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08/02/2012 07:40 AM

H & H Blood Test

booky1961
booky1961  
Posts: 817
Senior Member

Okay, I think I questioned this before but I'm still not there yet on understanding totally.

The PCP ordered Tom to have ANOTHER blood test last week called and H & H which is Hemoglobin and Hematocrit. The nurse called Tuesday and said it was better, have a nice day.

We went this morning to pick up a copy of the test so I could put it on his table.

It doesn't make sense that neither of the doctors seem concerned about it.

His Hemoglobin is 11.3 that's low and it says so on the paper. (13.2-17.1)

The Hematorit is 31.7, also low (38.5-50.0 %)

Does this sound normal to anyone? Sounds scarry to me! We still have no answer on the anemia.

Tom's down to 209! He's a big man, not fat, Tall! According to all the health charts his ideal weight is 170 - he looked like skin and bones at 220. No one seems concerned. He's tickled! He's a walking skelaton except for his belly. He obviously tires easily, he doesn't feel good a lot of the time but it doesn't bother him. And yesterday he seemed confused a little. He was aware enough to take lactulose but he said he wasn't having any "Issues" which is what we're calling the HE now. He's okay so far today. He says he feels off but not too bad.

I'm confused! He sees the surgeon next week and we find out about his breast... Hopefully not cancer...

Am I seeing Boogiemen everwhere?

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08/02/2012 08:33 AM
dmanflan
dmanflan  
Posts: 1734
Group Leader
I'm an Advocate

Hey Booky!

I found a pretty good answer but don't remember if Tom had/has HCV as well so it may not completely apply to his situation. There is an excellent explanation of the test and results at http://labtestsonline.org/understanding/analytes/hematocrit/ tab/test

Essentially, what I have seen/heard from many patients is that anemia is a common complication of cirrhosis (remember not all patients are the same). His doctors are keeping a close eye on his levels to ensure that he does not go too low with these lab results. It's not time too panic yet. When/if his labs indicate very low values his docs will probably order a platelet transfusion to try to jump start the process that will raise his own production of blood cells/platelets.

We've had some discussions in the past about the muscle mass loss that often occurs with cirrhosis. Many times this loss is due to a lack of sufficient protein in the diet, often due to lack of appetite or improper diet. I'm pretty sure you've indicated that you are watching his diet closely so please don't take offense! Remember protein, particularly from red meat, is a very fine balance that is essential to keeping the body functioning.


08/02/2012 12:41 PM
booky1961
booky1961  
Posts: 817
Senior Member

That helped, thank you Dennis. Though the doctors have not said what the results mean of all those causes. So as longs as they are not worried I'll try not to.

No offense at all. We do watch his diet closely. He can't eat any meat- can't stand the smell of it and almost throws up when he tries. We tried fish sticks today and he gagged and he loved that. He eats LOTS of fruits - peaches, cherries, plums seem to be the new favorite right now. He's been eating carrots and we love green beans so we've been eating that. I did get him to eat a little spaghetti the other day, no meat but used mushrooms... he ate very little. He tries to eat rice but not much appetite so I threw away the last. He does try and eat some nuts but he only likes them if they have salt and I won't buy those. I have gotten him to eat some oatmeal, I love that and since I'm already making it he'll eat some. Getting the protein in him is almost impossible. He take's potassium tablets with the lasix but I don't think that helps PLUS he has to watch his iron. Oh yeah - he was told to eat milk shakes, ice cream.

It's a constant struggle but he knows he needs to eat. I have been eating almost what he's been eating (I'm not a big fan of most fruits more a veggy person) and I've GAINED weight! I'm a heavy person to begin with and this doesn't help!

Anyway.... Thank you again for your help and insight... means a lot to me. I'm dealing with this alone. Tom doesn't want to talk about it that much, he's tired of dealing with it already. And now that the doctors have told him he's doing great, he'd just as soon not see them ever again. I hate sounding like Debbie Downer when I tell him the problem is still there he's just doing good dealing with it.

pplllllhhhhhh! (rasberry)

Peace Out! Smile


08/02/2012 01:25 PM
MommaMac
MommaMac  
Posts: 1483
Senior Member

Can he drink Ensure or Boost with extra protein? Fruit only gives him energy but nothing for muscle mass. I forgot the word but Jim's doctor explained the liver compromised, it uses muscles. (word is opposite of anaerobic) What about dairy? Milk, yogurt, cheese? Jim is anemic. He's had a problem even before his liver was a problem. His numbers are lower than normal but not too much a problem. He has H&H of 24 and 7.8. When 8 or below, recommended blood transfusion. (whole blood, packed plasma, and/or platelets. Jim's problem is a compromised bone marrow. He will most likely have iron infusions in the near future. They'll check it prior to surgery. Be aware the lab used may have slightly different numbers and it may or may not reflect a difference in Tom's counts.

Vent away...always around to listen. Our lives are mirrored, any way!


08/02/2012 03:14 PM
booky1961
booky1961  
Posts: 817
Senior Member

THAT'S RIGHT!!! WOW! THANK YOU JACKIE!! I have been trying to remember why Tom had the transfussion last time and you just reminded me why the "8" stuck in my head. When he had his transfussion last time his number was like 4 or 5 and he was 7.8 when he got out of the hospital.

No, no boost or ensure, he doesn't like it but I told him that this grocery run we're getting the boost, PERIOD!! He has to have it. We have to be carefull of Tom's iron since he has too much of it.

As for the dairy, that's not a problem. He loves milk and he eats cottage cheese. He's not big on much else with cheese except broccoli with cheese and mac n cheese.

We use the same lab and I use the ranges they use and it does compare to the hospital range so I go by that for ranges. I'm going back over his other labs since I wasn't watching the H & H.

I love how you learn something new every single day!!!

It's funny how much we are mirrored! Smile

Thank You!


08/02/2012 05:45 PM
MommaMac
MommaMac  
Posts: 1483
Senior Member

Jim was as low as 3.4....blood was thin and orange! Very scary. That was five years ago. Never that low. His anemia was iron related. No iron stores. They make Boost or ensure clear....has Tom tried that?

08/02/2012 07:24 PM
booky1961
booky1961  
Posts: 817
Senior Member

I'll give it a shot! Thanks! Smile
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