the time I'm busy with work and try my best to forget I'm even on tx. I'm pretty good with anxiety overall. I'm a therapist and have treated people for anxiety enough to know how to handle it in myself.

I think I'll just ride it out, take care of myself, and see what happens. I guess now the only other thing that worries me a little is the Procrit and the warnings stating I should be monitored between 10-12 hemoglobin. I'm at 11.9 now and my doctor is ok with that. I jumped to 11.9 fairly quickly since Procrit and since my next blood draw isn't for another 2 weeks, worries me a little that I'll go above 12 (easily I suspect), which can put one at risk. I'll post another thread asking people what their experience on Procrit has been.

Thanks again you all for helping me clarify things.

[Trish77]

That's good to know.  Your symptoms sounded awfully similar to mine at the time I went hyperthyroid.  Good on your doctor for covering that off.