CBC results week 4

Got the latest CBC results.  WBC came up a bit, but HMG dropped out. I am getting anemic which explains the dizzyness. Procrit has been ordered. My Albumin is low and it has never been low before, so that has me wondering.  Stage 1 complete and stage 2 begins.  I am going with a single dose tonight and 1400 riba. I will now add oxymatrine as well. Get PCR results next week. Any feedback on these labs appreciated guys!   -Geof

WBC 2.24 4.0-11.0 k/uL                L
RBC 3.23 4.5-6.0 M/uL                  L
Hemoglobin 9.8 13.5-17.5 g/dL       L
Hematocrit 32.2 40-52 %               L
MCV 99.7 80-100 fL  
MCH 30.3 27-34 pG  
MCHC 30.4 32-36 g/dL L
RDW-CV 18.8 11.7-15.0 %            H
Platelet Count 51 150-400 k/uL       L
MPV 10.2 7.3-11.1 fL  
Neut% 79.0 40-70 %                    H
Abs Neut 1.77 1.8-7.7 K/uL           L
Lymph% 14.3 22-44 % L
Abs Lymph 0.32 1.0-4.0 k/uL          L
Mono% 5.4 0-7.0 %  
Abs Mono 0.12 0-0.8 K/uL  
Eosin% 1.3 0-4 %  
Abs Eosin 0.03 0-0.4 K/uL  
Protein, Total 6.5 6.0-8.4 g/dL  
Albumin 3.4 3.5-5.0 g/dL                   L
Calcium 8.0 8.5-10.5 mg/dL               L
Bilirubin, Total 1.0 0.0-1.5 mg/dL  
Alkaline Phosphatase 67 40-150 U/L  
AST 55 7-40 U/L                               H
Glucose 93 65-100 mg/dL  
BUN 13 10-25 mg/dL  
Creatinine 0.84 0.70-1.40 mg/dL  
Sodium 139 135-146 mmol/L  
Potassium 4.1 3.5-5.0 mmol/L  
Chloride 109 98-110 mmol/L  
CO2 23 23-32 mmol/L  
Anion Gap 7 0-15 mmol/L  
ALT 62 5-50 U/L                           H
General Information
Baso% 0.0 0-1 %  
Abs Baso 0.00 0-0.2 K/uL

[HectorSF]

Looks like you are hanging in there pretty nicely for all the meds your throwing at the virus!
Let's hope for RVR when you get your VL results!!!

You say your albumin has never been this low. But under the circumstances of tx I don't think it is surprising. I'm sure your liver is getting stressed by the treatment as the meds start to build up in your body. Make sure your getting enough water (!) and protein in your diet. As they can cause albumin to drop. (My albumin went down to 2.8 - 3.0 during tx and I had some swelling of my ankles and feet for a few weeks and then they returned to almost normal). So you might want to keep an eye on that should the albumin continue to drop. It's more uncomfortable and ugly but won't hurt you.

Glad to see your bilirubin is within range as if you were experiencing liver failure (decompensation) bilirubin would rise. ALT and AST look normal for one with HCV/stage 4. (Slightly above average).

Where did you start with your platelet count?
You at 51k, which is not bad at all for someone with stage 4 and considering you've double dosing. Maybe it will come up a bit now that you are cutting back on the interferon. So it appears good. As long as your platelets very within a range, you should be okay. Falling platelets is always a problem for us cirrhotics. We don't have that many platelets to begin with to lose too many! But when you treated before I don't think you had to stop because of platelets so that is good history to know.
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Albumin, What is it?
Albumin is a protein manufactured by the liver.

WHAT DOES ALBUMIN DO?

Albumin performs many functions including maintaining the "osmotic pressure" that causes fluid to remain within the blood stream instead of leaking out into the tissues.

WHAT CAUSES ALBUMIN TO BE TOO LOW?

Liver disease, kidney disease, and malnutrition are the major causes of low albumin. A diseased liver produces insufficient albumin. Diseased kidneys sometimes lose large amounts of albumin into the urine faster than the liver can produce it (this is termed nephrotic syndrome). In malnutrition there is not enough protein in the patient's diet for the liver to make new albumin from.

WHAT IS THE NORMAL LEVEL OF ALBUMIN?

The normal value depends on the laboratory running the test. Most labs consider roughly 3.5 to 5 grams per deciliter to be normal.

WHAT HAPPENS IF MY ALBUMIN GETS TOO LOW?

In a healthy person with normal nutrition, the liver will simply manufacture more and the level will normalize. If albumin gets very low swelling can occur in the ankles (edema) and fluid can begin to accumulte in the abdomen (ascites) and in the lungs (pulmonary edema).

HOW DO YOU MAKE YOUR ALBUMIN HIGHER?

The person must return to health. Therefore the underlying disorder must be corrected. If the disorder is cirrhosis of the liver, the only way to correct low albumin is generally to have a liver transplant.

Albumin levels are also dependant on the state of hydration of the body. A person that is deficient of water ("dry") because of dehydration will have an artificially low albumin level. This returns to normal when the dehydration is corrected. Albumin fluctuates so widely because it is very sensitive to changes in hydration of the body.
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Keep hanging in there!
Keep up the good work.
I'm hoping for RVR for you!!!
Hector

[willing]

all the best with your all out attack and good luck with the VL results. The albumin seems borderline but your lymphocytes are pretty low - how much did tx push them down?

[gauf]

Thanks Hector, You are quite educated on this disease and glad you are here. My starting Platelets was .67, so doing surprisingly well thus far. The sx are easy to manage thus far as well. Did a single dose last night and feel no effects at all. Willing, Starting WBC was 4.2 so they tanked to 1.05 quickly, but after 1 shot of neupogen they bounced back to 1.7. My guess is that the supplements must be having a bearing on the sx. The VL will tell the tale next week. Thanks guys.

[gauf]

Correction, WBC bounced back to 2.24. This test was taken just 12 hours after the nuepogen injection.

[Marcia2202]

I am not able to comment on any of those things, but just wanted to let you know that you are in my thoughts. Take care, Marcia

[gauf]

Thanks Marcia!

"...Houston, those co2 levels have come down...and they are still dropping....."
"...roger that Jim... and you sir are a steely eyed missle man..."
"apollo 13 out...."

[alagirl]

your albumin is low due to your loss of red blood cells and hence, blood volume.  Mine stayed that way during tx since I had such severe anemia.  Its fine now though.  Its funny how a drop in hemaglobin affects people so dramatically.  If you are used to having a certain red blood cell count, even a small loss, like three points, can make you feel really terrible even though you aren't at transfusion level.  Hopefully the procrit will get you back go a level that makes you feel better soon!

Your wbc count is low but it can get lower, unfortunately.  Usually if your levels are critical on anything, your cbc will say LL for extremely low, or some other notation to flag it.  

[comeagain]

I got to say this about comparing your tx with a rocket journey is a good picture.

I think like you needed that double dose was like  getting more engine to take you out in the athmosphere. Now  when you have conquered the gravitation you can go on half engine.
And in the end of the journey coming back to earth you have a parachute, and that is boosting the immunual system by supplements. LOL

Its a fantastic trip you have started good luck!!

ca