Tuesday, December 4, 2012

Never quite normal. My latest lab shows a slightly high neutrophil count

Just once, it would be gratifying to get back a CBC (complete blood count) where every results was within normal limits. 

Just once.

Most of the time I am pretty close, but there is always some value that falls slightly out of the range of normal, causing my lab result to glow"red" in my electronic medical record.

I always disregard all the percentage of the white count and only focus on the absolute counts. Doing this is good medicine and gives me much less to ponder over. All patients should pay attention to the absolute counts, not the percentage.

Today my hemoglobin, my lymphocytes, and my platelets were all good. The size of my red cells (MCV or mean cell volume) remained a touch too big. This is probably a under-recognized consequence of having my spleen removed years ago, so I refuse to worry. I supplement my vitamin B12 as all vegans must (there is no source of B12 outside of animal products), my folate is fine and so it should be with my plant based diet, I don't drink, and my MCV is stable so I doubt it is a reflection of a damaged marrow. That list pretty much covers all the common causes of a macrocytic (big red cell) anemia that might apply to me, and besides I am not even anemic today.

What is new today is that my ANC or absolute number of neutrophils is a slightly high. Normal is under 8,000 (I usually run between 4,000 and 5,600), but today I'm 9,000. As a result my total white blood cell count is also raised at 12,300. 

A high ANC can be a sign of infection, usually bacterial. I have no infections that I know of other than a bit of a sore right nostril, that thankful has not bled in almost 2 weeks. Perhaps that could be enough.

Neutrophils also can jump up from any stress, physical or even emotional. That I alway have.

In my case, there is no cause for concern or worry, but it does demand monitoring to see if there is any trend.  One lab test means nothing. A level this close to the upper end of normal means nothing. 

Under react in my mantra, and this time it is easy.

Eight days from now, after a few days at the beach to relax and read and write, then the crazy busyness of ASH meeting in Atlanta, I will get my blood work all repeated at OSU.

This will all prove to be of no consequence, other than just once it would be great to get all normal results.

I guess it is just my fate, and that I suspect of the majority of my readers, never to be just like all the other kids.

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Anonymous Anonymous said...

While I have never seen any specifications, I have always assumed that lab tests had a variability of 10%. Physicians I have talked with have not offered any better estimate.
For me, better a high count than a low one. Be well, TomD

December 5, 2012 at 7:10 AM  
Anonymous Anonymous said...

Hello, I am doing a project for school and I was wandering if you could help me. If you ever have bad blood count results, do you have negative thoughts of relapse? If you do what are ways in which you get rid of these thoughts? Thank you for your help!

December 5, 2012 at 1:35 PM  
Blogger Brian Koffman said...

To whomever needs my help with a school report:

Happy to help. Please email at bkoffmanMD@gmail.com and we can connect. Your post was anonymous so I can't get back to you.

I believe my blog has several posts that deal with the issues you are researching, but it might be easier if we could connect by email.

Be well


December 5, 2012 at 8:33 PM  

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