Need advice about labs....

Hi all,
I'm asking for some advice about my lab work.  This may be a silly question, but how do you know if you need rescue drugs?  My doctor rarely prescribes Procrit; I don't know if it would help or not.  

Last Fri. was shot 5/48.  The sides have been very manageable, except I get so darn TIRED and dizzy! And now the brain fog.  Anyway, if someone could offer advice (I know there are no doctors here) I would appreciate it.

Labs were done on 8/11 and on 8/23. Let me see how I can write this.
8/11:                              8/23:
WBC 7.1                            WBC 3.3
RBC 3.96                           RBC 3.46
HGB 12.2                           HGB 10.6
HCT 35.8                           HCT 31.9
RDW 11.1                           RDW 12.8
EOSINOPHILS 0.4                    EOSIN 0.3    
BASO/100 WBC  0.1                  BASO 0.2

My next labs aren't until 9/25 and my Dr. appt is a couple of days after that.  Since I got my 2nd labs, they haven't called me or anything. Dont know if I should consider another dr. (my current one, doesn't seem to believe in any type of meds for sides, he says that's just part of it.)  
I know I'm rambling, but Mr. Brian Fog, has got me!! ;o   Thanks to everyone here for all the support and info.  Yall are the best!
Kim

[NYgirl]

Your hemoglobin has certainly gone down, unfortunately if your doctor does not usually prescribe you might run into trouble. Some doctors just don't get that "chemo is chemo" and just because we don't have "cancer" doesn't mean we don't have HEMOLYTIC ANEMIA.

Procrit saved my butt, I could not have done all this tx if not for it.

You might need to try and get a different doctor to prescribe it in the long run.  Once I started fainting dead away...I knew something was wrong and went down and I had gone from 15+ to 9 in only 10 days and was sinking fast.  With the Epogen I went back up and was able to continue. Without it I could not have.

BEST of luck!

[Mister beagle bailey]

I agree with NY girl, without procrit I never would have been able to finish tx.  Your HGB has dropped a lot in 2 weeks and I would talk to your Dr about getting procrit approved as it takes weeks to kick in.

Beagle

[GrandOak]

I'd be very concerned about the quick drop in the HGB because of the fact that Procrit takes 2-6 wks to kick in and become effective.  For me it seems about 3 wks.  A HGB of 8 or less is considered to be serverly anemic and I personally wouldn't trust any doc who would not take corrective action to avoid that.  But when HGB is dropping so quickly you want to introduce rescue meds ASAP to allow them to kick in before it drops to low.

Keep in mind HGB is a measure of how effective your blood is at distributing oxygen and nutrients to your body and is affected by the Ribavirin.  Probably explains why Brian Fog visits so many of us if our brains are not getting an adaquate supply of oxygen.

In addition to the WBC, RBC, and HGB, you probably want to watch your platelets and Absolute Neutrophils (ANC).  These in conjunction with your WBC indicates where your immune system is at and whether you may need a rescue med like Neupogen to keep it from failing, or worse yet resulting in an autoimmune problem.

[texas tornado]

Thanks for the quick response.  Think I'll start looking for a new doctor that will listen & work with me.  
I have learned so much on this forum, that I now feel "armed" to take facts from other heppers to my doc.

Have a great day! Kim

[texas tornado]

My platelets are at 293.  Isn't that within the normal range?  Thanks for the response.  

Sometimes I feel very lost on this forum, like not sure how to really respond.  Maybe I'm trying to hard.  It just seems everyone here is so friendly and helpful and when I want to jump in, somehow my words just don't convey the feelings that I have.  
Thanks for bearing with me guys.

[painterlady13]

Texas,
I am also on week 5/48.  My HGB went down from 13.9 to 11.0 after shot 3 and my Doc immediatly prescribed Procrit.  I believe it was because there was a more than 2 pt drop.  Then it went down the next week to 8.6  That was when they did a transfusion.  I am still low but I believe rising a little it was 9.6 last week.  I just went for my blood test yet again and am hoping that it is rising again but am very apprehensive as I am dizzy and lightheaded.  

Why is your doc only doing blood work every other week? My doc said for the first 6-8 weeks it is important to do it every week to keep an eye on how you are tolerating TX, Then he goes to the bi-weekly testing.

Good luck

[stewietoo]

I'm not sure about your dr but mine put me on rescue drugs on week 4. Figured if my counts were that low that early, lets not chance it. How is your fatique? That is how I pushed for procrit.
On another note-- Just got CBC--WBC finally up to 4.0. Yeah

[sfbaygirl]

At first my dr. only had labs every other week. Once my Hgb and ANC dropped, both dr's gave me a standing order for blood tests. I go once or twice a week, if I need to. I at least go once a week, b/c I know I am prone to low counts.

Texas;  Your WBC dropped alot! I would not be surprised if your ANC hadn't dropped as well. Be sure you check this out with the dr. too.

[texas tornado]

Labs for me aren't due again until 9/22, then not until 10/20.  Just got off the phone with another doc's office, and she said they due labs weekly.  Asked about the procrit and nurse said she's seen lower on the HGB and that the dr. probably wouldn't prescribe anything until it dropped more!  YIKES!!

[texas tornado]

Me again, I hit the wrong button and posted my thread.  OOPS! Anyway, was just wondering how you knew you needed a transfusion?  I'm afraid a lot will happen in 4 weeks.  What should I look for (besides a new doc!)  :)
Kim

[sfbaygirl]

I would get labs before the end of Sept. Your hgb dropped and you need to have it monitored closely now. Many dr's say they won't give procrit before you go below 10. My dr. gave them to me at 11 and will continue to do so. I believe the hardest part is when you have a huge drop in Hgb. If you have a 2 pt. drop, they should give you procrit. I would get another opinion and or dr.

[Kalio1]

We are reduced i here to our abiity to write things we normally talk about so it leaves out all the inflection, things dont "come across" how you intend them. You are doing great, it takes awhile to be comfortable with the new venue. Just keep posting your questions and thoughts like everyone else does, we are all equals members of the same "club" here just joining i you become like everyone else. It's a lot to take finding out you have this disease and then all the complicated learninng. Doctors who dont answer questions or dont know enough about it dont help. Plus its a "new" disease and evolving info. is always coming in.
Your numbers look pretty good to me the little that I know, my doctor doesnt consider Procrit unless Hemoglobin falls below 10.0 maybe yur doctor will do it sooner. The dizzies and tirednness are horrid, I agree. Ask if he will go the Procrit route. I find my Hgb fluctuates from around 10 to mid 12's ad I am dizzy and tired pretty much. I think your platelets look great. Nice to see you posting.

[GoofyDad]

Allow me to interupt this thread for a bit of personal business :)

SFbay, you once offered up some Giants tiks. I was thinking about taking L'il Goof and wondered if you still had some that weren't going to be used? Do you have my email? If so, howzabout dropping me a line????  

[FlGuy]

We read Jim's news yesterday.  How soon is you defining moment?  Went to see the Giants play when we were in Colo in July. It's still the second fastest way to drain a wallet.  No finer thing to do with a kid.

[sfbaygirl]

Sure do have tix! I will find your email and send you the days we have. I imagine you want weekends? Or weeknight?

[GoofyDad]

SF: Thanks, I'll watch for an email....

FL: 26 weeks would be on 9/9. I'll prolly go in before then, but strangely have completely switched attitude. At 12 weeks with an elevated LFT, I was expecting relapse and yet couldn't wait to get tested. Now I'm feeling confident, yet apprehensive about the test. I'm my own worst enemy it seems. But the physical attraction makes me keep myself around.  

<small>At least at the ballgame it's only your wallet that gets drained...</small>

[FlGuy]

That's the fastest way.