Low WBC after Surgery
Any thoughts on what could cause a significant drop in WBC. For the past 7 months I have had fairly consistent WBC ranges between 5 -7. For six months prior to surgery I was on Arimidex and Fulvestrant injections which did not seem to create any issues or changes in blood counts or CBC numbers. I had a UMX with tissue expander placement in Mid June and my first post op CBC on WBC was 6.84. Yesterday (6 weeks post surgery) my WBC was down to 3.08 which seems like a huge decrease in 4 weeks. I did not take the Arimidex and Fulvestrant for the last month (until final pathology was received) but am now resuming them. From what I have read low WBC causes a greater risk of infection should I be concerned? I am fatigued but I believe that may be due to discomfort from sleeping with TE and returning to work.
Comments
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I found that during my treatment, any drugs at all reduced my WBC, it was consistently below 1 or just around or above. It's still low and is always flagged up in blood tests. I have some blood test results from years back before my treatment, and it was around 6 then. So this seems to be the new norm for me. 3 isn't especially low and I was told the risk of infection is higher is it's under 1. I was hospitalised on numerous occasions when mine was under 1.
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RebzAmy thanks for the post! It helps to have perspective on the counts and levels. My MO is going to monitor the levels monthly even though my office visits will go to every 3 mos. I suspect this like many other areas of my life will have a new normal.
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It is also important to note that the ranges on lab tests were formulated for adult men, not women. My MO has pointed out that being at the low end of the range can be totally normal and acceptable for women. I have had a significant number of surgeries and continue to consistently be at the low end of, or slightly below, normal on WBC but have not had any issues with infection. I did receive Neulasta during chemo to keep my WBC high enough to avoid an opportunistic infection during that time period.
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Thanks SpecialK that makes sense! I already have run into issues with both lab tests and my vitals. Since I am a distance runner my resting heart rate is in low 40's which is normal for me. I also have issues when the lab work is done after a high mileage week which affects kidney function and such. I already have a fairly good diet but I may consider some supplements to boost my immune system as a preventative measure. I have heard that TE can be susceptible to infections and don't want to prolong the TE phase any more than necessary!
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lunderwood - my DH used to be a marathoner so I feel ya on the resting HR, his was always low as was his BP. He still has low-ish results for those when vitals are taken but he developed knee issues, mainly degenerative arthritis, so can't run distance anymore - he has had to settle for short races. His ortho said too much mileage means a total knee replacement. His doc is amazed that at 56 he takes no meds on a regular basis - low BP, blood sugar and cholesterol and a great BMI - he is very fit and started lifting eights again to keep his metabolism under control since he can't use running to do so. You may also see some elevated liver values if you are inducing muscle fatigue regularly - I have a friend who is experiencing this. I think often if we have not regularly had CBC and CMP or BMP done at intervals prior to diagnosis so we don't always know what our normal results are, then we have those tests more routinely after diagnosis and become concerned. If you don't already use one, you might consider a probiotic - so much of the immune system is in the gut and using probiotics seems to help strengthen that for some.
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SpecialK - you are right I did not have any lab tests or baseline prior to diagnosis. I didn't even have a primary care physician since I was never sick. Even now I don't feel sick, just more fatigued than normal. I think to my overall physical well being I have definitely weathered the side effects from the hormone therapy and surgery very well considering all the possible issues. I will try to add organic yogurt to my veggie/protein smoothie in the morning but will add a probiotic supplement too. I agree it's a good immune system booster. Thanks again for the good advice!
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