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Struggling A Lot
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Struggling A Lot

Hello - I'll try to make this quick.  I have stage 2 cirrhosis due to autoimmune hepatitis.  Took azathioprine many years (not now due to side effects) and have history of leukemia in my family.  My blood counts are pretty low.  Lower than they have been.  I feel not well.  I can almost tell when my body is really, really not right - and feel in some ways similar to how I felt when my autoimmune hepatitis was diagnosed.  

The oddest sensation is in my bones.  I don't know how to explain this, but it's as if my bones are "going to sleep".  Maybe a tingling or numbness.  I wonder if this is just my bone marrow shutting down.  I have a very demanding job, and often times don't get a lot of sleep.  When I sleep more, I feel better - as if my bones are waking up and full of energy.

I researched aplastic anemia, leukemia, and none of them seem to fit.  Aplastic anemia because my reticulocyte count was normal.  Leukemia because none of my differential WBC counts are high.  Am I just seeing the effects of chronic lack of sleep and pushing too hard?  When I push myself really hard, I can feel my organs begin to "Swell" if that makes sense.  Like I feel my liver like a big hockey puck in my side.

The borderline positive ANA test has me concerned.  I've posted all my abnormal values and reference ranges below.    Also, I had a thyroid and lipid panel that came back normal.  

All these issues makes it hard for me to eat.  I am 6 feet tall and weigh around 100lbs.

Do I need to go on disability?  I already work from home, but perhaps I am to a point where I need to let go.  I can't imagine I'll live very much longer.  I am 27.  There are many nights where I wonder if I will even wake up in the morning.  In fact I pray that God will let me out of my body.  That isn't suicidal or me giving up.  It's me wanting to move on.  I'm almost hoping I'll get something that will finally tell me it's OK to stop working, to stop pushing myself so hard.

I'd really appreciate any thoughts that anyone has.

The listing of my abnormal counts are below.

Hemoglobin: 12 (Ref 13.5-17.5)
Hematocrit: 33 (Ref 41-53)
MCH: 35 (Ref 26-34)
Platelets: 126 (Ref 150-450)
Abs Neut: 1.2 (Ref 1.8-7.7)
Abs Lymps: 0.9 (Ref 1-5)
Sodium: 133 (Ref 136-146)
AST: 38 (Ref 15-37)
WBC: 2.6 (Ref 3.8-11)
RBC: 3.4 (Ref 4.5-5.9)
Vitamin D Hydroxy: 19 (Ref 30-80)
ANA: 1:40 Titer, Nucleorar Pattern (Ref, Below 1:40 Titer)
Blood Osmolarity: 274 (Ref 280-305)

Reticulocyte Counts were normal
Tags: leukemia, CBC, rbc, reticulocyte, antidiureticets, Hepatitis, Thyroid, sleep, Liver
3 Comments Post a Comment
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907672_tn?1381029323
The fact that you feel better when you get enough sleep tells me you are probably just sleep deprived.  It's amazing what lack of sleep can do to the body.  I know for myself, if I don't get enough sleep I feel completely worn down and depleted of all energy.  My body aches, my skin suffers, and my brain is in a fog where concentration is nearly impossible.  

I'm not good at interpreting blood work, but it is obvious your numbers are a little off.  Have you talked to your doctor about them?  What do they say about it?  I must say, at 6 ft. tall and 100 lbs., you seem to be underweight and may not be getting enough nutrition and vitamins that your body needs.    
You may also need to consider cutting back on your work hours or find a different job that allows you to get more sleep.  

I would talk to your doctor about disability, but if it's a fixable problem then I think you should pursue that first.
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1081992_tn?1389907237
I'd say that Mocha is exactly right on all points.

Here is the likely reason (not a blood cancer) for marrow suppression and pancytopenia:
http://www.ncbi.nlm.nih.gov/pubmed/?term=4015988

Marrow cell necrosis in anorexia nervosa and involuntary starvation.

Abstract

Marrow specimens from six patients with anorexia nervosa and three with involuntary starvation were examined for the presence of gelatinous transformation and marrow cell necrosis. Five of the patients had pancytopenia. Acanthocytes were present in the circulation of all nine. In only two patients was marrow cellularity adequate. Gelatinous transformation was present in every marrow specimen and was of a marked degree in eight. Marrow cell necrosis was identified in all nine marrow specimens. The necrosis was extensive in one specimen, focal in the others and limited to the areas of gelatinous transformation. Severe malnutrition was the single element common to all the patients.

You can ask for a blood smear to look for acanthocytes.
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1081992_tn?1389907237
and I'd be wary of refeeding syndrome

good luck
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