at what point start procrit? Already low red B cells

I've been on ribavirin and peg interferon for 8 weeks and after about 3 weeks I did a test lab.

My red blood cell are marked "ALERT" at 2.59
hemoglobin is LOW at 11.3

White blood cells LOW at 2.9

My doc said I'm not that low yet to take procrit...geez how low it's gotta be?
I feel pretty weak but not very bad.

[jmjm530]

What was your pre-treatment hemoglobin?

Anything more than a two point drop in a three-week period could account for your symptons, especially if you're male, over 40 and have any heart issues.

In my case I ended up in the ER at week 3 with a hemoglobin of 11.4. It had dropped from a pre-treatment 14.9 -- a little more than three points.

Not sure if it's on the Procrit site or not, but Procrit is indicated not just for low hemoglobin levels, but for big drops in a short period of time. Unfortunately, a lot of docs are unaware of this and prescribe too late making many of us suffer needlessly.

[mauka]

Now that I think about it the Doc said is a 2 point drop but I found a lab done before HCV treament and hemoglobin was 14.1. So I guess it is more than 2 point drop huh?

Thanks!

[jmjm530]

Well, you're just short of two points so maybe your doc is seeing how your body will adjust.

However, I'd suggest you have another test to see what your hemo level is today. Frankly, I'm surprised it's been five weeks since your last hemoglobin test. I had them weekly for the first 12 weeks.

[mauka]

Yeah I have another appointment for another lab in a few days.
Thanks for your help :)

[friole]

I guess you are going to have to explain a 2 point drop to me.  14.9 less 11.3 is 3.6 == is this not more than a 3 point drop?

[friole]

duh,  did I tell you I was an accountant?  IF I did, forget it.  I did put the numbers into the calculator tho - just used the wrong ones.  (when you become dependent upon a calculator, your brain forgets how to add & subtract by itself)
LOL
Kathy

[cuteus]

They usually wait for it to get to below 9, sometimes regardless of your QOL.
my PA kept saying everything was fine, (I was not keeping copies of my bloodwork then) until I complained of strange chest pains that were not relieved by tums or such. She finally prescribed Procrit, at a HGB of 10.2, and I got copies of my bloodwork to find out it had been steadly declining since week one. The bottom line is if your job or QOL is suffering and there  is a familial hx of cardiac events, don't let them take chances on you.

[poolcue]

My hemoglobin was 9.4 when I ask to be put on procrit.  I was a low normal when I started tx hem was around 12.  Your body will tell ya when you need it (procrit).  DO NOT -----DO NOT -----DO  NOT---- dose reduce, get procrit first.
Diana

[jmjm530]

Time to bring out the calculator and I think we're both wrong. LOL.

I should have said earlier "just short of 3 points" not "2" for Mauka. The computation is 14.1-11.3=2.8

However, your computation used MY pre-treatmen hemo (14.9)and MAUKA's post treatment (11.3). So while it is indeed "more than a three point drop" the clinical significance is cloudy at best. LOL.

[Lynne5477]

I started with pre-tx Hgb of 14.3 (female, 47 yo) and it steadily dropped to 10.3 and stayed there through the whole of tx.  My doc didn't get concerned til it dropped once to 9.9 and she wanted me to reduce meds.  Instead, I had blood drawn again and it was 10.1.

Bottom line, I would have loved to have had Hgb at 11.3 during tx.  At any rate, keep a close watch on your blood counts.  If you think your Hgb is getting too low, ask your dr to get you approved for Procrit before you need it (just in case).  That way, if and when you do need it, you can get it without having to reduce meds for a couple wks waiting on the approval.

good luck to you.

[mauka]

Will Vitamin B12 help me being anemic from HCV meds?