Blood counts ( CBC ) ; blood clots

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Heme
Heme Member Posts: 3
edited June 2017 in Chemotherapy - Before, During, and After

Hi all

I am a BC patient and a doctor with knowledge of hematology --blood counts ( CBC issues ) , blood clots specifically during chemotherapy . This website has been invaluable to me as I go through treatment and I feel i want to give back more to the BC sisterhood. As such I want to try to informally help this sisterhood with advice as you go through chemotherapy. I of course cant give very specific medical advice, but i can help with questions and ideas you can take to your doctors. going through the rigors of treatment myself, i may not be prompt with responses always , but any help i can give will help me give back to this community which has helped me so much

PS--on a separate note, my profile as a patient is under a different user name in order to protect my privacy as a patient (approved by mods). I have chosen to be very private about my BC diagnosis and was a scared vulnerable woman with my diagnosis like anyone else --the anonimity of this site helped me greatly to express myself.

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  • Kicks
    Kicks Member Posts: 4,131
    edited June 2017

    Say What? You are openly using 2 different accounts? Claiming to be a hemotologist?. But also claiming to be a BCer? But has to be 'secret' with different 'identities'/ persona?

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2017

    Hi Heme,

    Thank you for registering, posting and offering to help in our community.

    We'll reach out to you privately, with our questions.

    Thank you,

    The Mods

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  • Heme
    Heme Member Posts: 3
    edited June 2017

    one of my first questions via private message was about iron deficiency anemia . This can be a common issue, especially in women durign their child bearing years , so I wanted to post a list of questions and ideas to ask your doctors about such iron deficiency anemia

    Iron deficiency anemia is diagnosed with a low ferritin done as part of testing for low hemoglobin. Other parameters that may be abnormal include a low MCV , low serum iron level, low transferrin saturation. Its always best to test iron studies in a fasting state --checking it right after a meal may give falsely high results

    Once iron deficiency anemia is confirmed, then the approach is two fold -diagnosis and treatment

    1) diagnose the reason --very important and I will expand on this below and divide into three categories below

    A) dietary lack of iron --vegan or vegeterian --if so , include good source of iron in diet- spinach , kale, quinoa

    B) lack of absorption ---the lining of the stomach doesn't absorb iron properly--most commonly this is celiac disease. Ask your doctor about blood tests for celiac disease

    C) blood loss --could be prior heavy periods. Could be occult (unseen, slow ) blood loss from the gastrointestinal tract such as a stomach ulcer or colon polyp.

    So in a patient with iron deficiency, seeign a gastroenterologist to address workup of catégories B and C is important. This testing would include consideration of EGD ( esophagogastroduodenoscopy to look at the stomach ) and colonoscopy ( to look at the colon) Colon polyps are increasingly common , so seeeking a gastro referral is a very important question to ask.

    2) treat the deficiency --this is with either oral or intravenous iron supplements. One tip about oral iron --tea prevents absorption of oral iron ,s o make sure there is a four to six hour gap between any oral iron tablet and a cup of tea


    Hope these general guidelines help folks facing iron deficiency anemia have a conversation with their docs

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  • Heme
    Heme Member Posts: 3
    edited June 2017

    my second question via private message was about blood clots in arms related to ports. A port, being an indwelling mechanical device in a vein, can trigger a blood clot in an arm. If this is the only blood clot you have experienced, that is a clot in an arm with a port , and you have never had a clot in your legs and there is no family history of clots, then this clot can be viewed as entirely mechanical due to the port and not due to any issue with your blood coagulation system

    In general, as long as the port is working well , it is not necessary to remove the port --the blood clot can be treated with blood thinners. Blood thinner treatment shoudl be done with close supervision. The arm will often feel better in a few days.

    In general blood thinner treatment shoudl continue for about three months. Many doctors will continue some blood thinner treatment till the port is removed. There is a lot ofroom for individualizing therapy based on risks and benefits of the blood thinner.

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