how to tell signs of anemia on CBC ?

[orphanedhawk]

What do you look for on your CBC to see if you are becoming anemic ?

[mkeela]

Red Blood Cell Count: normal range= (apx.4.0-5.40)
Hemoglobin: normal range= (apx.11.8-15.8)
Hematocrit: normal range= (apx.37-48)

When these drop below normal range, that is a sign of anemia.

[drofi]

http://www.labtestsonline.org/understanding/conditions/anemia.html

Ok?

drofi

[chcnme]

Hey OH. Look for the HGB  (hemoglobin).  Keep an eye on it, see what it was last time, time before that, and when it starts dropping (or if it has dropped)  you might start feeling like poop (hope you don't feel that way now.) Hope your platelets are doing better!

[pigeonca]

Anemia is not a specific number -- it also can be caused by dropping more than three numbers in four weeks or less.  For example, I went from 15.6 to 11.5 in under a month.  Felt horrible, couldn't get out of bed without major effort.  My doc immediately prescribed procrit - about two and a half weeks ago.  I think i'm starting to feel its effects - Procrit, I'm told, takes a while to work.  So If you feel you need it, don't wait.

[orphanedhawk]

I sometimes I think I drive myself crazy. My nurse told me I was undetected but it turns out that was just one test. The second showed me detected under 50.
I e-mailed my doc to see if there was anything we could do to help get rid of the remaining virus. He suggested upping my riba to 1000 ( from 800). I thought that sounded easy. HA! why do I never learn? He wrote back and told me to go ahead but we'll have to watch out for anemia. I wish I had more of an idea of what I am doing.I don't want to create more problems for myself. But I know my number one priority is getting rid of the virus. Not easy, this HepC!!

[FlGuy]

Tx is like that arcade game, the one in which the gopher pops up and you smash them down with a padded hammer. There's always something poppin' up.  If altering the med dose, in this case riba, is the path you take you should also make sure that you have a cbc schedule worked out with the doc.  Regular labs, every two weeks, will help the doc catch any significant changes and then react with rescue meds - if needed.  Walk softly and carry a padded hammer.

[friole]

I like that analagy.  Defitely a trueism.

How are you feeling these days?

[wyntre9]

"I wish I had more of an idea of what I am doing.I don't want to create more problems for myself."

I know what you mean.  I feel the same way.

[orphanedhawk]

Thanks for making me laugh. It is like that, isn't it? I keep trying to paddle this little canoe on a smooth lake and instead I am being pulled down river, look out here come more rapids!

[FlGuy]

Doing ok. 17 down, 29 to go.  29 sounds much better than 30, unless you have one of 'those' pcr results. Was thinking of you earlier as I was pulling out a bunch of tax stuff.  You know that you have turned some corner in your life when the things you think about are tx, taxes, teenage drivers and colonoscopies.  But not necessarily in that order.

[GoofyDad]

Hate to say it, but I think you want to be a fan of the anemia. I think you are a 3a? One rule of thumb is 1 riba pill for every 33 lbs. So 4 pills covers you up to 132 lbs or so, 5 pills up to 165. I started at 170 in street clothes so I did 6 pills, even though I dropped under 160 on tx. Getting anemia is a way to get a measure that you have a 'healthy' level of riba - so really it might be something to be welcomed, even if it is no fun.

Generally hgb dropping under 11.5 or so is getting into the realm of anemia. Some would place that higher - most insurances allow procrit at 11, though I think some require it to be lower. I offer that up just as a way to guage the threasholds. If your headed down that way, you might want to see what you can do to line up procrit.    

[dlr2007]

Hi everyone- While we're on the subject of anemia, I was wondering- does Hep C itself cause anemia? I've been slightly anemic off/on over the yeard and my hubby is very short of breath lately, plus still has that pain in his right side except now it's moved to his chest (??? perhaps he's just trying to drive me crazy...). So I'm wondering if anemia is just another fun complication of hep c. -Dee

[Cindy10]

I have had anemia on and off for years and yes I think it because of HCV, but I'll never know for sure.
I too get short of breath (due to the anemia) but in the long run I am hoping this will be my last bout with it. Good luck to you both!

[ladybug52]

I think your reduction in meds might have affected the latest pcr. Does your dr know that the last dr had you 1/2 your dosage for a week or so? You are tiny from what I understand and geno 2's are weight based usually. More meds mean stronger sides to me! I have not had any trouble with wbc's but hgb dropped at week 3 so I've taken the procrit. If you think you have low energy now, that drop in hgb really makes you tired. Not trying to give advice or scare you, just a heads up. As  others have said, make sure you know what hgb was before tx, and how it looks week to week in order to monitor it.You need all the lab results, before and after if possible
Take care, I think you need to go visit the dr. and eat Vietnamese food while your there!
Janice

[orphanedhawk]

Let's see. I'm genotype 2 and weigh around 105. I may have panicked. I think Dr.F. was just warning me of the possible problem involved in upping the riba. My hemoglobin has dropped from 13.9 to 13.in less than one month. I just cringe at the idea of another hole in my body.
I think about it as Zen; I am one with the dart board !

[GoofyDad]

Looks like your already on a preyy high riba dose for you weight and geno. On the other hand - you didn't clear as early as might be expected and your hgb drop is really minimal. In contrast, I went from 15.5 to under 10 in six weeks or so. Personally, I would probably be inclined to follow the docs suggestion and bump up the riba. Ensuring you have fat going into you system with the riba - an avacado was my favorite - can very significantly increase the absorbtion (and adversly affect hgb levels - which can be a good thing).

Good luck.  

[shastri20032003]

But I thought geno 3 need to follow the standard dose of 4 riba's a day(800 mg) and that their dose was  not weight based?
What if pretx the Hgb is already on the lower side, as in my case, it is 11.9?( My Geno 10a treated as geno 3)

Sorry OH for hijacking your post but this relates to anaemia also so I thought it should be ok to post
Best regards
Shastri

[orphanedhawk]

You can hi-jack my post any day. One sx of riba is lowered red blood cells. The interferon lowers the white blood cells, fun eh?

[ladybug52]

I haven't kept up with you lately here in the forum. Did you go to the wedding? Did you start tx and if so what week are you on?
I have been browsing looking for more info on weight based ribavirin and found this:
http://www.hivandhepatitis.com/2006icr/ddw/docs/052306_b.html
The conclusion at the bottom of the page is :
"Compared to G2 patients, SVR rates are lower and relapse rates are higher for G3 patients. G3 patients may benefit from higher ribavirin dosing.”
This is just one study, I like you thought it treatment was always weight-based for geno 2 and 3.

[GoofyDad]

Seems geno 3 lies between 2 and 1 in difficulty. Some centers treat it with wieght base riba, and others treat for 48 weeks. No clear standard at this point, but I believe the 'official' protocol is still 24 wks X 800 riba.

GT3 has a reputation for higher relapses, and riba is thought to work against relapse, so one could connect the dots and conclude extra riba might be a good thing in treating GT3.

Of course, that must be weight against the priority of keeping the patient on treatment, so it would seem a balancing act.

As I mentioned combining the driba doses with a high fat meal can really up the absorbtion, so you can possibly regulate how much gets into your system that way too. But whatever you choose, it woould seem inperative that you not jeopardize your tx but driving hgb too low.

[shastri20032003]

Thanks OH. Yes, but this is definitely some fun I wouldn’t mind avoiding ! Its more like watching out for  darts which are flying at you from different angles.

[shastri20032003]

Hi Ladybug…nice to touch base with you again.Yes,I went to the wedding and had a ball!(just realised its possible to have a ball without alcohol !)

Came back beginning of this month but the hepatologist recommended I start tx only after my enzyme levels come down…they were really elevated at ALT=428 and AST=252. So I would need to wait for 2 more weeks before checking my LFTS again.I had posted a thread on this a few days back
Thanks for your info….guess will discuss with the hepatologist on the riba dose
Best regards

[Kalio1]

Here is an article I thought might be of interest.


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16482560&query_hl=4&itool=pubmed_docsum

[GoofyDad]

Thanks for posting it Kalio. My take is that if it makes a point it's that GT3 is on par with the other GT's re damage - not set apart. It would take only 4 GT1's with advanced damage, and 1 GT2 to get all three GT's right on par with one another. That seems pretty statistically insignificant from this man's Kohler throne.